Limited efficacy of calcium and magnesium in a porcine model of hydrofluoric acid ingestion
This investigation evaluated the effectiveness of calcium and magnesium in treating oral hydrofluoric acid (HF) poisoning. The controlled laboratory investigation used anesthetized pigs. Subjects received HF via NG tube, titrated to abolish electrocardiographic abnormalities. The untreated group rec...
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| Veröffentlicht in: | Journal of medical toxicology 2007-06, Vol.3 (2), p.45-51 |
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| creator | Coffey, Jason A Brewer, Kori L Carroll, Robert Bradfield, John Meggs, William J |
| description | This investigation evaluated the effectiveness of calcium and magnesium in treating oral hydrofluoric acid (HF) poisoning.
The controlled laboratory investigation used anesthetized pigs. Subjects received HF via NG tube, titrated to abolish electrocardiographic abnormalities. The untreated group received saline infusion. The treatment group received serial injections of calcium chloride (CaCl2) and magnesium chloride (MgCl2). A third group received oral infusions of Calcium fluoride (CaF2). We measured heart rate, QRS interval, pH, bicarbonate, calcium, magnesium, and potassium. The Wilcoxon Rank Sum test was used to compare intra- and inter-subject differences.
Fatality occurred in all pigs receiving HF. Compared to the untreated group, trends for the treatment group were toward a larger amount of HF to produce fatality (83.1 +/- 17.5 grams vs. 37.7 +/- 16.1 grams, p = 0.08), to cause QRS prolongation (72.5 +/- 25.8vs. 33.8 +/- 14.9 grams, p = 0.08), and to lower potassium at mortality (4.9 +/- 0.7 vs. 8.7 +/- 2.7 mEq/L, p = 0.08). No major changes in calcium (-1.0 +/- 0.7 mEq/L) or magnesium (0.4 +/- 0.6 mEq/L) occurred in the untreated group. Tachycardia developed in all pigs and ventricular arrhythmias occurred in 2 of 3 pigs of both groups [CaF2 administration caused no QRS prolongation or ventricular arrhythmias and had no effect on laboratory parameters].
CaCl2 and MgCl2 replacement delayed but did not prevent fatality and QRS prolongation. Although this result suggests Ca++ and Mg++ may be beneficial in the treatment of systemic HF toxicity, factors other than hypocalcemia and hypomagnesemia play a role in toxicity. |
| doi_str_mv | 10.1007/bf03160907 |
| format | Article |
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The controlled laboratory investigation used anesthetized pigs. Subjects received HF via NG tube, titrated to abolish electrocardiographic abnormalities. The untreated group received saline infusion. The treatment group received serial injections of calcium chloride (CaCl2) and magnesium chloride (MgCl2). A third group received oral infusions of Calcium fluoride (CaF2). We measured heart rate, QRS interval, pH, bicarbonate, calcium, magnesium, and potassium. The Wilcoxon Rank Sum test was used to compare intra- and inter-subject differences.
Fatality occurred in all pigs receiving HF. Compared to the untreated group, trends for the treatment group were toward a larger amount of HF to produce fatality (83.1 +/- 17.5 grams vs. 37.7 +/- 16.1 grams, p = 0.08), to cause QRS prolongation (72.5 +/- 25.8vs. 33.8 +/- 14.9 grams, p = 0.08), and to lower potassium at mortality (4.9 +/- 0.7 vs. 8.7 +/- 2.7 mEq/L, p = 0.08). No major changes in calcium (-1.0 +/- 0.7 mEq/L) or magnesium (0.4 +/- 0.6 mEq/L) occurred in the untreated group. Tachycardia developed in all pigs and ventricular arrhythmias occurred in 2 of 3 pigs of both groups [CaF2 administration caused no QRS prolongation or ventricular arrhythmias and had no effect on laboratory parameters].
