From Big Medical Encyclopedia

ACETIC ACID (ethanoic acid, metankarbonovy turned sour

that) — monobasic organic acid of an aliphatic series,

SNDSOON. In a human body and other mammals At. to. forms atsetil-KOA (monothioester U. to. and KOA), a metabolic role to-rogo is very big. He is a donor of the active acetyl group (the active acetyl rest, active acetate) which is widely used in processes of a metabolism and energy (see), such as a cycle tricarboxylic to - t (see. Tricarboxylic acids a cycle), synthesis of fatty acids (see), ketone bodies (see), sterols (see) and an ubikhinona (see Coenzymes). Atsetil-KOA participates also in biosynthesis of acetylcholine (see), the atsetilglyukozamina (see the Glycosamine) and appealing of nek-ry medicinal substances, napr, streptocides and xenobiotics (the substances alien to an organism), and in plants atsetil-KOA is a predecessor of terpenes (see) and acetogenins. In medicine derivatives At. to. are used as pharmaceuticals — acetylsalicylic acid (see) is analgesic and an antipyretic, acetic lead salts (see) and aluminum (see) apply as astringents at inflammatory diseases of skin and mucous membranes, potassium acetate (see) — as osmotic diuretic. In practice a wedge, and medical - biol. laboratories U. to. use for neutralization and acidulation of solutions, and also for preparation of buffered solutions (see). At. to. apply as the acetylating substance in production of cellulose acetate, to receiving atsetilproizvod-Ny — ethers U. to. (acetates), used as solvents (ethyl of quotes), monomers (vinyl acetate) and food essences (isoamyl acetate, pear essence), and also in the food industry for conservation (see) foodstuff. At. to. possesses the cauterizing action on skin and mucous membranes and the action expressed rezorb-tivntm; on the productions connected with receiving and use At. to., it can represent professional harm.

At. to. it is eurysynusic in a plant and animal life in a stand-at-ease and in the form of the derivatives — salts and ethers. Many bacteria and mushrooms are capable to split organic compounds with education At. to., owing to what it is often formed at fermentation (see) and rotting (see). At the acetic fermentation caused by Acetobacter aceti and other acetobacters there is an aerobic oxidation of alcohol to At. to., edges as a by-product it is formed also at lactic, propionate PI butyrate fermentation.

At. to, represents a colorless

liquid with a pungent smell, t ° 16,75 °,

pl ’’

G.P 118,1 °, density at 20 ° [d]20 1,0492, 20 1

index of refraction [n]D 1,3730; At. to. belongs to slabodissotsiiruyushchy to - there, its dissociation constant is equal 1,75 10-5 (25 °), Anhydrous (ice) At. to. a goryucha, warmth of its combustion makes 874 J / mol. Acetic to - that forms with air explosive mixes, concentration limits of a vzryyuayemost to-rykh a sost z l yat 3,3 — 22%. With in to y, with pi a mouth, ether U. to. mixes up in every respect, with carbon sulfur does not mix up. During the mixing with water density of solution U. to. at first increases, and then decreases: the maximum density (1,075) 77% have solution acetic to - you.

In the cleared look At. to. it was for the first time received by the Russian chemist T. E. Lovits in 1789, its structure was established in 1814 by Swedish x and m and to about I. B m of ER of c ate. and at with about m.

In the industry At. to. receive liquid-phase oxidation of butane, a carbonyl and a rovaniye of methanol, oxidation of acetaldehyde, food At. to. receive fermentation of alcohol. World production At. to. makes 3,5 — 3,7 million t a year (1980).

In the main ways of education At. to. in a human body and animals are (3 oxidation fat to - t and oxidizing decarboxylation (see) iirovinogradny to - you (pyruvate). At the person and mammals free At. to. forms with To And atsetil-KOA (active acetate) in the presence of ATP as an energy source. Reaction -

enzyme atsetil-KOA-sintetaza talizirut (KF acetic


to - that 4“ KOA + ATP —> atsetil-KOA + + AMF + a pyrophosphate. Per day in a human body it is formed apprx. 500 g acetic to - you in a look atsetil-KOA.

