Extracorporeal Therapy as a Treatment Method in Patients with Acute Ethylene Glycol Poisoning

Song, Jae Woo; Choi, Sang Chun; Lampotang, Samsun; Min, Young Gi; Joung, Yoon Seok

J Korean Soc Emerg Med > Volume 28(1); 2017 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2017;28(1): 109-116.

급성 에틸렌리콜 중독 환자의 치료 방법으로서 체외제거법 적용

송재우¹, 최상천^1,2, Samsun Lampotang², 민영기¹, 정윤석¹

¹아주대학교 의과대학 응급의학교실
²플로리다 의과대학 시뮬레이션 센터

Extracorporeal Therapy as a Treatment Method in Patients with Acute Ethylene Glycol Poisoning

Jae Woo Song¹, Sang Chun Choi^1,2, Samsun Lampotang², Young Gi Min¹, Yoon Seok Joung¹

¹Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
²Center for Safety, Simulation and Advanced Learning Technologies, University of Florida, FL, USA

Correspondence

Sang Chun Choi ,Tel: 031-219-7750, Fax: 031-219-7760, Email: avenue59@ajou.ac.kr ,

Received: October 21, 2016; Revised: October 25, 2016 Accepted: January 5, 2017. Published online: February 28, 2017.

ABSTRACT

Purpose:
Extracorporeal treatment has been used increasingly to treat patients with acute ethylene glycol poisoning. We analyzed all patients with acute poisoning of ethylene glycol during a recent 10-year period to provide clinical recommendations for adequate application of continuous renal replacement therapy for these patients.
Method:
A retrospective chart review study was conducted for patients whose final diagnosis were “toxic effects of glycols or other alcohols,” between October 2006 and September 2016. The basal characteristics of patients, suspected amount of ingestion, intention of poisoning, concomitant alcohol ingestion, mental state at admission, time from exposure to admission, chief complaint, length of hospital stay, method of treatments, laboratory results including acute kidney injury and urine oxalate crystal, as well as treatment results were examined.
Results:
A total number of 14 patients were included in this study. Nine patients (64.3%) underwent continuous renal replacement therapy; 5 patients (35.7%) underwent ethanol mono-therapy. Between the antidote therapy group and the extracorporeal treatment group, there was a significant difference in the levels of plasma bicarbonate, chloride, anion gap, pH, and base excess in arterial blood gas analysis, as well as the calculated osmolar gap. One patient expired due to multi-organ failure, while the others recovered completely.
Conclusion:
Continuous renal replacement therapy was most frequently chosen as a treatment method in patients with acute ethylene glycol poisoning. Further research regarding indication of continuous renal replacement therapy and combing therapy with other treatment will be necessary to determine the best treatment method.

Key words: Ethylene glycol, Poisoning, Renal replacement therapy