The Efficacy of Neutralization Therapy with Weak Acid against Strong Alkali Ingestion: Invivo Study

Jo, You Hwan; Jo, Ik Joon; Shin, Jung Ho; Rhee, Joong Eui; Suh, Gil Joon; Youn, Yeo Kyu

Abstract

PURPOSE
This study was designed to prove the efficacy of neutralization with weak acid against strong alkali ingestion and to evaluate exothermic reaction of neutralization therapy.
METHODS
30 New Zealand White rabbits were anesthetized with intravenous injection of ketamine and xylazine. After gastric lavage was done, a orogastric catheter and a electric thermometer probe were inserted into stomach. And then the rabbits were divided into six groups. The first group was given 3M NaOH 16.5 mL only. The second and third groups were given 3M NaOH 16.5 mL and then 1M C H3COOH 52.14 mL one and three minutes later, respectively. The fourth and fifth groups were given tap water instead of CH3COOH, and the sixth group was given C H3COOH only. We monitored intragastric temperature continuously, compared arterial pHs before alkali infusion and 15 minutes later, measured gastric pH 15 minutes later, and examined pathologic findings of stomach after sacrificing.
RESULTS
There was no significant thermal effect in all groups, and gastric pH of neutralization groups was much lower than alkali alone or dilution groups. Changes of arterial pH after 15 minutes were greater in alkali alone and dilution groups than neutralization groups. In gross and microscopic findings of stomach, only mucosal injuries were observed in neutralization groups, especially in one minute group. But all stomach layers were destroyed in alkali alone and dilution groups.
CONCLUSION
Neutralization therapy never makes additional thermal injury, and has protective effects against local tissue destruction and systemic alkalemia. Dilution therapy shows little or no effects.