Qualitative test At. to. it is based on its turning into ethers, an ureide or benzilizotiuroniye-vy salt and their identifications, and also on formation of acetone (see) during the heating with calcium carbonate and staining reaction on acetone. Quantitative definition At. to. consists in it craved meter and ches a lump titration after an otgonka (see. Titrimetric analysis).

Acetic acid as professional harm. Intoxications At. to. at disturbance of the accident prevention are possible on the productions connected with its receiving and use in chemical laboratories, at breath by air of big tanks where wine, in silage towers and holes, etc. was stored. At. to. is one of the widespread feedstuffs used in life as nutritional supplement, for house conservation, etc. It is applied in the form of acetic essence (80% acetic to - that) and vinegar (3 — 15% water solution U. to.); until the end of 19 century vinegar as foodstuff was prepared by fermentation of grape wines: such vinegar contained apprx. 5% acetic to - you.

A lethal dose anhydrous At. to. — 12 — 15 ml, acetic essence — 20 — 40 ml, vinegar — apprx. 200 ml. At. to. possesses the expressed local and resorptive action, on toksikol. classifications it treats poisons of skin and resorptive action. At hit on skin even of 30% of solution U. to. note emergence of a chemical burn (with a necrosis of fabrics in hard cases) and formation of slowly healing ulcers. At influence of vapors U. to. observe irritation of a mucous membrane of upper respiratory tracts and a conjunctiva of eyes, burning sensation in a throat, cough, a stethalgia, the complicated breath, nausea, vomiting.

Hron. intoxication at constant stay of people in a working zone, air a cut contains couples At. to., it is characterized by hypertrophic and atrophic rhinitises (see), pharyngitises (see), laryngitis (see), bronchitis (see), the progressing destruction of teeth, conjunctivitis (see); in the conditions of long work in the atmosphere of vapors U. to. at working noted emergence of a pneumosclerosis (see).

Constant intake of rather weak solutions U. to. (in the form of marinades, sauces, etc.) can lead to development hron. gastritis (see).

Treatment at hron. intoxications in couples At. to. it has to be carried out at the unconditional termination of contact with poison. Gastritis treat by usual methods: to lay down. food, pathogenetic therapy, etc. At damage of upper airways a symptomatic treatment. Treatment of the burns of skin caused At. to. — see Burns.

Acute intoxication as a result of intake of acetic essence or At. to. high concentration or inhalation of its concentrated vapors first of all the wedge, is characterized by a picture of a burn disease of a chemical etiology, during a cut it is possible to allocate stages of ekzo-toxic shock and initial displays of intoxication, a toxaemia, inf. complications, stenozirovaniye and burn adynamy and, at last, stage of recovery.

Distinguish acute poisonings At. to. easy, average and heavy degree. Poisonings of easy degree are characterized by a chemical burn, to-ry extends to a mucous membrane of an oral cavity, a throat, a gullet and has character of a catarral and serous inflammation; note a toxic nephropathy of easy degree, insignificant disturbances of blood circulation in a liver. At poisonings of average degree the burn covers a mucous membrane of an oral cavity, a throat, a gullet, a stomach and has character of a catarral and serous or catarral and fibrinous inflammation; are observed ekzotoksichesky shock in the compensated phase, hemolysis (see), a haemoglobinaemia (5 — 10 g! k), hemoglobinuric nephrosis, toxic nephropathy of average degree, toxic hepatopathy easy or moderately severe. At a serious poisoning At. to. the burn extends to a gullet, a stomach, a small bowel and has character of an ulcer and necrotic inflammation; develop a heavy chemical burn of upper respiratory tracts, ekzotoksichesky shock and hemolysis, the haemoglobinaemia is higher than 10 g/l, acute haemo - a globinuriyny nephrosis, a toxic nephropathy and a toxic hepatopathy of average or heavy degree. The course of poisoning, as a rule, is complicated by an esophagitis (see), gastritis (see), a tracheobronchitis, heavy hemorrhagic pneumonia (see), reactive pancreatitis (see), reactive peritonitis (see) etc.

