Ethylene Glycol Poisoning

Ethylene Glycol Poisoning – General Information

Ethylene Glycol Poisoning – Symptoms

The most popular symptoms and signs that are generally triggered by the intake of ethylene glycol include vomiting and / or nausea, CNS depression, and so on. However, these symptoms are nondescript. Furthermore, they are triggered by a variety of other disorders (including other types of poisoning), which make them inconclusive evidence that are not able to point to a correct diagnosis. Patients who suffer from Ethylene Glycol Poisoning will also experience other symptoms that are bound to let the professional health care provider know what he or she is dealing with. Such signs include: respiratory distress that is generally accompanied by hyperventilation; metabolic acidosis (it can be easily determined by the analysis of the patient’s arterial blood gas or electrolyte values); increases of the osmolal gap; increased levels of anion, and so on.

In order to rapidly diagnose Ethylene Glycol Poisoning, it is always an advantage for the physician to be familiar with the thorough medical history of the patient. As in most cases, patients are distressed, confused or even comatose; it is difficult for them to provide the physician with any reliable information. It is important to contact a friend and / or a family member for further information. About half of the entire number of patients who suffer from Ethylene Glycol Poisoning also presents urinary calcium oxalate crystals. With the help of the latest medical techniques (x-ray diffraction tests) it has been established that the most popular crystals are the needle-shaped ones that are found in greater numbers than the envelope-shaped crystals.

Ethylene Glycol Poisoning – Treatment

A fast and correct diagnosis is very important in the case of patients who suffer from Ethylene Glycol Poisoning, as a proper therapy for this medical condition is quite efficient (in most clinical cases) provided that it is administered to the patient in due time. If the patient does not receive a proper prophylaxis in time, even the best therapies for this medical condition might not prove efficient. In order to keep the patient under direct supervision (and monitor the way in which his general health condition improves / worsens) it is important to regularly test his or her acid base balance and ethylene glycol blood concentration. It has been proved that the mortality of this medical condition is directly related to the severity of the patient’s acidosis. The proper therapy for patients who suffer from Ethylene Glycol Poisoning follows three important goals: emendation of the patient's abnormal metabolic acidosis, removal of the ethylene glycol from the patient’s organism (this also includes the removal of the poison’s toxic metabolytes), goal which can be accomplished through hemodialysis; not allowing the poison’s metabolites to be metabolized by the patient’s organism. Some patients who suffer from Ethylene Glycol Poisoning might have to undergo gastric lavage, procedure which is very efficient provided that it is performed in a matter of hours after the patient has ingested the poison. Comatose clinical cases and also patients who are more prone to experiencing severe convulsions should also undergo this medical procedure. A therapy with charcoal is not very effective as the toxic substance is not absorbed in high amounts by charcoal. However, this therapy method is quite efficient if the patient has ingested more than one type of chemicals.

Because Ethylene Glycol Poisoning can easily trigger CNS depression, each patient should be granted airway protection as well as proper respiratory support (if it is the case). The correction of the patient’s electrolyte imbalance can be done with the help of the administration of intravenous (IV) fluids. Some medical products available on the market (such as Thiamine and Pyridoxine) have proved to be quite efficient in the therapy of patients who suffer from this medical condition. Patients with this medical condition must not be given calcium to treat Hypokalemia, as this is known to sometimes increase the abnormal precipitation of calcium oxalate crystals (that remain in the body’s tissues). However, if the patient experiences seizures or tetany, he or she might have to be treated with IV calcium chloride / gluconate. The patient’s initial metabolic acidosis ought to be taken care of with an intensive therapy with sodium bicarbonate. However, physicians ought to keep into consideration the importance and the clinical benefits that are granted by the alkali treatment.