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Trichloroethylene Toxicity
How Should Patients Exposed to Trichloroethylene Be Treated and Managed?

Course: WB1112
CE Original Date: November 8, 2007
CE Renewal Date: November 8, 2010
CE Expiration Date: November 8, 2012
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Learning Objectives

Upon completion of this section, you should be able to

  • describe the principal treatment strategy for treating and managing TCE poisoning.


There is no antidote for TCE poisoning. Treatment consists of support of respiratory and cardiovascular functions.

Acute Exposure

In the case of dermal contact with liquid TCE, contaminated clothes should be removed and the affected areas washed with copious amounts of soap and water. Direct eye splashes require irrigation for at least 15 minutes. Corneal epithelium damage usually resolves spontaneously after irrigation.

Patients should be removed from the contaminated environment as soon as possible; begin artificial ventilation, if needed. Those with altered mental status or apparent respiratory insufficiency should receive supplemental oxygen. If the patient's pulse is absent, cardiopulmonary resuscitation should be initiated.

Gut decontamination (emesis, lavage, or saline cathartic) is recommended if it can be initiated within two to three hours after the ingestion of more than a swallow of TCE. However, the effects of these measures have not been clinically evaluated. If emesis is considered, administer the emetic only to patients who are fully conscious and have an intact gag reflex. Activated charcoal has not been proven to absorb TCE, but, in general, it effectively decreases absorption of most ingested toxic agents.

  • No data are available on the ability of hemodialysis or hemoperfusion to increase TCE elimination.
  • No specific antidotes exist (Meditext 2004).
  • Patients with serious TCE toxicity should be monitored for the possible development of arrhythmias.
  • When diarrhea is present, monitor for the development of electrolyte abnormalities and screen for the possible development of hepatorenal dysfunction (Meditext 2004).
  • Sequelae are unusual in acute exposures but reported (Lawrence and Partyka 1981; Feldman, White et al. 1985; Szlatenyi and Wang 1996).

Chronic Exposure

No known treatment for chronic exposure to TCE exists. Potentially involved organ systems should be independently evaluated, and supportive measures should be initiated.

Key Points

  • Removal from the source and supportive care is the recommended treatment for acute TCE exposure.
  • Symptomatic treatment is recommended for chronic TCE exposure.

Progress Check

17. The primary strategy for managing TCE poisoning patients includes

A. supportive measures
B. ventilation therapy
C. reduction or elimination of exposure
D. All of the above.


To review relevant content, see Introduction and Acute Exposure in this section.

18. All of following statements are correct EXCEPT

A. Symptoms related to chronic exposure tend to worsen during exposure and improve when exposure ceases.
B. CNS symptoms due to acute TCE inhalation exposure are transient but may linger for hours after exposure ceases.
C. Supportive care directed to adequate ventilation and circulation should be provided.
D. There is a specific antidote for TCE poisoning.


To review relevant content, see Chronic Exposure in this section.

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