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[Surrogate alcohol poisonings].
Outi Lapatto-Reiniluoto1, Risto Ikäheimo
1HUS, Myrkytystietokeskus.
Duodecim; Laaketieteellinen Aikakauskirja
|November 22, 2012
Summary
Surrogate alcohol poisoning from methanol, ethylene glycol, and isopropanol causes deaths in Finland. Immediate treatment for metabolic acidosis is crucial, even with ethanol present, using antidotes like fomepizole.
Area of Science:
- Toxicology
- Emergency Medicine
- Clinical Chemistry
Background:
- Surrogate alcohols (methanol, ethylene glycol, isopropanol) are a significant cause of toxicological emergencies in Finland.
- Diagnosis and severity assessment of surrogate alcohol poisoning are complicated by the frequent co-ingestion of ethanol.
- Metabolic acidosis is a key indicator of severe surrogate alcohol poisoning.
Purpose of the Study:
- To highlight the clinical challenges in diagnosing and managing surrogate alcohol intoxication.
- To emphasize the importance of prompt treatment initiation in suspected cases.
- To discuss the role of different antidotes and supportive therapies.
Main Methods:
- Clinical assessment of patients with suspected surrogate alcohol ingestion.
- Monitoring for metabolic acidosis.
- Analysis of treatment strategies including antidote administration and hemodialysis.
Main Results:
- Delayed treatment due to awaiting concentration analysis can worsen outcomes.
- Ethanol remains a common antidote, but fomepizole use is increasing.
- Reversal of metabolic acidosis and hemodialysis are critical interventions.
Conclusions:
- Immediate treatment for metabolic acidosis in suspected surrogate alcohol poisoning is vital.
- Prompt intervention can mitigate the severity of methanol and ethylene glycol poisoning.
- Antidote choice and supportive care are essential for patient survival.
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