Delivery of Calcium Gluconate by Combination of Subcutaneous Injection and Intravenous Infusion for Hydrofluoric Acid Burns

Objective To evaluate the efficacy and safety of simultaneously using subcutaneous injection and intravenous infusion of calcium gluconate to treat hydrofluoric acid burns.

Methods Eighty-two patients with hydrofluoric acid burns were admitted from January 2006 to August 2013. A one-time subcutaneous injection of calcium gluconate was administered to all the patients after admission at dosages of 30-45 mg/cm² (9 cases), 10-30 mg/cm² (32 cases), and 5-10 mg/cm² (41 cases), respectively. For first degree burn areas caused by hydrofluoric acid, calcium gluconate was subcutaneously injected at a dosage of 0.25-5.00 mg/cm², or wet dressing with 2.5% calcium gluconate solution was used for local treatment. The total dosages of calcium gluconate for subcutaneous injection varied by case:1-5 g for 57 cases, 5-10 g for 14 cases, 10-20 g for 10 cases, and 20-30 g for 1 case. Meanwhile, the level of serum calcium was dynamically monitored for all the patients involved, based on which the velocity of intravenously administrated calcium gluconate was regulated.

Results All the 82 patients with hydrofluoric acid burns were cured at discharge. Specifically, 5 cases, showing hypocalcemia when admitted, were corrected immediately in the following 4 h after diagnosis; 71 cases were steady in the normal range of serum calcium; and the other 6 cases occurred hypercalcemia. No outstanding adverse effects, such as local infection, subcutaneous nodules, skin necrosis, or deepened burn wounds, were observed during the hospital stay and the one-month follow-up visit.

Conclusion Subcutaneous injection in combination with intravenous infusion of calcium gluconate could be an effective method to treat hydrofluoric acid burns. The dosage of calcium gluconate for subcutaneous injection requires adjustment according the local wound degree to avoid hypercalcemia resulted from over-dosage.