Clinical features, multi-organ damage, and prognosis of 1,1-dichloroethylene poisoning: a retrospective case series of 13 patients

Background: 1,1-Dichloroethylene (1,1-DCE) is a widely used chlorinated solvent with known hepatotoxicity in animals, but human acute poisoning data are scarce. This study summarizes clinical features and multi-organ injury in acute 1,1-DCE poisoning. Methods: A retrospective case series of 13 patients with single occupational exposure was conducted. Clinical data, laboratory parameters (liver, renal, coagulation, hematologic, and cardiac markers), organ support, and outcomes were analyzed. Results: All patients developed early symptoms. Severe hepatocellular injury was prominent (median alanine aminotransferase 3,400 U/L; aspartate aminotransferase 2,516 U/L). Five patients (38.5%) developed acute kidney injury, including four with anuria. All showed coagulation abnormalities with elevated D-dimer, and 12 had myocardial injury. Organ support included mechanical ventilation (30.8%), continuous renal replacement therapy (61.5%), and veno-venous extracorporeal membrane oxygenation (7.7%). Three patients (23.1%) died of multiple organ failure. Conclusion: Acute 1,1-DCE exposure rapidly causes multi-organ dysfunction, dominated by severe liver injury with renal, coagulation, and cardiac involvement. Early monitoring and aggressive supportive treatment are critical.