Studies on ethylene glycol poisoning.
Toxicokinetic studies during hemodialysis are presented in two patients with blood ethylene glycol concentrations of 40 and 41 mmol/l, respectively. Treatment involved bicarbonate, ethanol and hemodialysis with a 1.6 m2 dialysator. Both patients developed acute renal failure and one was discharged with permanent cerebral impairment. The other made an uneventful recovery. The average dialysator clearance of ethylene glycol at a blood flow of 200 ml/min was 145 and 148 ml/min, respectively. Assuming a volume of distribution of ethylene glycol of 0.7 l/kg, the dialysator represented about 92 and 95%, respectively, of the total body clearance of ethylene glycol during ethanol treatment. During hemodialysis a blood ethanol concentration of about 15 mmol/l (0.7 g/l) caused a near complete inhibition of ethylene glycol metabolism at ethylene glycol concentrations up to about 25 mmol/l (1.6 g/l). We recommend prompt hemodialysis in ethylene glycol poisoning to supplement alkali and ethanol treatment.
D058186:Acute Kidney Injury / Q000139:chemically induced; D000328:Adult; D001639:Bicarbonates / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000139:chemically induced; D000431:Ethanol / Q000627:therapeutic use; D005026:Ethylene Glycols / Q000097:blood / Q000506:poisoning*; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D006435:Renal Dialysis
D001639:Bicarbonates; D005026:Ethylene Glycols; D000431:Ethanol