Author/Editor		Lainščak, Mitja; Petric, Vlasta; Mikolič, Rudolf; Štivan, Franc
Title		Zastrupitev z etilenglikolom ob istočasnem zaužitju alkohola
Translated title		Ethylene glycol poisoning with concurent ethanol ingestion
Type		članek
Source		In: Bručan A, Gričar M, Fink A, et al, editors. Urgentna medicina: izbrana poglavja 7. Zbornik 8. mednarodni simpozij o urgentni medicini; 2001 jun 13-16; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2001
Volume		str. 259-64
Language		slo
Abstract		Introduction. Ethylene glycol, odourless and colourless fluid with bitter sweet taste causes uncommon but severe poisoning: Well defined clinical picture is divided into three stages and involves central nervous, cardiovascular and renal systems. Diagnosis is based upon history, clinical presentation, metabolic acidosis with elevated anion and osmolal gap and transient presentation of calcium oxalates in urine since ethylene glycol determination if often unavailable. Immediate therapeutic measures are necessary. First aid procedures include spirit ingestion and, if possible, gastric lavage. In hospital we have to correct the patient electrolyte and acid base status, continue with ethanol according to its blood concentration and, if necessary, start hemodialysis. Fomepizole is effective antidote but in many countries still under investigation. Case. A 74-years-old female ingested unknown quantity of ethylene glycol based antifreeze during heavy drinking. On admission, 15 hours after the ingestion, she was disoriented and confused. On physical examination we detected nistagmus, tachycardia and tachypnoe. Laboratory findings showed metabolic acidosis with elevated anion gap elevated ethanol (0.05% in blood) and ethylene glycol concentrations (0.015% in blood and 0.131 % in urine). Despite appropriate therapy with ethanol, sodium bicarbonate, hydration and other supporting measures patient developed acute renal failure which required hemodialysis. Conclusions. Concurrent ingestion of spirit and ethylene glycol improved prognosis in our patient. Late arrival to hospital caused, despite adequate measures upon arrival, acute renal failure and patient had to be hemodialysed.
Descriptors		ETHYLENE GLYCOLS ALCOHOL DRINKING AGED