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PubMed1985

Hydrochloric acid infusion for treatment of metabolic alkalosis: effects on acid-base balance and oxygenation.

The effects of hydrochloric acid (HCl) administration were studied in 15 critically ill patients whose metabolic alkalosis caused a significant alkalemia (pH 7.50 to 7.58) unresponsive to sodium and potassium chloride administration. Arterial pH and bicarbonate and chloride concentrations normalized after a 6- to 12-h mean infusion of 200 +/- 54 mmol of .25 N HCl. There were no deleterious vascular, hematologic, or metabolic side-effects. HCl administration was associated with an increase in mean PaO2 from 94 +/- 21 to 121 +/- 31 torr (p less than .001). This increase was comparable in patients breathing spontaneously and those treated with controlled mechanical ventilation, and was attributed at least in part to a decrease in pulmonary shunt. These results indicate that .25 N HCl, infused at the rate of 100 ml/h into the superior vena cava, can correct metabolic alkalosis safely and rapidly. The persistence of the beneficial effects of this treatment on arterial oxygenation remains to be confirmed.

Acid-Base Equilibrium↗
PubMed1989

[The role of alkaline secretion of the duodenal mucosa in protecting the mucosa from hydrochloric acid].

In animal experiments, an in vivo comparison was made of the alkaline secretion (AS) of the duodenal mucosa and of its ability to defend against hydrochloric acid. An i.v. infusion of NaHCO3 and glucagon was applied to stimulate AS, and one of NH4Cl, vasopressin and furosemide to depress it. In the stage of AS influenced via various mechanisms and to different extents, the luminal surface of the duodenum was exposed with HCl. The extent of mucosal damage was determined by quantitative morphometry. The mucosa-damaging effect of standardized HCl-exposure was significantly lower in the stage of enhanced AS than in the control experiments. In contrast, during inhibition of AS hydrochloric acid caused more extensive and deeper mucosal damage. A linear correlation was observed between the degree of AS of the duodenum and the proportion of damaged intestinal villi. In the opinion of the authors, inhibition of the As of the duodenum is accompanied by a decreased acid tolerance of the mucosa, while its stimulation enhances the ability of the mucosa to defend against hydrochloric acid.

Alkalies↗
PubMed2005

Solubility of chlorine in aqueous hydrochloric acid solutions.

The solubility of chlorine in aqueous hydrochloric acid solutions was studied. The effects of HCl concentration and temperature on the solubility were evaluated, and the thermodynamic parameters of the dissolution were calculated. It was found that the solubility isotherms had a minimum at about 0.5M HCl concentration at all the temperatures studied and that solubility decreased with the increase of temperature at all the HCl concentration range investigated.

Chlorine↗
PubMedDate not supplied

Does the use of hydrochloric acid damage silicone rubber central venous catheters?

BACKGROUND: Hydrochloric acid (HCl) is commonly used to clear obstructions in central venous catheters (CVC). METHODS: To determine if HCl adversely affects the integrity of a CVC we infused 0.1 N HCl daily into CVC in vitro. At weekly intervals sections of the CVC were removed and examined using scanning electron microscopy. RESULTS: Over 8 weeks, no damage to the CVC was visible. CONCLUSIONS: HCl administration poses no threat to the structural integrity of a CVC.

Catheterization, Central Venous↗
PubMed2004

Reactive airways dysfunction syndrome in housewives due to a bleach-hydrochloric acid mixture.

