Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome Caused by Anhydrous Ammonia Burns: Two Case Reports.

This article focuses on the use of extracorporeal membrane oxygenation (ECMO) as a supportive treatment for severe acute respiratory distress syndrome (ARDS) caused by anhydrous ammonia burns, which are rare but often fatal due to inhalation injury. It presents two cases of occupational anhydrous ammonia exposure with skin burns and severe inhalation injury, both treated with venovenous ECMO; one patient survived while the other died due to complications including septic shock and bleeding. The report highlights ECMO's potential to improve oxygenation and reduce carbon dioxide levels in ammonia-induced ARDS but also notes challenges such as infection control, coagulopathy, and the need for comprehensive care including wound management and organ support. These cases represent the first documented use of ECMO in patients with combined ammonia skin burns and inhalation injury, supporting its cautious application in similar severe cases.