CaCl2 and MgCl2 replacement delayed but did not prevent fatality and QRS prolongation. Although this result suggests Ca++ and Mg++ may be beneficial in the treatment of systemic HF toxicity, factors other than hypocalcemia and hypomagnesemia play a role in toxicity.</description><identifier>ISSN: 1556-9039</identifier><identifier>EISSN: 1937-6995</identifier><identifier>DOI: 10.1007/bf03160907</identifier><identifier>PMID: 18072159</identifier><language>eng</language><publisher>United States: University of Pennsylvania Press</publisher><subject>Abnormalities ; Acids ; Animals ; Bicarbonates ; Blood pressure ; Calcium ; Calcium - therapeutic use ; Calcium chloride ; Calcium fluoride ; Calcium, Dietary ; Cardiac arrhythmia ; Case studies ; Disease Models, Animal ; Drinking water ; Drug dosages ; Electrocardiography - drug effects ; Environmental health ; Fatalities ; Fluorides ; Fluorides - blood ; General anesthesia ; Heart rate ; Hogs ; Hydrofluoric acid ; Hydrofluoric Acid - poisoning ; Hypocalcemia ; Hypomagnesemia ; Infusion ; Ingestion ; Magnesium ; Magnesium - therapeutic use ; Magnesium chloride ; Magnesium in the body ; Medical laboratories ; Medical research ; Medicine ; Mortality ; Poisoning ; Potassium ; Prolongation ; Swine ; Tachycardia ; Tachycardia, Ventricular - chemically induced ; Toxicity ; Toxicology ; Toxicology Investigations ; Ventricle</subject><ispartof>Journal of medical toxicology, 2007-06, Vol.3 (2), p.45-51</ispartof><rights>COPYRIGHT 2007 University of Pennsylvania Press</rights><rights>American College of Medical Toxicology 2007</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-9fc2e352efa8dac797586bb32eb7b51c4cb7714829caedcedbcb596d106aabde3</citedby><cites>FETCH-LOGICAL-c536t-9fc2e352efa8dac797586bb32eb7b51c4cb7714829caedcedbcb596d106aabde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550082/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550082/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18072159$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coffey, Jason A</creatorcontrib><creatorcontrib>Brewer, Kori L</creatorcontrib><creatorcontrib>Carroll, Robert</creatorcontrib><creatorcontrib>Bradfield, John</creatorcontrib><creatorcontrib>Meggs, William J</creatorcontrib><title>Limited efficacy of calcium and magnesium in a porcine model of hydrofluoric acid ingestion</title><title>Journal of medical toxicology</title><addtitle>J Med Toxicol</addtitle><description>This investigation evaluated the effectiveness of calcium and magnesium in treating oral hydrofluoric acid (HF) poisoning.
The controlled laboratory investigation used anesthetized pigs. Subjects received HF via NG tube, titrated to abolish electrocardiographic abnormalities. The untreated group received saline infusion. The treatment group received serial injections of calcium chloride (CaCl2) and magnesium chloride (MgCl2). A third group received oral infusions of Calcium fluoride (CaF2). We measured heart rate, QRS interval, pH, bicarbonate, calcium, magnesium, and potassium. The Wilcoxon Rank Sum test was used to compare intra- and inter-subject differences.
Fatality occurred in all pigs receiving HF. Compared to the untreated group, trends for the treatment group were toward a larger amount of HF to produce fatality (83.1 +/- 17.5 grams vs. 37.7 +/- 16.1 grams, p = 0.08), to cause QRS prolongation (72.5 +/- 25.8vs. 33.8 +/- 14.9 grams, p = 0.08), and to lower potassium at mortality (4.9 +/- 0.7 vs. 8.7 +/- 2.7 mEq/L, p = 0.08). No major changes in calcium (-1.0 +/- 0.7 mEq/L) or magnesium (0.4 +/- 0.6 mEq/L) occurred in the untreated group. Tachycardia developed in all pigs and ventricular arrhythmias occurred in 2 of 3 pigs of both groups [CaF2 administration caused no QRS prolongation or ventricular arrhythmias and had no effect on laboratory parameters].
