Chest wall necrosis and death secondary to hydrochloric acid infusion for metabolic alkalosis.
Central line complications are common, and extravasation injuries related to infusion of caustic substances have been previously described. Although hydrochloric acid has been used for many years to treat metabolic alkalosis, there have been no reported fatal complications. We report the case of a 53-year-old female who received a fatal chemical burn due to extravasation from a subclavian central venous catheter of hydrochloric acid infused to correct severe metabolic alkalosis. This case illustrates the hazards of the infusion of caustic substances through central lines and underscores the importance of constant vigilance regarding line positioning and changes to the surrounding tissues when infusing these substances.
Buchanan
Ian B
IB
North Carolina Jaycee urn Center, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7228, USA.
Campbell
Brendan T
BT
Peck
Michael D
MD
Cairns
Bruce A
BA
D000471:Alkalosis / Q000188:drug therapy*; D002057:Burns, Chemical / Q000209:etiology*; D002405:Catheterization, Central Venous; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006851:Hydrochloric Acid / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008875:Middle Aged; D009336:Necrosis; D035441:Thoracic Wall / Q000293:injuries* / Q000473:pathology
D006851:Hydrochloric Acid