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Severe poisoning after accidental pediatric ingestion of glycol ethers
George S Wang1, Shan Yin, Brian Shear
1Denver Health and Hospitals, Rocky Mountain Poison and Drug Center, 777 Bannock St #0180, Denver, CO 80204, USA. george.wang@childrenscolorado.org
Insights
A child
Area of Science:
- Toxicology
- Pediatric Medicine
- Environmental Health
Background:
- Human glycol ether poisoning is infrequently documented.
- Brake fluid contains various glycol ethers, posing a poisoning risk.
Observation:
- A 22-month-old boy ingested a significant amount of brake fluid.
- He presented with somnolence and metabolic acidosis within hours of ingestion.
Findings:
- Fomepizole administration showed no clinical or metabolic improvement.
- Hemodialysis was administered approximately 8 hours post-ingestion.
- Symptoms resolved following hemodialysis, leading to an uneventful recovery.
Implications:
- This case highlights the potential toxicity of glycol ethers in brake fluid.
- Hemodialysis may be an effective treatment for severe glycol ether poisoning.
- Further research is needed on glycol ether toxicity and treatment protocols.
Abstract:
Human glycol ether poisonings are sparsely reported in the medical literature. We describe a healthy 22-month-old boy who accidentally drank up to 330 mL of brake fluid containing a 75% bleed of various glycol ethers (5%-50% polyethylene glycol monomethyl ether, 15%-40% triethylene glycol monoethyl ether, 1%-30% triethylene glycol monomethyl ether, 1%-25% triethylene glycol monobutyl ether, 1%-20% polyethylene glycol, monobutyl ether, 1%-20% triethylene glycol, and <10% of other glycol ethers). Within 4 hours, he became somnolent and developed a persistent metabolic acidosis. Thirty minutes later, he received 1 dose of fomepizole. Neither progression nor improvement in clinical or metabolic status was noted after the fomepizole. He received hemodialysis for 3 hours ∼8 hours after ingestion, and his symptoms resolved resulting in an uneventfully recovery.
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