CaCl2 and MgCl2 replacement delayed but did not prevent fatality and QRS prolongation. Although this result suggests Ca++ and Mg++ may be beneficial in the treatment of systemic HF toxicity, factors other than hypocalcemia and hypomagnesemia play a role in toxicity.</description><subject>Abnormalities</subject><subject>Acids</subject><subject>Animals</subject><subject>Bicarbonates</subject><subject>Blood pressure</subject><subject>Calcium</subject><subject>Calcium - therapeutic use</subject><subject>Calcium chloride</subject><subject>Calcium fluoride</subject><subject>Calcium, Dietary</subject><subject>Cardiac arrhythmia</subject><subject>Case studies</subject><subject>Disease Models, Animal</subject><subject>Drinking water</subject><subject>Drug dosages</subject><subject>Electrocardiography - drug effects</subject><subject>Environmental health</subject><subject>Fatalities</subject><subject>Fluorides</subject><subject>Fluorides - blood</subject><subject>General anesthesia</subject><subject>Heart rate</subject><subject>Hogs</subject><subject>Hydrofluoric acid</subject><subject>Hydrofluoric Acid - poisoning</subject><subject>Hypocalcemia</subject><subject>Hypomagnesemia</subject><subject>Infusion</subject><subject>Ingestion</subject><subject>Magnesium</subject><subject>Magnesium - therapeutic use</subject><subject>Magnesium chloride</subject><subject>Magnesium in the body</subject><subject>Medical laboratories</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Mortality</subject><subject>Poisoning</subject><subject>Potassium</subject><subject>Prolongation</subject><subject>Swine</subject><subject>Tachycardia</subject><subject>Tachycardia, Ventricular - chemically induced</subject><subject>Toxicity</subject><subject>Toxicology</subject><subject>Toxicology Investigations</subject><subject>Ventricle</subject><issn>1556-9039</issn><issn>1937-6995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkU9rGzEQxUVoaNK0l3yAIJpbYVP9sVarS8EJTRsw5NKeehDSSHIUdiVX6y3420eL3TaBoMNoRr95PPEQOqfkihIiP9tAOG2JIvIInVLFZdMqJd7UuxBtowhXJ-jdOD4SUnu2eItOaEcko0Kdol-rOMStd9iHEMHADueAwfQQpwGb5PBg1smPcxcTNniTC8Tk8ZCd72f2YedKDv2USwRsILrKrf24jTm9R8fB9KP_cKhn6Oft1x8335vV_be7m-WqAcHbbaMCMM8F88F0zoBUUnSttZx5K62gsAArJV10TIHxDryzYIVqHSWtMdZ5foa-7HU3kx1mIm2L6fWmxMGUnc4m6pcvKT7odf6juRCEdKwKfDwIlPx7qub1Y55Kqp61YpJQRiiv0OUeWpve65hCrlowxBH0krZ8ISkVM3X1ClWP80OEnHyIdf5i4dN-AUoex-LDP9-U6DlefX37N94KXzz_6X_0kCd_AhcQoL8</recordid><startdate>20070601</startdate><enddate>20070601</enddate><creator>Coffey, Jason A</creator><creator>Brewer, Kori L</creator><creator>Carroll, Robert</creator><creator>Bradfield, John</creator><creator>Meggs, William J</creator><general>University of Pennsylvania Press</general><general>Springer Nature B.V</general><general>Springer-Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>20070601</creationdate><title>Limited efficacy of calcium and magnesium in a porcine model of hydrofluoric acid ingestion</title><author>Coffey, Jason A ; Brewer, Kori L ; Carroll, Robert ; Bradfield, John ; Meggs, William J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-9fc2e352efa8dac797586bb32eb7b51c4cb7714829caedcedbcb596d106aabde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Abnormalities</topic><topic>Acids</topic><topic>Animals</topic><topic>Bicarbonates</topic><topic>Blood pressure</topic><topic>Calcium</topic><topic>Calcium - therapeutic use</topic><topic>Calcium chloride</topic><topic>Calcium fluoride</topic><topic>Calcium, Dietary</topic><topic>Cardiac arrhythmia</topic><topic>Case studies</topic><topic>Disease Models, Animal</topic><topic>Drinking water</topic><topic>Drug dosages</topic><topic>Electrocardiography - drug effects</topic><topic>Environmental health</topic><topic>Fatalities</topic><topic>Fluorides</topic><topic>Fluorides - blood</topic><topic>General anesthesia</topic><topic>Heart rate</topic><topic>Hogs</topic><topic>Hydrofluoric acid</topic><topic>Hydrofluoric Acid - poisoning</topic><topic>Hypocalcemia</topic><topic>Hypomagnesemia</topic><topic>Infusion</topic><topic>Ingestion</topic><topic>Magnesium</topic><topic>Magnesium - therapeutic use</topic><topic>Magnesium