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[Accidental glycol poisoning].

A Theurl1, H J Battista, W Fritzer

  • 1Abteilung für Innere Medizin, a. ö. Bezirkskrankenhauses Lienz.

Wiener Medizinische Wochenschrift (1946)
|September 15, 1989
PubMed
Summary
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Immediate intravenous ethanol therapy effectively treated acute ethylene glycol intoxication, preventing renal failure. Parenteral ethanol proved more effective than oral administration in managing serum glycol levels.

Area of Science:

  • Toxicology
  • Emergency Medicine

Background:

  • Acute ethylene glycol intoxication can be life-threatening, potentially leading to renal failure.
  • Early intervention is crucial for managing antifreeze poisoning.

Observation:

  • A patient ingested a lethal dose of monoethylene glycol (100-130 ml) but presented without immediate complications.
  • Intravenous ethanol therapy was initiated, maintaining therapeutic ethanol levels and preventing toxic metabolite formation.

Findings:

  • Intravenous ethanol administration led to a steady decrease in serum glycol levels.
  • Oral ethanol administration resulted in a rebound increase in serum glycol, which was reversed by reinstituting intravenous therapy.
  • The patient maintained normal renal function and electrolyte balance despite significant fluid excretion.

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Implications:

  • Parenteral ethanol is a more effective treatment for ethylene glycol intoxication than oral administration, especially at doses not exceeding 7 g/h.
  • While conservative management with ethanol can be successful, hemodialysis remains a more efficient and rapid elimination method for confirmed glycol poisoning.