Calcium gluconate versus hexaflourine in the treatment of hydrofluoric acid exposure

Abstract

Hydrofluoric acid (HF) is the inorganic acid of elemental fluorine and causes tissue damage in humans by two mechanisms; free hydrogen ions cause a caustic burn and fluoride ions penetrate tissues resulting in chemical burns. The mode of action this acid assumes is to bind to calcium and magnesium when it comes into contact with skin and tissues. Once HF is absorbed through the skin or eyes, it dissociates and can cause extensive damage to tissues by the formation of insoluble fluoride salts. If enough Ca and Mg are absorbed, there may be an inadequate supply available for vital body functions. Exposures to hydrofluoric acid must be treated immediately, as sudden death has been reported from acid burns to as little as 2.5% of body surface area. Two treatments available today include calcium gluconate and Hexafluorine. Calcium gluconate works by combining with free fluoride ions to form insoluble calcium fluoride, thus preventing the burns that result from the extraction of calcium from tissue and bones. Depending on the surrounding circumstances, calcium gluconate can also be administered by injection or intra-arterial infusion. Hexafluorine has both absorption and chelating capacities enabling it to trap H+ and F+ ions immediately as it contacts HF. This ability prevents the superficial layers of skin from being destroyed and also halts the fluoride ion advancement.