en سم شناسی Toxicology پژوهشي Original Research <strong>Background</strong>: Poisonings are a major medical emergency, contributing to 15-20% of hospital visits. Acute respiratory distress syndrome (ARDS), defined by acute hypoxemia and non-cardiogenic pulmonary edema, presents significant challenges in diagnosis and management.&nbsp;<br> <strong>Objectives</strong>: This study investigates the incidence of ARDS in patients with drug and chemical poisoning hospitalized at Shah Vali Hospital in Yazd City, and Shahid Beheshti Hospital in Taft City, Iran from 2014 to 2023.<br> <strong>Methods</strong>: We conducted a descriptive cross-sectional study involving patients with drug and chemical poisoning presenting to the emergency departments of the two hospitals. After obtaining ethical approval, we reviewed medical records of eligible patients. Data were analyzed using SPSS software, version 25, presenting qualitative data as frequencies and percentages, and quantitative data as Mean&plusmn;SD. The chi-square test assessed statistical significance, with P<0.05 deemed significant.<br> <strong>Results</strong>: Our analysis included 61 patients, comprising 77% men and 23% women, with a mean age of 46.1 years and an average hospitalization duration of 9.7 days. The primary cause of poisoning was suicide, accounting for 49.2% of cases, predominantly through oral ingestion (96.7%). Methadone was identified as the most common poisoning agent. Notably, 68.9% of patients had a history of addiction, and 27.9% required dialysis, while sepsis was present in 31.1% of cases. Among patients with ARDS, 21.3% had pre-existing pulmonary conditions. Elevated urea and creatinine levels were observed in 85.2% of cases, and metabolic acidosis was noted in all patients. Seizures occurred in 32.8% of individuals, with an overall mortality rate of 59%. Although no significant differences in mortality were associated with addiction history (P=0.310), a strong correlation was found with the type of poisoning agents (P<0.001).<br> <strong>Conclusion</strong>: The study found 59% mortality rate among ARDS patients due to drug and chemical poisoning, emphasizing the need for effective management strategies. A significant proportion of cases were involved with addiction, primarily to methadone, yet no mortality correlation with addiction was observed. The findings underscore the complexities of treating ARDS in the context of poisoning, necessitating a diverse approach to improve patient outcomes. Acute respiratory distress syndrome (ARDS), Drug poisoning, Chemical poisoning 339 346 http://pbr.mazums.ac.ir/browse.php?a_code=A-10-1366-2&slc_lang=en&sid=1 Saeed Ghorbani dr.sa.ghorbani@gmail.com 100319475328460011824 100319475328460011824 No Department of Medical Science, Yaz.C., Islamic Azad University, Yazd, Iran. Hamid Owliaey hamid.owliaey@gmail.com 100319475328460011825 0009-0000-9940-4088 Yes Department of Forensic Medicine & Clinical Toxicology, Yaz.C., Islamic Azad University, Yazd, Iran. Komeil Aghazadeh-Habashi komeil.aghazade@gmail.com 100319475328460011826 100319475328460011826 No Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Fatemeh Razavi fatmarazavi0@gmail.com 100319475328460011827 100319475328460011827 No Department of Medical Science, Yaz.C., Islamic Azad University, Yazd, Iran. Navid Rostami navidd.rostamii@gmail.com 100319475328460011828 100319475328460011828 No School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sareh Rafatmagham Niloofarderavi@yahoo.com 100319475328460011829 100319475328460011829 No Department of Internal Medicine, Fasa University of Medical Sciences, Fasa, Iran. Hamid Reza Ghasemirad hr.ghasemirad@yahoo.com 100319475328460011830 100319475328460011830 No Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Fatemeh Mahdizadeh Gazoui mdzdf962@gmail.com 100319475328460011831 0009-0005-1255-2712 No Department of Medical Science, Yaz.C., Islamic Azad University, Yazd, Iran. Mehrdad Kiasi kiasimehrdad@gmail.com 100319475328460011832 0009-0009-9670-6211 No Department of Medical Science, Yaz.C., Islamic Azad University, Yazd, Iran. Mohsen Jabbari Mo.jabbari75@gmail.com 100319475328460011833 0009-0003-1724-4968 No Department of Medical Science, Yaz.C., Islamic Azad University, Yazd, Iran. Khashayar Moravej Khashayarmoravej@hotmail.com 100319475328460011834 0009-0006-2391-1052 No Faculty of Dentistry, Is.C., Islamic Azad University, Isfahan, Iran. Rouzina Shabani Rozhina.shabani@icloud.com 100319475328460011835 0009-0002-2387-2226 No Department of Medical Science, Yaz.C., Islamic Azad University, Yazd, Iran.