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Hemodialysis for methanol intoxication.

A Gonda, H Gault, D Churchill

    The American Journal of Medicine
    |May 1, 1978
    PubMed
    Summary
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    Prompt hemodialysis is crucial for methanol poisoning, especially when blood levels exceed 50 mg/dl or acidosis is present. Early treatment significantly improves outcomes, though visual impairment can still occur.

    Area of Science:

    • Toxicology
    • Nephrology
    • Emergency Medicine

    Background:

    • Methanol poisoning is a life-threatening condition requiring prompt medical intervention.
    • Hemodialysis is a recognized treatment modality for toxic ingestions.
    • Understanding the optimal timing and criteria for hemodialysis in methanol poisoning is critical.

    Observation:

    • Nine patients with methanol poisoning were treated with hemodialysis, with treatment initiation ranging from 4 to 100 hours post-ingestion.
    • Predialysis methanol levels varied widely (3–570 mg/dl), and all patients presented with acidosis and an increased anion gap.
    • Two patients died, while seven recovered; however, three survivors experienced permanent visual impairment.

    Findings:

    • There was a weak correlation between initial blood methanol levels or anion gap and visual outcomes.

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  • The time interval between methanol ingestion and initiation of hemodialysis appeared more significant than initial biochemical markers for predicting outcomes.
  • Prompt hemodialysis is recommended for methanol levels >50 mg/dl, known ingestion of >30 ml, acidosis, or neurological/visual abnormalities.

    • Implications:

    • Early hemodialysis is vital for improving survival rates in methanol poisoning.
    • While hemodialysis can be life-saving, permanent visual impairment remains a risk, emphasizing the need for timely intervention.
    • Concurrent administration of alkali and ethanol alongside hemodialysis is essential for comprehensive management of methanol toxicity.