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

Abstract

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.

Injuries following a serious hydrofluoric acid leak: First aid and lessons

“…The rates of sporadic HF injury are increasing due to the extensive utilisation of this chemical in some areas around the world [17][18][19]. Within these areas of high chemical usage, the incidence of HF burns is ranked first among all chemical burns [6].…”

Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study

“…HF industries and derivatives have shown explosive growth in the past decade and play a vital role in the local economy. Consequently, the incidence of chemical burns, especially those caused by HF, has increased [10, 14, 15]. …”

Hydrofluoric Acid: Burns and Systemic Toxicity, Protective Measures, Immediate and Hospital Medical Treatment

“…Intra-arterial infusion of calcium gluconate, firstly reported by Köhnlein and Achinger [ 50 ], is indicated when exposed to high HF concentrations with severe burns [ 51 ], rapid destruction of tissues and acute systemic toxicity especially in patients with upper and lower extremities- and facial burns [ 29 ], [ 30 ], [ 63 ], [ 77 ], [ 78 ]. According to ASTDR, the initial dosage is 10 mL of 10% calcium gluconate diluted with 40 mL D 5 W given intra-arterially over 4 hours.…”