Citation

Fang H, Wang GY, Wang X, He F, Su JD. World J. Clin. Cases 2019; 7(20): 3341-3346.

Affiliation

Department of Burn and Plastic Surgery, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215002, Jiangsu Province, China. jiandongsu@njmu.edu.cn.

Copyright

(Copyright © 2019, Baishideng Publishing Group)

DOI

10.12998/wjcc.v7.i20.3341

PMID

31667189

PMCID

PMC6819295

Abstract

BACKGROUND: Hydrofluoric acid (HF) is one of the most common causes of chemical burns. HF burns can cause wounds that deepen and progress aggressively. As a result, HF burns are often severe even if they involve a small area of the skin. Published cases of HF burns have mostly reported small HF burn areas. Few cases of HF inhalation injury have been reported to date. CASE SUMMARY: A 24-year-old man suffered from extensive hydrofluoric acid burns covering 60% of the total body surface area (TBSA), including deep second degree burns on 47% and third degree burns on 13% of the TBSA, after he fell into a pickling pool containing 15% HF. Comprehensive treatments were carried out after the patient was admitted. Ventricular fibrillation occurred 9 times within the first 2 h, and the lowest serum Ca²⁺ concentration was 0.192 mmol/L. A dose of calcium gluconate (37 g) was intravenously supplied during the first 24 h, and the total amount of calcium gluconate supplementation was 343 g. Extracorporeal membrane oxygenation (ECMO) was applied for 8 d to handle the acute respiratory distress syndrome (ARDS) induced by the HF inhalation injury. The patient was discharged after 99 d of comprehensive treatment, including skin grafting.

CONCLUSION: Extensive HF burns combined with an inhalation injury led to a potentially fatal electrolyte imbalance and ARDS. Adequate and timely calcium supplementation and ECMO application were the keys to successful treatment of the patient.

©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

Language: en

Keywords

Acute respiratory distress syndrome; Case report; Extracorporeal membrane oxygenation; Hydrofluoric acid burn; Hypocalcemia; Inhalation injury