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Hypernatraemia and hyperchloraemic acidosis after bleach ingestion
1Department of Pharmacology and Therapeutics, University of Wales College of Medicine, Llandough Hospital, South Glamorgan, UK.
Human Toxicology
|January 1, 1988
Summary
Ingesting strong household bleach (sodium hypochlorite, NaOCl) can cause severe metabolic issues, including hypernatremia and hyperchloremic acidosis. This occurs due to the high sodium content and chemical reactions within the stomach.
Area of Science:
- Toxicology
- Internal Medicine
- Emergency Medicine
Background:
- Household bleach, a common corrosive agent, contains sodium hypochlorite (NaOCl).
- Accidental or intentional ingestion can lead to significant internal injury and systemic toxicity.
- Understanding the metabolic consequences is crucial for effective clinical management.
Observation:
- Deliberate ingestion of 'strong' household bleach resulted in severe metabolic disturbances.
- Patients presented with symptoms indicative of significant systemic compromise.
- The concentration of NaOCl in 'strong' bleach is approximately 10%.
Findings:
- Hyperchloremic acidosis was observed, likely from the reaction of NaOCl with gastric hydrochloric acid, forming hypochlorous acid and chlorine.
- Ingestion of 500 ml of bleach led to a substantial sodium load (673 mmol).
- This large sodium load resulted in clinically significant hypernatremia.
Implications:
- Prompt recognition and management of metabolic derangements are essential in cases of bleach ingestion.
- The high sodium content of bleach contributes significantly to its toxicity.
- Further research into specific antidotes or treatment protocols for NaOCl poisoning may be warranted.