Klin, a picture of acute poisoning At. to. (1 — the 5th days) it is characterized by severe pain in an oral cavity, a drink and a gullet, vomiting, the dysphagy connected with hypostasis of a gullet and its sharp morbidity.

The burn of a stomach causes the sharp pain in epigastric area which is often irradiating in a back; the burn of intestines is followed by his paresis. Pallor and a cold snap of skin against the background of a hyperthermia (a stage of a toxaemia) note the psychomotor excitement which is replaced by confusion of consciousness and full indifference to surrounding. Systolic pressure increases to 150 — 160 mm of mercury., then sharply decreases, at the same time the central venous pressure falls, tachycardia and short wind accrue, release of urine decreases. At victims the expressed hypovolemia, deep disturbances of acid-base equilibrium (see) with the phenomena of a decompensated metabolic acidosis develops (see). As a result to hemoglobin of a riya (see) urine is painted in red and cherry color. In all cases of poisoning At. to. coagulating activity of blood changes: at poisonings

of easy and average degree note a tendency to hypercoagulation, at heavy — to hypocoagulation.

In 1 — the 2nd days big danger to life of the victim represent development aspiratsi-onno-obturatsionnoy forms of disturbance of external respiration, a cut is shown by asphyxia (see), and (at a serious poisoning) gastric bleeding.

A lethality at acute poisonings At. to. it is high, the main reasons for death on 1 — the 2nd days are intoxication and shock.

Diagnosis hron. and acute poisoning At. to. put taking into account a toxicological situation, on the basis of the toxicological anamnesis and features a wedge, pictures.

Differential diagnosis of acute poisonings At. to. various degrees of severity does not present considerable difficulties. The expressed hemolysis, as a rule, helps to distinguish poisoning At. to. from poisonings with other poisons of the cauterizing action. Unlike other hemolitic poisons poisoning with acetic acid is combined with the expressed burn of a digestive tract.

First aid and urgent t e r ii and I. The immediate measures directed to removal At. to. from a digestive tract of the victim; at a pre-hospital stage:

the gastric lavage (8 — 10 l of a cold water) by means of the thick probe, is possible with buzhy, before washing enter subcutaneously 1 ml of 2% of solution of Promedolum, 2 ml of 2% of solution of a papaverine of a hydrochloride, 1 ml of 0,1% of solution of Atropini sulfas for the purpose of reduction of pain and a spasmolysis. This procedure is effective in the first 6 hours after nri-

an ema At. to., further its efficiency decreases, in 12 hours the gastric lavage is inexpedient. A tubeless gastric lavage at poisoning At. to. it is dangerous since at artificially caused vomiting acid can get into a gullet for the second time. Use of hydrosodium carbonate for the purpose of acid removal in a stomach is inadmissible since the carbon dioxide gas which is formed at neutralization causes an acute gastrectasia and strengthening of bleeding. As corrective magnesium oxide (magnesia usta) or Almagelum with the subsequent gastric lavage can be used. Greasing or irrigation of an oral cavity and a throat of 2 — 5% by solution of cocaine of a hydrochloride or 0,5% solution of Dicainum is shown; at hypostasis of a throat — aerosol inhalation of penicillin with solution of ephedrine or adrenaline. The victim can allow to swallow of pieces of ice, oil, ovalbumin. Immediate hospitalization is shown. In would hold events for removal of a pain syndrome: morphine, Promedolum,


Omnoponum on 1 ml 3 — 4 times a day; Atropini sulfas — 1 ml of 0,1% of solution, a papaverine a hydrochloride — 2 ml of 2% of solution, Platyphyllinum hydrothat rtrat — 1 ml of 0,2% of solution subcutaneously 6 — 8 times a day; glyukozonovo-kainovy mix (300 ml of 5% of solution of glucose, 50 ml of 40% of solution of glucose from 30 ml of 2% of solution of novocaine) intravenously 2 — 3 times a day; 1 ml of 0,5% of solution of a haloperidol intravenously (in combination with narcotic analgetics — 1 ml of Promedolum or Omnoponum) or neuroleptanal-geziya — 0,1 mg of fentanyl and 5 mg of Droperidolum in 20 ml of 5 — 40% of solution of glucose 2 — 3 times a day. Inside — reception of Almagelum And with anaesthesin.

