Abstracto
Intoxications by aliphatic halogenated hydrocarbons: hepatotoxic risks for patients and clinical issues including role of CO2-induced hyperventilation as therapy option.
Rolf Teschke
Human liver toxicity by alcohol use is highly prevalent in most countries as opposed to the rarity of liver injury by other chemicals. This applies preferentially to industrial and household chemicals of the aliphatic halogenated hydrocarbon type, with carbon tetrachloride as one of the best known chemical. Mainly eliminated through the lungs, such hydrocarbons are metabolized in very small amounts in the liver to toxic radicals. However, due to the rarity of published liver injury cases, little information is available of the clinical course of patients with acute intoxication by aliphatic halogenated hydrocarbons and therapy options. In the present article, case data of 60 patients with these intoxications are briefly reviewed and treatment options recommended. These include forced removal of the toxins through the lungs via CO2-induced hyperventilation with the aim to increase the respiratory volume to 25-30 liter per minute. Duration of this hyperventilation therapy was 106.0 ± 10.5 hours among the 60 patients, and discharge calculated from the day of intoxication was after 14.5 ± 1.5 days. Age of the patients was 41.1 ± 3.9 years, with significantly higher ages in patients with unintentional poisoning as compared to those with intentional intoxication (49.8 ± 6.5 years vs. 31.6 ± 2.8 years; p<0.005). Lethality rate was 4/60 patients corresponding to 6.7%. In summary, cases of acute intoxications by aliphatic halogenated hydrocarbons and associated liver injury are rarely described in the scientific and medical literature, but therapy options exist that include increased toxin removal via the lungs through CO2-induced hyperventilation.