Ethylene glycol intoxication

Definition

Ethylene glycol is a colorless, odorless, sweet-tasting chemical found in many household products, including antifreeze, de-icing products, detergents, paints, and cosmetics. It is poisonous if swallowed.

Alternative Names

Causes

Ethylene glycol may be swallowed accidentally, or it may be taken deliberately in a suicide attempt or as a substitute for drinking alcohol (ethanol).

Symptoms

The first symptom of ethylene glycol ingestion is similar to the feeling caused by drinking alcohol (ethanol). Within a few hours, more toxic effects become apparent. Symptoms may include nausea, vomiting, convulsions, stupor, or even coma.

An overdose of ethylene glycol can damage the brain, lungs, liver, kidneys, and lungs. The poisoning causes disturbances in the body's chemistry, including metabolic acidosis

As little as 120 ml (approximately 4 fluid ounces) of ethylene glycol may be enough to kill an average-sized man.

Exams and Tests

Ethylene glycol toxicity should be suspected in anyone who is severely ill after drinking an unknown substance, especially if they initially appear drunk and do not have a smell of alcohol on their breath.

Diagnosis of ethylene glycol toxicity is usually made through a combination of blood, urine, and other tests such as:

• Arterial blood gas analysis
• CHEM-7
• Osmolality
• Ethylene glycol test
• Urinalysis (shows abnormal crystals)
• Ketones - serum
• CBC
• Chest X-ray (shows fluids in the lungs)
• CT scan (shows brain swelling)
• EKG
• Toxicology screen

Tests will show elevated levels of ethylene glycol, severe metabolic acidosis, blood chemical disturbances, and possible signs of kidney failure and muscle or liver damage.

Treatment

The goal of treatment is to support the body's vital functions and remove the poison from the body.

If the patient recently swallowed the ethylene glycol, the stomach may be pumped (suctioned). This can help physically remove some of the product.

Activated charcoal may also be given.

Most people with ethylene glycol poisoning will need to be admitted to the intensive care unit (ICU) for close monitoring. They may require a breathing machine (respirator).

Intravenous (IV) sodium bicarbonate solution is used to reverse severe acidosis.

Medications for ethylene glycol poisoning include fomepizole or intravenous ethanol, which slow the formation of the toxic by-products.

In severe cases, a procedure called hemodialysis (dialysis) may be used to directly remove the ethylene glycol and other poisonous substances from the blood. Dialysis reduces the time needed for the body to clear the toxins. Dialysis is also needed by patients who develop severe kidney failure as a result of ethylene glycol poisoning. It may be needed for many months afterwards.

Outlook (Prognosis)

If treated promptly, patients with ethylene glycol poisoning can recover, even from renal failure or coma. However, with delayed or no treatment, ethylene glycol poisoning can be deadly.

Possible Complications

• kidney failure
• shock
• coma
• death

When to Contact a Medical Professional

Ethylene glycol ingestion is a medical emergency.  If you suspect possible poisoning, seek emergency care immediately. Do not wait for poisoning symptoms to develop.

You may also want to contact the National Poison Control Center. Call 1-800-222-1222 anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take any containers with you to the emergency room, if possible.

Prevention

Keep substances that contain ethylene glycol out of the reach of children, and counsel persons who may abuse it.