Ethylene glycol intoxication: pathophysiology, diagnosis, and emergency management

Acute ethylene glycol intoxication is a medical emergency that, if not diagnosed correctly and treated aggressively, will lead to serious neurologic, cardiopulmonary, and renal dysfunction, and may result in death. Ethylene glycol toxicity is characterized by severe metabolic acidosis with high anion and osmolal gaps, and calcium oxalate crystals in the urine. Early recognition of ethylene glycol intoxication and rapid, aggressive use of large amounts of sodium bicarbonate, ethanol infusion, and hemodialysis may improve survival.