Hypocalcaemia and hypomagnesaemia due to hydrofluoric acid

Sanz-Gallén, Pere

doi:10.1093/occmed/51.4.294

Cited by 30 publications

(11 citation statements)

References 4 publications

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“…The concentration of HF in household products is usually less than 10%, while industrial products may have concentrations as high as 70% (3). Acute systemic toxicity from HF occurs through dermal exposure to highly concentrated solutions, and through ingestion (1,2,(4)(5)(6)(7)(8)(9)(10)(11). Ingestion of the sodium salt form of HF (NaF), which was historically used as a pesticide, resulted in many deaths (12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Vohra

Velez

Rivera

et al. 2008

Clinical Toxicology

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University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas, USAIntroduction. Hydrofluoric acid (HF) is a weak inorganic acid used for etching and as rust remover. Systemic toxicity is manifested as ventricular dysrhythmias. The mechanisms for these dysrhythmias are not well elucidated. Case report. An 82-year-old woman ingested 8 ounces of 7% HF. Shortly after emergency department (ED) arrival, she became pulseless, developing recurrent ventricular dysrhythmias. She was defibrillated 17 times and received several doses of calcium, magnesium, and lidocaine. After three hours, she returned to sustained NSR. She was discharged home after four days. Discussion. The electrocardiographic findings in this patient demonstrate hypocalcemia, which has been implicated as the culprit in HF-induced arrhythmias. However, despite correction of the hypocalcemia, the ventricular arrhythmias persisted. The proposed mechanisms of systemic HF toxicity and the relevant literature are discussed. Conclusion. Ventricular dysrhythmias due to HF toxicity seem to be independent of either hypocalcemia or hyperkalemia. Systemic toxicity after ingestions may be delayed and precipitous.

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Section: Introductionmentioning

confidence: 99%

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Vohra

Velez

Rivera

et al. 2008

Clinical Toxicology

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“…[1][2][3] Hypocalcemia and hypomagnesemia have been reported after HF exposure. 4 Treatment of a HF burn is with calcium, most commonly delivered either topically or through an intraarterial infusion. 5 The purpose of this article is to review our changing practice in the management of these burns.…”

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confidence: 99%

Hydrofluoric Acid Burns: A 15-Year Experience

Stuke

Arnoldo

Hunt

et al. 2008

Journal of Burn Care & Research

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Hydrofluoric acid (HF) is a strong inorganic acid commonly used in many domestic and industrial settings. It is one of the most common chemical burns encountered in a burn center and frequently engenders controversy in its management. We report our 15 year experience with management of HF burns. We reviewed our experience from 1990 to 2005 for patients admitted with HF burns. Primary treatment was with calcium gluconate gel. Arterial infusion of calcium and fingernail removal were reserved for unrelenting symptoms. There were 7944 acute burn admissions to our center during this study period, 204 of which were chemical burns. HF burns comprised 17% of these chemical burn admissions (35 patients). All were men, with a mean burn size of 2.1 +/- 1.5% (range, 1-6%) and hospital stay of 1.6 +/- 0.7 days (range, 0-3 days). The most common seasonal time of injury was in the summer. Twelve patients (34%) were admitted to the intensive care unit for a total of 14 intensive care unit days, primarily for arterial infusions. Ventilator support was not required in any patient. No electrolyte abnormalities occurred. All burns were either partial thickness or small full thickness with no operative intervention required and no deaths. The upper extremity was most commonly involved (29 patients, 83%). The most common cause was air conditioner cleaner (8 patients, 23%). HF is a common cause of chemical burns. Although hospital admission is usually required for vigorous treatment and pain control, burn size is usually small and does not cause electrolyte abnormalities, significant morbidity, or death.

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“…Moreover, the treatment results are aggravating the swelling and pain, and even hampering the blood supply, is not suitable for the treatment of HF burns. The intravenous infusion as a systemic treatment, can be used to rectify the hypocalcemia and hypomagnesemia [16,17]. The Bier's block technique was first used by August Gustav Bier to perform anesthesia in the case of a limb surgery [18,19].…”

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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Hypocalcaemia and hypomagnesaemia due to hydrofluoric acid

Cited by 30 publications

References 4 publications

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Hydrofluoric Acid Burns: A 15-Year Experience

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

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