No specific treatments are available for acute tetrachloroethylene exposures (Ellenhorn MJ 1988; Stutz DR 1992).
Data from humans are insufficient to determine an ingestion level at which emesis should be induced. If a gag reflex is not apparent, emetics should not be administered because the patient could breathe in the gastric contents. Gastric lavage may be useful if the person has recently ingested a large amount of tetrachloroethylene. The clinical value of charcoal and cathartics in this setting is not proven.
If a worker is exposed to a spill in which the clothing has become soaked with tetrachloroethylene, the contaminated clothing should be removed without endangering health care personnel. Supportive care directed to adequate ventilation and circulation should be provided. Moderately to severely exposed patients should have cardiac monitoring for possible dysrhythmias. Oxygen should be administered to those patients if respiratory depression has occurred.
CNS symptoms due to acute tetrachloroethylene inhalation exposure are transient but may linger for hours after exposure ceases. Patients usually recover rapidly without permanent neurological sequelae if hypoxia and shock have been prevented (Patel, Janakiraman et al. 1977) .
Because more than 80% of tetrachloroethylene is eliminated in exhaled air, controlled hyperventilation may enhance its elimination.
Hyperventilation therapy (volume, 10 liters/minute) was successfully used in a comatose 6-year-old who had ingested 8 -10 milliliters of pure tetrachloroethylene 2 hours before. The initial tetrachloroethylene blood level was 2,150 μg/dL. On the fifth day, when hyperventilation was terminated, the blood level had fallen to less than 100 μg/dL. However, the extent to which hyperventilation contributed to the child's recovery remains uncertain, and the effectiveness of hyperventilation in tetrachloroethylene overdose has not been adequately validated (Koppel, Arndt et al. 1985). |
