Removal of propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy.
We report a case of successful treatment of propylene glycol toxicity by discontinuation of propylene glycol administration and hemodialysis therapy. A critically ill woman receiving high dose intravenous lorazepam therapy is described. Although propylene glycol toxicity often resolves promptly after discontinuation of the causative parenteral source, renal or liver dysfunction may prolong the sequelae of propylene glycol infusion. Hemodialysis efficiently lowers propylene glycol serum concentrations in a manner analogous to extracorporeal therapy for other small molecular weight alcohol intoxications. Therefore, hemodialysis may be a useful component of therapy for critically ill patients exhibiting propylene glycol toxicity in the context of multiple organ dysfunction.
Parker
Mark G
MG
Division of Nephrology and Renal Transplantation, Maine Medical Center, 22 Bramhall Street, Portland, Maine 04102, USA. mparker@maine.rr.com
Fraser
Gilles L
GL
Watson
Donald M
DM
Riker
Richard R
RR
D000140:Acidosis, Lactic / Q000139:chemically induced; D000328:Adult; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008140:Lorazepam / Q000008:administration & dosage*; D009994:Osmolar Concentration; D019946:Propylene Glycol / Q000506:poisoning*; D006435:Renal Dialysis; D012997:Solvents / Q000506:poisoning*
D012997:Solvents; D019946:Propylene Glycol; D008140:Lorazepam