The sudden onset of asthmalike symptoms and persistence of airway reactivity following an acute exposure to an irritant gas or vapor has been termed reactive airways dysfunction syndrome (RADS). A mixture of sodium hypochlorite (bleach, 40%) and hydrochloric acid (18%) is commonly used as a household cleaning solution in our region. From this mixture, chlorine gas is produced, which can cause airway damage and ensuing RADS. Here we describe findings of patients with RADS due to this cleaning mixture, and determine factors associated with a favorable outcome. Data were collected retrospectively on 55 symptomatic patients presenting to our emergency department after inhalation exposure to a mixture of bleach and hydrochloric acid. Symptoms, past medical and smoking history, details of the exposure, initial peak expiratory flow rate (PEFR) and oxygenation, and acute reversibility of airways obstruction were documented. All patients met previously defined criteria for the diagnosis of RADS, but did not undergo methacholine challenge testing and bronchoalveolar lavage or histopathologic study. Fifty patients were followed over the course of 3 mo. The majority of exposures (64%) occurred in the bathroom or kitchen. Only 21 of 55 (38%) patients showed an improvement in PEFR of 15% or greater following two beta(2)-agonist inhalation treatments. In follow-up, 48 patients (87%) improved clinically and functionally (FEV(1)). Seven patients (13%) deteriorated, with ARDS developing in two, one of whom died from respiratory failure. Advanced age, initial low PEFR, exposure in a small enclosed area, use immediately after mixing, and prolonged short- and long-term exposures were associated with a poorer prognosis. This descriptive study is the largest case series in the literature of RADS developing after exposure to a bleach-hydrochloric acid mixture. The optimum acute treatment and long-term outcomes for patients with RADS due to this combination still need to be determined.

Accidents, Home↗
PubMed1989

Pulmonary artery catheter deterioration during hydrochloric acid infusion for the treatment of metabolic alkalosis.

Hydrochloric acid (HCl) infusions for the correction of metabolic alkalosis have been used for 20 yr. In the critical care setting, HCl is usually infused through a central venous or pulmonary artery (PA) catheter. In two patients receiving HCl infusions through a PA catheter, we observed and examined solid yellow particulate material in the aspirating syringe while testing the proximal lumen for patiency. We carried out in vitro investigation infusing PA catheters with 0.1, 0.2, 0.3, and 0.4 normal HCl at 20 degrees, 38 degrees, and 42 degrees C for 24 and 48 h. Although frank catheter deterioration could not be documented, the surface and interior of those catheters infused with greater than 0.1 normal HCl changed texture, indicating a change in catheter composition. Exceeding a concentration of 0.1 normal is not recommended when HCl is infused through PA catheters.

Alkalosis↗
PubMed1998

[Determination of trace Fe in doxycycline hydrochloric acid by flame atomic absorption spectrophotometry].

This paper reports the development of the determination of trace metal Fe in doxycycline hydrochloric acid by flame atomic absorption spectrophotometry. The method is convenient to determine elements in doxycycline hydrochloric acid. The results show that the method offers good precision and accuracy. The relative standard deviation for Fe was 0.54% and the rate of recovery was 99.2%.

Calibration↗
PubMed1982

Formation of 99mTc-plasmin in presence of gentisic acid using 99mTc pretreated with concentrated hydrochloric acid and vacuum evaporation.

The concentrated hydrochloric acid/vacuum evaporation method has been applied to form 99mTc-plasmin complexes free from radiocolloids for medical scintigraphy. The yield and radiochemical purity were insufficient for medical application when no antioxidant was present during the complex formation. With gentisic acid present the yield was increased by a factory of 2-3, and high radiochemical purity was obtained. No preparative chromatography was necessary. Presence of ascorbic acid inhibited the 99mTc-plasmin formation.

Fibrinolysin↗
PubMed1989

Effect of hydrochloric acid and prostaglandins on pepsinogen synthesis and secretion in canine gastric chief cell monolayer cultures.

