Poisoning with ethylene glycol treated by haemodialysis

Prikazan je tijek bolesti 56-godišnjeg bolesnika koji je poto nepoznatu količinu alkoholnog pića i zabunom je usto popio 150 ml 95%-tne otopine etilen glikola. Primljen je u Kliniku 28 sati nakon incidenta, a izmjerena koncentracija etilen glikola iznosila je 14 mg/100 ml seruma. Relativno spora eliminacija etilen glikola tijekom 28 sati prije početka hemodijalize možda se može objasniti zaštitnim djelovanjem etilnog alkohola koji je bolesnik popio prije etilen glikola. Nakon prijema, proveden je postupak izvantjelesne hemodijalize u trajanju od četiri sata, s protokom krvi u aparatu od 200 ml/min i s površinom membrane za dijalizu od 1,3 m2. Klirens etilen glikola i njegovih metabolita iznosio je 110- 150 ml/min. Ukupna izlučena količina etilen glikola tijekom 4-satne hemodijalize iznosila je oko 5 g, s time da je između prvog i drugog sata hemodijalize iznosila 1,5 g. Zbog razvoja akutnog zatajenja bubrega u još dva navrata preveden je postupak hemodijalize. Bolesnik je otpušten kući 13 dana nakon prijema, u zadovoljavajućem kliničkom stanju u fazi oporavka bubrežne funkcije.The paper deals with the course of illness in a patient aged 56 years who had ingested accidentally an unknown amount of alcoholic drink followed by 150 ml of 95 percent solution of ethylene glycol. The patient was admitted to the intensive care unit 28 hours after the accident. The serum ethylene glycol concentration reached 14 mg/100 ml. The slow elimination of ethylene glycol during 28 hours before haemodialysis could be explained by the protective effect of ethanol which the patient had consumed before ethylene glycol. The method of extracorporeal haemodialysis was applied for four hours; the membrane surface was 1.3 m2 and blood velocity 200 ml/min. The rate of clearance of ethylene glycol and its metabolites was 110-150 ml/min. The total amount of ethylene glycol eliminated during four hours of haemodialysis came to about 5 g. Four hours from the beginning of the treatment the serum ethylene glycol concentration was not measurable. As the patient developed signs of acute renal failure the haemodialysis method was applied two more times. The patient was dismissed from hospital in good clinical condition, with normal diuresis and repaired renal function on the 13th day from admission