Isopropanol ingestion: interpretation of blood concentrations and clinical findings

We evaluated blood concentrations and clinical findings in 17 cases of isopropanol (IPROH) ingestion seen over a 8.5 year period at our institution. Eight ingestions involved IPROH alone ("pure") while the remainder involved at least ethanol in addition to IPROH ("mixed"). Fourteen patients had a history of alcoholism. Admission blood IPROH concentrations ranged from 5 to 70 mg/dL while the concentration of the acetone metabolite ranged from nondetectable to 220 mg/dL. The mean acetone concentration was significantly higher for "pure" ingestions than for "mixed" ingestions (p less than 0.05); however, the mean IPROH concentrations showed no significant difference. The mean anion gap was significantly higher for "mixed" ingestions than for "pure" ones (p less than 0.01). Fifteen patients were either alert or lethargic while two, who had ingested no compounds other than IPROH, were comatose. The most common other physical findings were tachycardia (10 cases), decreased deep tendon reflexes (5), dysarthria (4), and ataxia, hypotension, fever, and mydriasis (3 cases each). None of the findings including level of consciousness showed statistically significant correlation with the IPROH concentrations. Twelve patients were hospitalized; eleven of these recovered with supportive care alone. One patient expired from trauma suffered in a motor vehicle accident.