Treatment of Methanol and Ethylene Glycol Poisoning: RESULTS part 2
Adverse Effects
Because this was a retrospective study that depended on information available in the medical record, the incidence of hypoglycemia was the only adverse effect evaluated. Of the 162 serum glucose determinations during the IV ethanol infusions, none had a value below 4 mmol/L.
Outcomes of Ethanol Administration
In addition to the 6 patients who had received loading doses at other institutions before transfer, 18 patients received an IV loading dose of ethanol upon presentation at the authors’ institution. For these 18 patients, the dose was appropriate in 6 patients (33%), higher than recommended in 7 (39%), and lower than recommended in 3 (17%). Two (11%) of the 18 loading doses could not be evaluated because the patients’ weights were not documented in the medical record.Ethanol infusion rates were considered appropriate if within 15% of recommended guidelines, taking into account both patient weight (if documented in the medical record) and concurrent hemodialysis. The infusion rate after the loading dose (if given) or after transfer from another institution was considered the initial infusion rate. Weights (some approximate) were documented in 25 of the 27 medical records. Initial IV ethanol infusion rates were appropriate in 10 (40%) of the patients, lower than recommended in 6 (24%), and higher than recommended in 9 (36%). After initiation of the ethanol infusion, the average number of changes in the infusion rate during treatment was 3.8 per patient (range 0 to 11). There was no apparent association between the appropriateness of the initial ethanol infusion rate and the number of subsequent changes in infusion rate: there were 4.8, 4.0, and 3.4 rate changes per patient in patients with appropriate, lower-than- recommended, and higher-than-recommended initial infusion rates, respectively. canadian cialis
Serum ethanol concentration was measured in 194 samples obtained during ethanol infusion (average 7.1 per patient, range 4 to 20). In 108 (55.7%) of these, the concentration was greater than or equal to the target concentration of 22 mmol/L. In 5 of the 27 patients (19%), the target concentration was never achieved during the course of treatment. Only 4 patients had serum ethanol concentration greater than 22 mmol/L throughout the course of ethanol therapy.