Treatment of ekzotoksichesky shock consists in infusional therapy under control of indicators of a hemodynamics (intravenously enter colloid plazmozamenyayushchy solutions — Polyglucinum, reopoliglyukin, hypertensive 10—15% solution of glucose with insulin), and also in elimination of metabolic disturbances, hemolysis, a toxic coagulopathy (administration of heparin), correction of hemodynamic frustration. For treatment of a burn of a digestive tract appoint antibiotics of a broad spectrum of activity, spasmolysants, oil emulsions. Patients with heavy burns need long hormonal therapy in combination with introduction of antibiotics; at cicatricial esophageal stenoses (see the Gullet, damages) the main method of conservative treatment is bougieurage (see)*. At a chemical burn of the upper respiratory tracts which are shown a syndrome of mechanical asphyxia the tracheostomy is shown (see).

Further treatment — symptomatic, the dietotherapy is shown.

Examination of t r at d about with p wasps about N about with t and. The patients who had poisoning At. to., are subject to dispensary observation: at

a burn of a stomach of easy degree — 6 months, moderately severe — till 1 year, after a heavy burn — not less than 5 years. A basis of dispensary observation is endoscopic control.

At initial forms hron. intoxications At. to., the current to-rykh is not inclined to progressing, the diseased can be temporarily transferred to other work which is not connected from a profvrednostya-ma. At permanent disturbances of the state of health of the diseased discharge of the work connected with profvrednost (see Examination). In cases of a serious poisoning At. to. the hospitalization which were injured later go to medical labor commission of experts (see) for definition of group of disability (see) owing to an occupational disease or loss of professional working capacity (see).

Prevention of poisonings with acetic acid comes down to improvement tekhnol. process of receiving At. to., sealing of the equipment, increase in efficiency of ventilation (see) workrooms, mechanization of transportation and pouring to - you. For protection of skin and eyes from hit At. to. use of overalls from acid protective fabric (see Clothes special), a boot, protective gloves, points (see), the guards from plexiglas covering the face, industrial gas masks (see) is obligatory. Carrying out preliminary (before employment) and periodic medical examinations is necessary (see. Medical examination), control of a condition of the air environment in a working zone. For the prevention of poisonings At. to. in life it is necessary to follow rules of its storage (in the place, unavailable to children). It is dangerous to store acetic essence in the house.

Extremely milk at with t to them and I am a game of c entrats and I vapors U. to. in air of a working zone

of 5 mg/m3.

Acetic acid in the medicolegal relation. The conclusion

the 06th poisoning At. to. as

to a cause of death the wedge, manifestations, morfol is based on set. a picture and results additional a method about in and with with l e d about van and y. 11ep red-

ekzotokspchesky shock, mechanical asphyxia (at the expense of hypostasis of a throat), an acute renal failure, acute blood loss (on

1 — the 2nd days after poisoning or at the beginning of the 2nd week after reception of poison at rejection of a nekrotizirovan-ny epithelium of a mucous membrane of a gullet and stomach), pulmonary insufficiency (can be of wasps a stvenny cause of death at hemorrhagic pneumonia).

