Related Experiment Video
Updated: Jun 27, 2026
06:12
Inducing Acute Liver Injury in Rats via Carbon Tetrachloride (CCl4) Exposure Through an Orogastric Tube
Published on: April 28, 2020
Ethylene glycol poisoning presenting with a falsely elevated lactate level.
Sandra Verelst1, Pieter Vermeersch, Koen Desmet
1Department of Emergency Medicine, University Hospitals Leuven, Campus Gasthuisberg, Leuven, Belgium. sandra.verelst@uzleuven.be
Clinical Toxicology (Philadelphia, Pa.)
|November 19, 2008
Summary
Early diagnosis of ethylene glycol poisoning is critical. Falsely elevated lactate on blood gas analyzers can delay diagnosis, but a "lactate gap" may aid detection.
Area of Science:
- Toxicology
- Clinical Chemistry
Background:
- Early diagnosis of ethylene glycol poisoning is vital to prevent severe outcomes.
- Metabolites of ethylene glycol, like glycolate, can interfere with diagnostic tests.
Observation:
- A case presented with falsely elevated lactate levels on a blood gas analyzer.
- Point-of-care analyzers may yield false readings due to differing measurement methods.
Findings:
- Glycolate interference can cause inaccurate lactate measurements in certain analyzers.
- A "lactate gap" measured using distinct technologies can help diagnose poisoning.
Implications:
- Awareness of analyzer interference is crucial for emergency department and critical care settings.
- Utilizing a "lactate gap" offers an efficient diagnostic strategy for ethylene glycol poisoning.
Related Concept Videos
01:29Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
01:25Diabetic Ketoacidosis l: Introduction
DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
01:22Diabetic Ketoacidosis ll: Pathophysiology
Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
01:26Pharmaceutical Poisoning: Potential Scenarios
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
01:26Pharmaceutical Poisoning: Treatment Strategies
Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
01:30Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...