Klinik und Therapie der Tetrachlorkohlenstoffvergiftung

Abstract

Massenvergiftungen mit Tetrachiorkohienstoff, wie sie Lendle (27) und Aiha (1) beschrieben, sind selten. Die breite gewerbliche Anwendung des Tetrachiorkohienstoffs in der Farben-, Lack-und Gummi-Industrie, das Vorkommen Dume u. a. Klinik und Therapie der Tetrachlorkohlenstoffvergiftung

Liver Injury by Carbon Tetrachloride Intoxication in 16 Patients Treated with Forced Ventilation to Accelerate Toxin Removal via the Lungs: A Clinical Report

“…As opposed to historical reports on previous patients, who did not receive a specific therapy directed against CCl 4 as the poisonous chemical ( Table 1 and Table 2 ) [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ], some actual recommendations how to diagnose and treat patients intoxicated by acute ingestion or inhalation of CCl 4 or other aliphatic halogenated hydrocarbons have been presented in a recent report [ 34 ]. Essential diagnostic requirements at admission and during the clinical course are now outlined in a tabular listing ( Table 3 ), which should be followed in a setting of an intensive care unit and at best within a center with special experience with these intoxications as described [ 34 ].…”

“…Clinical features of human CCl 4 -induced liver injury and CCl 4 poisoning in general have been well described in a variety of publications [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Most of these clinical details described are expected as transferable from results obtained in animal studies [ 2 , 3 , 4 , 5 , 6 ].…”

“…Clinical evidence suggests the efficacy of CO 2 -induced hyperventilation by accelerating CCl 4 removal via the lungs ( Figure 9 , Figure 10 , Figure 11 and Figure 12 ). However, these data do not allow the firm conclusion that this therapy reduces the overall lethality rate in patients with CCl 4 intoxication [ 36 ], which was estimated at 28–35% until 1953 and at 17% thereafter until 1965 due to increased use of dialysis devices [ 25 ], but with 25% this rate was somewhat higher in a study from Düsseldorf published in 1969 without applying the new CO 2 -induced hyperventilation therapy [ 25 ]. These figures compare with the lethality rate of 6.7% observed with 16 patients treated with forced ventilation ( Table 7 ), but such comparisons of various clinical cohorts with their case variabilities are uncertain and open for discussion.…”