Successful treatment of oral acetic acid poisoning with plasmapheresis

Successful management of 70% acetic acid ingestion on the intensive care unit: A case report

“…It has a diverse range of uses, reflecting the breadth of available concentrations. Its most common form found for domestic use is that of dietary vinegar (2-6%) 1 ; however, highly concentrated solutions of up to 80% are frequently used in Eastern Europe and Russia in the production of homemade vegetable preservatives and cleaning solutions. 2 Consequently, its ease of access and high potency make it one of the most common forms of self-harm in Eastern Europe with mortality rates as high as 20%.…”

“…Industrial use of acetic acid includes etching metals, fabric dye production and leather tanning. 1 Some of its properties have also been harnessed for medical purposes, specifically in the treatment of hepatocellular carcinoma, 3 diagnosis of cervical cancer 4 and for the treatment of box-jelly fish stings. 5 Exposure to concentrations as low as 10% has been reported to cause permanent damage to eyesight in animal studies, 5 whilst those exceeding 12% result in corrosive and systemic effects of skin loss, damage to mucosal membranes, haemolysis, renal failure, acidosis, shock and ultimately death.…”

“…A number of studies report rapid progression to renal, hepatic failure and subsequent disseminated intravascular haemolysis and death shortly after ingestion with acetic acid. 1,19 In the Brusin review, nearly 60% of the 105 patients who developed pneumonia as a consequence of acid ingestion died, 7 whilst mortality approached 40% in those with systemic complications in patients studied by Chisishev. 2 Haemolysis and renal failure is reported in all cases of acute acetic acid poisoning.…”

“…The authors do suggest, however that, for cases where there is ongoing haemolysis, repeated sessions of treatment may prove beneficial. 1 Hakenbeck et al 21 in the 1980s were able to successfully use haemodialysis to treat a patient who had ingested 200 ml of 80% acetic acid, thus leading others to extrapolate that CVVH therapy may have a role in the management of similar patients. A similar benefit was reported by Russian authors who suggested that morality was reduced by nearly 30% in those patients undergoing early haemodialysis and death within 24 h of poisoning was reduced by almost 9%.…”

The Role of Hemodialysis in Treatment of Acute Acetic Acid Poisonings

“…In the therapy protocol we include protein pump inhibitors, H 2 blockers, antibiotics and intensive hyper alimentation. Perforation of parts in the gastrointestinal system, mainly esophageal or gastric, can only be treated surgically (9, 10).…”