Pulmonary artery catheter deterioration during hydrochloric acid infusion for the treatment of metabolic alkalosis

Abstract

Hydrochloric acid (HCl) infusions for the correction of metabolic alkalosis have been used for 20 yr. In the critical care setting, HCl is usually infused through a central venous or pulmonary artery (PA) catheter. In two patients receiving HCl infusions through a PA catheter, we observed and examined solid yellow particulate material in the aspirating syringe while testing the proximal lumen for patiency. We carried out in vitro investigation infusing PA catheters with 0.1, 0.2, 0.3, and 0.4 normal HCl at 20°, 38° and 42°C for 24 and 48 h. Although frank catheter deterioration could not be documented, the surface and interior of those catheters infused with > 0.1 normal HCl changed texture, indicating a change in catheter composition. Exceeding a concentration of 0.1 normal is not recommended when HCl is infused through PA catheters.