The actions of hydrochloric acid, natural PGE1, PGE2 and a synthetic commercial PGE1 preparation, Enisoprost (Searle) on pepsinogen synthesis and secretion were studied in canine chief cell monolayer cultures. Hydrochloric acid, applied directly to the apical surface of chief cells using culture plate inserts (Millipore) had no effect on secretion, nor did it affect the action of any secretagogue in the basolateral medium. All prostaglandins tested showed significant stimulation of pepsinogen secretion. Basal secretion of pepsinogen after 90 min was 9.4 (1.3)% to total initial monolayer content. At 10(-6) M, PGE1 stimulated secretion was 26.1 (3.8)%; PGE2 27.9 (4)% and Enisoprost 28.8 (4.2)% of initial pepsinogen content. Stimulations by all tested prostaglandins were additive with carbachol (10(-4) M) and CCK (10(-9) M), but not with VIP (10(-6) M), dbcAMP (10(-3) M) or forskolin (10(-6) M) responses. All three prostaglandins stimulated pepsinogen synthesis as measured by 14C labelled amino acid incorporation into pepsinogen. Time course experiments were similar to those for forskolin and showed shorter time delays between stimulus and increased synthesis rate than carbachol but longer than dbcAMP. Stimulated pepsinogen secretion was inhibited by high pepsin concentrations (greater than 800 micrograms/ml) in the medium. The inhibited abolished simultaneous carbachol induced stimulation of synthesis but prostaglandin or forskolin stimulation only after two hours. Combined with the shorter response time, as compared with carbachol, these data support our previous findings that potent stimulators of cAMP production can stimulate pepsinogen synthesis directly by stimulation of mRNA synthesis, independently from an increased secretion. The additivity of effects with carbachol or CCK and similarity with forskolin stimulated synthesis supports the suggestion that the actions of prostaglandins are mediated by cAMP.

Animals↗
PubMed2001

Massive necrosis of the gastrointestinal tract after ingestion of hydrochloric acid.

OBJECTIVE: To describe our experience of dealing with patients admitted as emergencies after massive ingestion of hydrochloric acid, and to find out the most important prognostic factors. DESIGN: Retrospective review. SETTING: Teaching hospital, Spain. SUBJECTS: 21 patients with massive necrosis of the upper gastrointestinal tract after ingestion of acid who presented during the past 14 years (November 1984-March 1998). INTERVENTIONS: All patients were operated on immediately, 17 without an endoscopic examination. In all cases, the laparotomy showed various degrees of damage to the intra-abdominal oesophagus (from oedema to blackening) and gastric necrosis. Twelve patients also had necrosis of the entire duodenum. In the other nine, the necrosis did not affect more than the pylorus or duodenum. All these 12 patients were treated by a total oesophago-gastrectomy without thoracotomy. Of the 12 patients with total necrosis of the duodenum, 4 did not have resections and in 8, various massive resections of the necrotic structures were done. MAIN OUTCOME MEASURES: Mortality. RESULTS: Fourteen of the 21 patients died during the operation or in the early or late postoperative period. All 12 patients with total duodenal necrosis died, whereas only 2 patients in the other group. CONCLUSIONS: The ingestion of relatively small amounts of water-based solutions of hydrochloric acid of 24% or 32% concentration produces immediate and massive necrosis of the upper digestive tract, which results in high mortality. The poor prognosis might be improved by rapid responses to stop duodenal necrosis.

Adult↗
PubMed1984

Gas production after reaction of sodium bicarbonate and hydrochloric acid.

Ingestion of sodium bicarbonate has been implicated as one of the proximate causes of spontaneous gastric rupture. However, the volume and rate of gas released from the reaction of ingested sodium bicarbonate and gastric acid has not been previously studied in detail. We, therefore, developed an in vitro method for measuring gas release after addition of sodium bicarbonate to a solution containing hydrochloric acid. From the results of our studies, we conclude that even though hydrochloric acid and sodium bicarbonate react instantaneously, the resulting gas production is slow, mainly because CO2 produced from the dehydration of carbonic acid dissolves in water and is only slowly released into the gas phase. The major exogenous factors that determine the rate of gas release are the volume of the solution, the quantity of reactants, the air volume over the reaction mixture, the partial pressure of CO2 of the acid solution before the addition of bicarbonate, and the stirring rate. The presence of food, alcohol, and carbonic anhydrase had relatively little if any effect. Based on our results, we believe that ingestion of the recommended dose of sodium bicarbonate (one-half teaspoon) would result in only small amounts of sudden gas release, probably not enough to be an important factor in causing spontaneous gastric rupture. On the other hand, we measured the amount of sodium bicarbonate that people actually select to take for indigestion, and all exceeded the recommended dose. Some people selected doses of bicarbonate that would result in several hundred milliliters of gas release within 3 min; it seems likely that such injudicious ingestion of sodium bicarbonate, if taken when the stomach was distended with air, food, and liquid, could be an important factor in spontaneous gastric rupture.

