An approach to dialysis for ethylene glycol intoxication

Eleven cases of ethylene glycol ingestion were retrospectively analyzed for presentation, treatment, and outcome. Patients were grouped according to the time it took to receive medical attention, and whether or not they received I continuous hemodialysis (CHD) versus intermittent hemodialysis (IHD). Six patients presented within 12 h of exposure (Group 1), whereas 5 patients presented later (Group 2; range 48-120 h). Comparisons were made for age, ethylene glycol level, anion gap, osmolar gap, pH, admission creatinine level, time from ingestion to presentation, total time spent on hemodialysis, number of dialysis treatments, recovery time, recovery creatinine, hospital length of stay, and status. Significant differences were observed for ethylene glycol level, osmolar gap, and presentation time. Ten of the 11 patients received single pass hemodialysis, and 5 of these received I CHD. Of the 5 patients who received CHD versus the 5 patients who received IHD, none developed complications (p=0.004). Patients who presented within 10 h of exposure had fewer complications than those who presented > 12 h after exposure Timely CHD is superior to IHD in treating ethylene glycol intoxication. An adeQuate time course of hemodialysis can be approximated using the ethylene gycol index, and may eliminate reliance on ethylene glycol levels in determining adequate endpoints of dialysis in treating poisoned patients.