Protection against alkali injury to rabbit esophagus by CO2 inhalation.

Lye ingestion, a poisoning with no known effective treatment, frequently results in esophageal ulceration and healing by stricture formation. Tissue injury by lye is due to its alkalinity, and so therapy is logically directed at neutralization by acid. Here we describe a novel method, the inhalation of CO2, for the rapid delivery of (carbonic) acid capable of neutralizing tissue and luminal alkalinity. We also show that CO2 inhalation in anesthetized rabbits provides protection to the lye-exposed esophagus against transepithelial necrosis. This method has the potential to protect the human esophagus against lye injury, because it is relatively safe, rapidly effective, and can be administered in the field under emergency circumstances.