Finger burns caused by concentrated hydrofluoric acid, treated with intra-arterial calcium gluconate infusion: case report

Capitani, Eduardo Mello De; Hirano, Elcio Shiyoti; Zuim, Isabela de Souza Cortez; Bertanha, Laura; Vieira, Reinaldo Wilson; Madureira, Paulo Roberto de; Bucaretchi, Fábio

doi:10.1590/s1516-31802009000600011

Cited by 16 publications

(16 citation statements)

References 6 publications

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“…HF has now become the most common substance to cause chemical injuries [3]. HF is a relatively weak acid, but it is strongly corrosive to biological tissues [8,9]. HF causes tissue injury by two different mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

Zhang¹,

Ni²,

Wang³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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Objective: This study was designed to evaluate the efficiency and safety of arterial infusions of calcium gluconate to treat hydrofluoric (HF) acid burns of the distal human limbs. Materials and Methods: Eligible patients with HF burn limbs, collected from January 2008 to October 2011, were given the arterial infusion of calcium gluconate into the injured limbs. The measures of pain were conducted before the infusion, immediately after the infusion, 4 h after the infusion, and 2 days after the infusion by the visual analogy score (VAS). If the VAS score was higher than 4.0 at the time point 4 h after the first infusion, the infusion was repeated. The time of wound healing, and the number and ratio of the cases receiving the surgical operation were also evaluated. Results: A total of 118 patients, male (107 cases) and female (11 cases), were collected, including 64 cases of outpatients and 54 cases of inpatients. The age of the subjects ranged from 16 to 60 years, with the mean age of 37.6. The burn sites were located in the lateral limbs (28 cases) and in the unilateral limbs (90 cases). For 107 cases, the pain scores decreased quickly after the first infusion. The other 11 cases, with the VAS score higher than 4.0 at the time point 4 h after the first infusion, received the second infusion. The average time of wound healing and the ratio of the cases receiving the surgical operation were closely related to the interval from the injury to the reception of infusion. Conclusions: Arterial infusion of calcium gluconate, effectively relieving the pain, blocking wound progressive deepening, and causing no adverse effects, could be the preferential method to treat hydrofluoric acid burns of the distal human limbs.

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Section: Discussionmentioning

confidence: 99%

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

Zhang¹,

Ni²,

Wang³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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“…Following acute toxicity of ingested fluoride, administering 1% calcium chloride or calcium gluconate or, alternatively milk orally is recommended (Whitford 2011). In human medicine several studies indicate the ameliorative effect of calcium for reducing fluoride-induced damage (Vance et al 1986, Chinoy et al 1993, Graudins et al 1997, Roblin et al 2006, De Capitani et al 2009, Yu et al 2013. Recently, Wang et al (2014) described the different injury mechanism of fluoride ions after hydrofluoric acid burns.…”

Section: Figmentioning

confidence: 99%

Clinical findings, treatment and resolution of Simplex® toxicity in three horses

Michutta¹,

Cavalleri²,

Ohnesorge³

2016

PHK

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Summary: Three horses were presented two hours after accidental ingestion of plants contaminated with Simplex ® . Simplex ® , containing aminopyralid (30 g/l) and fluroxypyr (100 g/l), is an herbicide used against common ragwort. The toxic effect of both ingredients is probably induced by free acid, but an effect of dissociated fluoride ions of fluroxypyr is conceivable, too. At presentation, all horses showed a moderate impairment of their general condition, appeared sedated with intestinal hypomotility and showed symptoms of marked conjunctival irritation. A mild ataxia and cardiac arrhythmia were observed in one horse. Within one day, all horses revealed a slight decrease in plasma calcium concentration, two horses developed a mild oral ulceration and one horse a mild skin irritation in the area of the mouth. The initial treatment consisted of minimising absorption from the gastrointestinal tract and increasing urinary excretion. To counteract any damage induced by dissociated fluoride ions, calcium gluconate was administered as a continuous rate infusion. Initially, an irrigation of the stomach with 1% calcium gluconate was performed, and the horses received a resuscitative intravenous fluid therapy with Ringer`s solution and 23 % calcium gluconate. Subsequently, a lavage of the eyes was performed. Over 36 hours Ringer s solution was administered, and sucralfate (40 mg/kg bwt/tid p.o.) was given over three days. On day five and day six two horses and one horse, respectively were discharged without abnormal clinical or laboratory findings. Follow-up enquiries after 3 months with the owners indicated that the horses were healthy, sound and had returned to their previous level of work. To our knowledge, these are the first documented clinical cases of Simplex ® toxicity in horses.

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“…1 Intra-arterial perfusion of calcium gluconate is available in cases of swollen and painful injured fingers. 3 However, arterial access, by the radial artery, is required and complications of arterial puncture include bleeding and arterial vasospasm. Moreover, intra-arterial infusion of calcium gluconate may cause systemic disturbances of the body's calcium levels.…”

Section: Dear Sirmentioning

confidence: 99%

Early surgical treatment by free flap reconstruction of hydrofluoric acid burn injury

Kim

Dhong

2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Finger burns caused by concentrated hydrofluoric acid, treated with intra-arterial calcium gluconate infusion: case report

Cited by 16 publications

References 6 publications

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

Clinical findings, treatment and resolution of Simplex® toxicity in three horses

Early surgical treatment by free flap reconstruction of hydrofluoric acid burn injury

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