Diphoterine

An in vitro manipulation helps to objectify the variations of pH and of temperature when we add to 1 mL of tetrachloride of titanium, an increasing volume of water then, in comparison, an increasing volume of Diphoterine . 

The reaction instantaneously generates a release of energy and an increase of temperature. Very quickly, when adding 5 mL of water or Diphoterine , this exothermic effect decreases, because of dilution, and the temperature returns to 20°C. 

On this purely physical aspect water and Diphoterine have the same effect. However, there is a big difference on the chemical side. From this point of view, Diphoterine , with a very low volume added, restores the pH toward the acceptable physiologic zone very quickly, while water maintains a very corrosive pH (Fig. 3.65). 

Evolution of the pH and temperature variation ot 1 ml of 99% TiCI4 with an increased volume of water versus Diphoterine complete experiment... 

The same release of energy occurs with trichloromethylsilane than with titanium tetrachloride. We observed the same conclusions than in the previous paragraph using water compared Diphoterine (Fig. 3.69). 

Beyond the simple polyvalent dilution of a water wash, the wash (Fig. 3.83) of various types of corrosives by Diphoterine an amphoteric agent shows the need and proht of the use of an active answer. 

In experiments in which we have used medium supply for cell cultures with 800 mOsmol/kg, we have found the cellular resistance, needed to keep cellular integrity without exploding cells, to be acutely above 280 mOsmol/kg [41]. Lower osmolarities resulted in lysis of cells. The rinsing concept of Diphoterine with an osmolarity of 820 mOsmol/kg reflects a stepwise reduction of the osmolar constitution of the tissues [42]. 

This was not a subject of systematic research except the approval that phosphate buffer was preferred due to data of the 1970s from Laux [4]. Up to now, there is only one scientific prove out of chemical neutralization experiments on borate buffer, phosphate buffer, or Diphoterine in the beaker [5]. In clinical context, there is only one systematic study of Merle and Gerard who... 

Fig. 6.2 Healthy corneal stroma, aqueous fluid, and corneal stroma osmolalities after prolonged 16 day treatment with phosphate buffer (Isogutt ), saline solution, and Diphoterine ...

Isogutt NaCI 0.9% Diphoterine Aqueous todays burnt 16 rinsing days rinsing... 

All burnt comeal stroma show lower osmolarity due to the loss of ions by continuous rinsing. The higher osmolar Diphoterine adds some ions to the burnt corneal stroma, but its osmolarity is still much lower than the one of the aqueous humor. It is obvious that there is no change in osmolarity in aqeous humor in healthy and in burnt eyes due to autoregulation of this milien by the ciliary body secretion. The considerable differences in tissue osmolarity indicate that there will be a strong fluid uptake into the comeal tissue, resluting in opacity. This indicates a severe water uptake and a lack of the endothelial pumping function. 

This severe water uptake is confirmed by the next figure (Fig. 6.3) showing the hydration of the cornea after bum that is kept untreated for up to 7 days or respectively treated by three times daily rinsing of the eye with phosphate buffer (Isogutt ), saline solntion, or Diphoterine solution for 16 days. 

Higher osmolarities in early rinsing have effect on the integrity of cells and stabilize the cellular bodies against the water influx. This concept is realized by Diphoterine of 820 mOsmol. 

The same tissue culture is incubated with Diphoterine of 820 mOsmol (Fig. 6.9), and shows cells with a stabilized low volume and without any lack of integrity. 

The comparison of all rinsing fluid based on their effect on the anterior chamber pH is presented in the following figures. All experiments were repeated five times and mean and standard deviation are given to elucidate the variance of the experimental set up. There is clear evidence that only some solutions buffer acids and alkali (Eigs. 6.11-6.13). These solutions are polyvalent and are Diphoterine and the phosphate buffer of higher concentration like the plum pH neutral. Borate buffer has a high capacity to buffer alkali but a low capacity to buffer acids. 

The curves represent the intraocular pH over time measured on real rabbit eyes that are burnt with 50 pL of 2M NaOH for 20 min and on the cornea for 20 s with a filter paper. The rinsing solutions were applied for 15 min with a flow of 66 mL/min. All curves represent five repeated experiments. Original data were published by Rihawi et al. in 2005. There is a considerable later onset of pH rise with low osmolarity rinsing and a lower extent of pH rise with tap water rinsing and an earlier onset of pH rise in all solutions containing ions like saline, Diphoterine , phosphate buffer, and RINGER lactate. 

The ratio of glutathione to reduced glutathione is reestablished only by Dimercaprol and Diphoterine (Fig. 6.19). 

Thus with Diphoterine and Dimercaprol, there is a considerable improvement of the physiological capacity of chemical decontamination. By this, the use of polyvalent solutions in first aid offers a considerable advantage as the best currently available treatments. 

With the concept of Diphoterine , even the restoration of glutathione contents in the burnt cornea can be achieved without any action of the regenerating tissues. This is a major value. Dimercaprol has similar effects and might be an opportune alternative, but this drug does not act on alkali and acids as well as the buffers and amphoteric substances do. 

Finally, there is a case where the injured has not been administered care before arrival at the hospital, which may be several hours after the accident. If the symptoms unfortunately appeared and progressed, it is absolutely necessary to stop the action of the chemical before initiating treatment. Polyvalent active solutions, such as Diphoterine , are the most effective solutions to stop the chemical, avoid aggravation, and consider secondary therapy under the best possible conditions. 

Viala, B., Blomet, J., Mathieu, L., Hall, A.H. (2005). Prevention of CS tear gas eye and skin effects and active decontamination with diphoterine preliminary studies in 5 French gendarmes. J. Emerg. Med. 29 5-8. 

Flush eyes with copious amounts of tepid 0.9% saline or water for at least 15 min. Diphoterine solution can be used for decontamination of both eyes and skin after exposure to lacrimators (Viala et al., 2005). Ocular signs resolve... 

Diphoterine is a product for chemical spatters on the eye and skin. Prevor Laboratory in France manufactures this odorless, colorless liquid dispensed as an eye wash or skin decontamination spray. It is composed of an aqueous solution to wash many chemical families and pull hydrophilic chemical agents away from the surface of tissues, an amphoteric solution that acts on acids and bases and restores the tissue physiological pH, and a hypertonic solution that stops penetration of corrosive chemicals into tissues. The pH is slightly alkaline (pH 1.2-1.1) and is sterile. Although not classified as such in the USA, it is classified as a medical device in Europe, Canada, Australia, and Brazil (www.prevor.com). 

The bulk of evaluation of Diphoterine has occurred in the European workplace. There, it has been reported not to be irritating to normal human eyes or skin, and is essentiaUy... 

Mathieu, L., Burgher, F., Hall, A.H. (2007). Diphoterine chemical splash decontamination solution skin sensitization study in the guinea pig. Cutan. Ocul. Toxicol. 26 181-7. 

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