Document Detail


Hemodialysis for methyl alcohol poisoning: A single-center experience.
MedLine Citation:
PMID:  22237216     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Methanol is a cheap and potent adulterant of illicit liquors. Hemodialysis (HD) is the best method to rapidly remove both toxic acid metabolites and parent alcohols, and it plays a fundamental role in treating severely poisoned patients. This retrospective study was carried out on 91 patients with detectable serum methanol levels who underwent HD. Because toxic alcohol levels were not immediately available, the initial diagnosis and treatment was based on clinical history with evidence of toxic alcohol intake, presence of high anion metabolic acidosis and/or end organ damage. Patients received bicarbonate, ethanol, according to clinical features and blood gases. Patients underwent HD in the setting of known methanol ingestion with high anion gap metabolic acidosis, or evidence of end-organ damage, regardless of methanol level. HD prescription included large surface area dialyzer (≥1.5 m2), blood flow rate of 250-350 mL/min and dialysate flow rate of 500 mL/min for 4-6 h. Between 9 and 11 July 2009, 91 males with mean age 40 ± 8.5 years underwent HD, and 13 patients required a second HD session. Patients consumed 100-500 mL illicit liquors, and symptoms appeared six and 60 h later. Clinical features were gastro-intestinal symptoms (83.5%), visual disturbances (60.4%), central nervous system symptoms (59.3%) and dyspnea (43.9%). Before HD, mean pH was 7.11 ± 0.04 (range 6.70- 7.33) and mean bicarbonate levels were 8.5 ± 4.9 mmol/L (range 2-18). Three patients died due to methanol intoxication. Mortality was associated with severe metabolic acidosis (pH ≤ 6.90), ventilator requirement and coma/seizure on admission (P < 0.001). Timely HD, bicarbonate, ethanol and supportive therapy can be life-saving in methanol intoxication.
Authors:
Vivek B Kute; Suraj M Godara; Pankaj R Shah; Manoj R Gumber; Kamal R Goplani; Aruna V Vanikar; Bipin C Munjappa; Himanshu V Patel; Hargovind L Trivedi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia     Volume:  23     ISSN:  1319-2442     ISO Abbreviation:  Saudi J Kidney Dis Transpl     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9436968     Medline TA:  Saudi J Kidney Dis Transpl     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  37-43     Citation Subset:  IM    
Affiliation:
Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India.
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