At an outside research of a corpse yellowness of skin and scleras, signs of a burn around a mouth and on a neck are characteristic. At an internal research, in addition to a specific smell, the necrosis of a mucous membrane of an oral cavity, a throat, the lower third of a gullet, stomach in the form of dim gray-brown films — the layers of a nekrotizirovanny epithelium which are strongly connected with the subject fabrics is characteristic. Necrotice changes in a stomach cover or the whole sites of a wall (usually in the field of the gatekeeper), or only tops of folds of a mucous membrane. Less often the necrosis extends to all thickness of a wall with development gan-grenozno-gekhmorragicheskogo gastritis and perforation of a stomach. Over time the mucous membrane of a gullet and a stomach becomes sharply edematous, bulked up, gets brown-black coloring due to formation of acid hematin and at easy pressing is torn away in the form of a mold of body. Kidneys are increased, saturated dark red color, on a section the border between cortical and marrow is indiscernible. In a liver — focal necroses and hemorrhages. Morfol. changes of respiratory system are shown in the form of a burn of a mucous membrane of a throat, an epiglottis, phonatory bands, a trachea and bronchial tubes, the expressed inflammatory changes in lungs.

At gistol. a research the most characteristic changes find in kidneys: in 2 hours after reception of poison the bringing arterioles of a spazmirovana, contain gemolizirovanny blood, a part of renal balls of an outside zone of cortical substance fallen down, in gleams of capsules of renal balls and tubules light pigmental bodies, in an epithelium of gyrose tubules of adjournment of a pigment in the form of small granules come to light. If death came on 3 — the 5th days after reception of poison, find sharp ischemia of cortical substance, a necrosis of an epithelium of gyrose tubules with a rupture of basal membranes. Since - x days reparative processes with formation of pigmental cylinders prevail. In tissue of a brain note a sharp plethora of vessels, pericellular and perivascular hypostasis, near myelin fibers I am visible meta chromatic with at bstash sh.

In went. - kish. a path note a sharp plethora with sites of a necrosis and extensive hemorrhages, leukocytic and lymphocytic infiltration in superficial and podelizisty layers.


At court. - a chemical research U to. from biol. material isolate extraction by alcohol with the subsequent alkalinize it, evaporation, acidulation of a solid residue and an otgonka with water vapor, or At. to. receive directly from objects wet distillation after preliminary acidulation. Qualitative test At. to. carry out on reaction of formation of acetone in the presence of oxide and calcium carbonate. Contacting with about-nitrobenza degidy, acetone turns into indigotin therefore solution is painted in blue color. Other method is based on heating of a solid residue of the extraction containing At. to., with dry arsenous anhydrite or salt arsenous to - you. At the same time there is an off-flavor of oxide of cacodyl. Quantitative definition At. to. carry out by a neutralization test.

See also Poisonings.

Bibliography: And N d r yu to and A. A. and Borisov Yu. E. N. About the most dangerous complications at poisoning with acetic acid, Owls. medical, No. 4, page 143, 1974; Harmful substances in the industry, under the editorship of N. V. Lazarev and E. N. Levina, t. 2, page 5, L., 1976; L. I. Haler and B and and p A. P. O to clinic and therapy of poisoning with acetic essence, Klin, medical, t. 46, N ° 1, page 140, 1968; To and with with and A. G N. Poisonings with acetic essence, in the same place, t. 44, No. I, page 137, 1966; Loeb

of N. N. Himiya's maidens and technology of organic and petrochemical processing, M., 1981; Luzhniki E. A. Clinical toxicology, page 266, M., 1982; Acute management at acute poisonings, the Reference book on toxicology, under the editorship of S. N. Golikov, page 267, M., 1977;

The guide to forensic medical examination of poisonings, under the editorship of R. V. Berezhny, etc., M., 1980; The Reference book on

professional pathology, under the editorship of L. N. Gratsianskaya and V. E. Kovshilo, page 112, L., 1981; Forensic medicine, under the editorship of V. M. Smolyaninov, M., 1982;

Whyte A., etc. Fundamentals of biochemistry, the lane with English, t. 1 — 3, M., 1981; Capellini A. a. S and of t about e 1 1 i E. Episoido di intossicazione collettiva da anidride acetica ed acido acetico, Med. d. Lavoro, y. 58, p. 108, 1967; Reinhardt J. ii. Kittner E. Berufsbedingte Sauer-schaden der Zahne, Zbl. Arbeitsmed., Bd 25, S. 72, 1975. A. H. Klimov,

D. V. Ioffe (biochemical), I. V. Buromsky (court.), V. S. Filatova (gigabyte.).