Possibility of Dilution and Neutralization Therapy with Cold Solution in Cases of Strong Acid or Strong Alkali Ingestion

Rhee, Joong Eui; Song, Hyoung Gon; Kim, Dong Hoon; Kweon, Woon Yong; Kwak, Young Ho; Suh, Gil Joon; Youne, Yeo Kyu

Abstract

BACKGROUND: There is no effective treatment modality for caustic agent ingestion. Dilution and neutralization are prohibited because of the risk of secondary thermal injury. This experiment is designed to evaluate the amount of dilution and neutralization heat and to gauge the applicability of dilution and neutralization therapy using cold solutions to suppress the peak temperature.
METHODS
This is an in-vitro chemical experiment. HCl, CH3COOH, NaOH, and NH4OH are selected as representatives of strong and weak acids and strong and weak alkali, respectively. 20degrees C, 11.6M, 5.8M, and 2.9M solutions of each acid and alkali are made and mixed using a magnetic stirrer at a room air temperature of 28degrees C. The peak temperature, the duration above 40degrees C, and the heat amount are measured or calculated.
RESULTS
When a 11.6M HCl or NaOH solution is diluted with same amount of water, 32 or 18cal. per mL of HCl or NaOH is produced, respectively. HCl produces a significant peak temperature, but NaOH does not. The lower the concentration, the lower the amount of heat production. 11.6M CH3COOH and NH4OH solutions don't produce dilution heat. 11.6M and 5.8M solutions of all acids and alkali produce destructive neutralization heat. However, 2.9M solutions produce neutralization heat which might be controllable. When a 11.6M HCl or NaOH solution is neutralized with a -10degrees C 2.9 M NaOH or HCl solution, respectively, the peak temperature produced is below 40degrees C and seems to add little thermal damage to viable tissue.
CONCLUSION
Dilution and neutralization with a cold solution in cases of strong acid or alkali ingestion is a promising method to avoid thermal injury.