chloride</topic><topic>Magnesium in the body</topic><topic>Medical laboratories</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Mortality</topic><topic>Poisoning</topic><topic>Potassium</topic><topic>Prolongation</topic><topic>Swine</topic><topic>Tachycardia</topic><topic>Tachycardia, Ventricular - chemically induced</topic><topic>Toxicity</topic><topic>Toxicology</topic><topic>Toxicology Investigations</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coffey, Jason A</creatorcontrib><creatorcontrib>Brewer, Kori L</creatorcontrib><creatorcontrib>Carroll, Robert</creatorcontrib><creatorcontrib>Bradfield, John</creatorcontrib><creatorcontrib>Meggs, William J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medical toxicology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coffey, Jason A</au><au>Brewer, Kori L</au><au>Carroll, Robert</au><au>Bradfield, John</au><au>Meggs, William J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limited efficacy of calcium and magnesium in a porcine model of hydrofluoric acid ingestion</atitle><jtitle>Journal of medical toxicology</jtitle><addtitle>J Med Toxicol</addtitle><date>2007-06-01</date><risdate>2007</risdate><volume>3</volume><issue>2</issue><spage>45</spage><epage>51</epage><pages>45-51</pages><issn>1556-9039</issn><eissn>1937-6995</eissn><abstract>This investigation evaluated the effectiveness of calcium and magnesium in treating oral hydrofluoric acid (HF) poisoning.
The controlled laboratory investigation used anesthetized pigs. Subjects received HF via NG tube, titrated to abolish electrocardiographic abnormalities. The untreated group received saline infusion. The treatment group received serial injections of calcium chloride (CaCl2) and magnesium chloride (MgCl2). A third group received oral infusions of Calcium fluoride (CaF2). We measured heart rate, QRS interval, pH, bicarbonate, calcium, magnesium, and potassium. The Wilcoxon Rank Sum test was used to compare intra- and inter-subject differences.
Fatality occurred in all pigs receiving HF. Compared to the untreated group, trends for the treatment group were toward a larger amount of HF to produce fatality (83.1 +/- 17.5 grams vs. 37.7 +/- 16.1 grams, p = 0.08), to cause QRS prolongation (72.5 +/- 25.8vs. 33.8 +/- 14.9 grams, p = 0.08), and to lower potassium at mortality (4.9 +/- 0.7 vs. 8.7 +/- 2.7 mEq/L, p = 0.08). No major changes in calcium (-1.0 +/- 0.7 mEq/L) or magnesium (0.4 +/- 0.6 mEq/L) occurred in the untreated group. Tachycardia developed in all pigs and ventricular arrhythmias occurred in 2 of 3 pigs of both groups [CaF2 administration caused no QRS prolongation or ventricular arrhythmias and had no effect on laboratory parameters].
CaCl2 and MgCl2 replacement delayed but did not prevent fatality and QRS prolongation. Although this result suggests Ca++ and Mg++ may be beneficial in the treatment of systemic HF toxicity, factors other than hypocalcemia and hypomagnesemia play a role in toxicity.</abstract><cop>United States</cop><pub>University of Pennsylvania Press</pub><pmid>18072159</pmid><doi>10.1007/bf03160907</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Springer Nature - Complete Springer Journals; PubMed Central |
| subjects | Abnormalities Acids Animals Bicarbonates Blood pressure Calcium Calcium - therapeutic use Calcium chloride Calcium fluoride Calcium, Dietary Cardiac arrhythmia Case studies Disease Models, Animal Drinking water Drug dosages Electrocardiography - drug effects Environmental health Fatalities Fluorides Fluorides - blood General anesthesia Heart rate Hogs Hydrofluoric acid Hydrofluoric Acid - poisoning Hypocalcemia Hypomagnesemia Infusion Ingestion Magnesium Magnesium - therapeutic use Magnesium chloride Magnesium in the body Medical laboratories Medical research Medicine Mortality Poisoning Potassium Prolongation Swine Tachycardia Tachycardia, Ventricular - chemically induced Toxicity Toxicology Toxicology Investigations Ventricle |
| title | Limited efficacy of calcium and magnesium in a porcine model of hydrofluoric acid ingestion |
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