Bicarbonates↗
PubMed1986

Action of hydrochloric acid on aluminum hydroxide-magnesium hydroxide gels and magaldrate: quasi-elastic light scattering studies.

The effects of hydrochloric acid on mixed gels of aluminum and magnesium hydroxide and on magaldrate have been examined using quasi-elastic light scattering. Particles of magaldrate and mixed gels behave differently. The magaldrate particles initially decrease in size in response to increasing amounts of hydrochloric acid up to that sufficient to neutralize all the magnesium hydroxide present, then increase in size to approximately 2 microns. The composition of the mixed gels appears to be particularly important in determining the reaction with limited amounts of acid. For these particles, which are thought to consist of a magnesium hydroxide core surrounded by an aluminum hydroxide sheath, slow erosion of the aluminum hydroxide was apparently followed by complete disintegration of the particles. Particles which remain grow in size to approximately 3 microns.

Aluminum Hydroxide↗
PubMed1979

Treatment of metabolic alkalosis with intravenous hydrochloric acid.

Severe alkalosis requires aggressive treatment. Twenty patients at the Talmadge Memorial Hospital have been treated for metabolic alkalosis by infusion of dilute hydrochloric acid through a central venous line. The treatment was effective and there were no major complications. Intravenous hydrochloric acid is preferred to other modes of therapy for refractory alkalosis, especially in the presence of hepatic or renal failure.

Adolescent↗
PubMed2004

Cytotoxic synergy between indomethacin and hydrochloric acid in gastric mucosal cells.

Orally ingested non-steroidal anti-inflammatory drugs (NSAIDs) and acid in gastric secretions are gastric irritants that co-exist at the surface of the gastric mucosa. Here, we examined the individual and combined effects of indomethacin, a typical NSAID, and hydrochloric acid on cell death in primary cultures of guinea pig gastric mucosal cells. Indomethacin alone (at concentrations less than 200 microM) did not induce apoptosis; however, hydrochloric acid-induced apoptosis was stimulated in the presence of indomethacin (50-200 microM). Isobologram analysis confirmed the presence of a cytotoxic synergy between indomethacin and hydrochloric acid. The synergistic response between the two gastric irritants was also observed for necrosis. Given that the IC50 value of indomethacin for inhibition of prostaglandin synthesis is about 5 nM, the synergistic response between indomethacin and hydrochloric acid appears to be independent of the inhibition of cyclooxygenase activity by indomethacin.

Animals↗
PubMed2003

Modeling of the hydrolysis of sugar cane bagasse with hydrochloric acid.

Sugar cane bagasse was hydrolyzed under different concentrations of hydrochloric acid (2-6%), reaction times (0-300 min), and temperatures (100-128 degrees C). Sugars obtained (xylose, glucose, arabinose, and glucose) and degradation products (furfural and acetic acid) were determined. Based on the Saeman model and the two-fraction model, kinetic parameters for predicting these compounds in the hydrolysates were developed. The influence of temperature was studied using the Arrhenius equation. The optimal conditions selected were 128 degrees C, 2% HCl, and 51.1 min. Using these conditions, 22.6 g xylose/L, 3.31 g arabinose/L, 3.77 g glucose/L, 3.59 g acetic acid/L, and 1.54 g furfural/L were obtained.

Acetic Acid↗
PubMed1981

Transport of protons and hydrochloric acid through lipid bilayer membranes.

Transport of protons and hydrochloric acid through lipid bilayer membranes was studied by a combination of electrical conductance and pH electrode techniques. In the presence of large pH gradients, proton transport occurs primarily by diffusion of molecular HCl. The permeability of egg phosphatidylcholine/decane bilayers to HCl is about 3 cm . s-1, seven to nine order of magnitude higher than the permeability to H+, OH- or Cl-. The HCl permeability of phosphatidylserine or egg phosphatidylcholine/cholesterol (1 : 1) bilayers is about 50% lower than the permeability of egg phosphatidylcholine bilayers. Diffusion of molecular HCl may be an important process in tissues exposed to high HCl concentrations, e.g., gastric mucosa. However, at neutral pH the diffusion of molecular HCl is too slow to contribute significantly to net movements of H+ or Cl-.

Biological Transport↗