Dichloromethane poisoning

Dichloromethane (e.g., methylene chloride) is a volatile solvent commonly used as an industrial solvent or paint stripper. Xenobiotic metabolism by the liver renders CO2 and CO as byproducts with the latter causing a CO poisoning. The hallmark of this type of poisoning is secondary deterioration even after removal from fumes. This is because there is a continuous production of CO for some time after the methylene chloride has been absorbed, which is why COHb levels remain high71.

Treatment consists of providing oxygen and can even justify HBO in the case of cardiac dysfunction or neurological impairment. Oxygen has to be administered over a longer period of time; COHb levels need to be monitored intermittently to confirm a downward trend and HBO sessions may need to be repeated.

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