Thermal Effects of Neutralization Therapy and Water Dilution for Acute Alkali Exposure in Canines

• Published in: Academic emergency medicine Vol. 4; no. 1; pp. 27 - 32
• Main Authors: Homan, Clark S., Singer, Adam J., Henry, Mark C., Thode, Henry C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.1997
• Subjects: Acids - therapeutic use; alkali; Analysis of Variance; animal study; Animals; Body Temperature; burn; Burns, Chemical - physiopathology; Burns, Chemical - therapy; Caustics - adverse effects; Disease Models, Animal; Dogs; Gastric Mucosa - injuries; Gastric Mucosa - physiology; neutralization; Sodium Hydroxide - adverse effects; stomach; toxicology; Water
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/j.1553-2712.1997.tb03639.x

ABSTRACT Objective: To evaluate the change in temperature of the gastric mucosa and lumen contents when a weak acid or water is used to manage acute alkali exposure. Methods: A prospective in‐vivo canine model was used in a university‐based animal laboratory setting. Eighteen adult canines weighing 20–25 kg were placed under a surgical plane of anesthesia and a laparotomy was performed. A gastrotomy was then made after ligation of the distal esophagus and proximal duodenum. Separate mucosa and lumen temperature probes were placed. Then 25 mL of room‐temperature (24–26°C) 50% sodium hydroxide (NaOH) was instilled in the gastric lumen. After 5 minutes, each canine was given treatment. Group 1 (n = 10) was treated with 75 mL of room‐temperature orange juice. Group 2 (n = 8) was treated with 75 mL of room‐temperature water. Continuous mucosa and lumen temperatures were observed and recorded at baseline and at specified intervals for 35 minutes after the alkali insult. Repeated‐measures analysis of variance was used to evaluate the overall temperature profile. Signed‐rank tests were used to compare the changes in temperature immediately following neutralization treatment. Results: Significant temperature decreases of 1.1°C and 2.1°C were observed for both mucosa (p = 0.002) and lumen (p < 0.001) temperatures, respectively, following neutralization therapy with room‐temperature orange juice. In the group treated with room‐temperature water, significant temperature decreases of 2.1°C for mucosa (p = 0.01) and 2.4°C for lumen (p = 0.01) were observed. Posttreatment temperatures did not exceed baseline for the entire observation period. Conclusion: Neutralization therapy with room‐temperature orange juice or water dilution for acute gastric injuries by liquid alkali does not cause a rise in mucosal or intraluminal temperatures in an in‐vivo canine model.