Effectiveness of IV Ethanol Therapy Combined with Hemodialysis in the Treatment of Methanol and Ethylene Glycol Poisoning
Bibliographic record
Abstract
ABSTRACT Background: The management of methanol and ethylene glycol poisoning includes inhibition of alcohol dehydrogenase by IV ethanol therapy or fomepizole. There is a lack of contemporary information on IV administration of ethanol in this setting. Objective: To evaluate the effectiveness of IV ethanol therapy in combination with hemodialysis for the treatment of methanol and ethylene glycol poisoning. Methods: The medical records of patients with methanol or ethylene glycol poisoning who had been treated with at least 6 h of IV ethanol therapy were reviewed. Patients were included in the study if initial serum methanol or ethylene glycol concentration was at least 6.2 or 3.2 mmol/L, respectively, or if the laboratory findings were consistent with poisoning. Outcomes included in-hospital death, incidence of visual disturbances secondary to methanol poisoning, incidence of renal dysfunction secondary to ethylene glycol poisoning, incidence of hypoglycemia secondary to IV ethanol therapy, and success in achieving target ethanol concentration of greater than 22 mmol/L. Results: Twenty-seven patients met the eligibility criteria, 25 of whom survived. Twenty-six of the 27 patients underwent concurrent hemodialysis. Renal dysfunction occurred in 2 of 11 patients with ethylene glycol poisoning, and 1 of these patients required long-term dialysis. No visual disturbances secondary to methanol poisoning were documented, and there were no episodes of hypoglycemia in any patient during infusion of ethanol. In 56% of all serum samples obtained during ethanol treatment, the ethanol concentrations were above the threshold of 22 mmol/L. Conclusion: IV administration of ethanol, combined with hemodialysis, appears to be effective and safe for the management of patients with methanol and ethylene glycol poisoning. RESUME Historique : Le traitement de l’intoxication par le methanol et l’ethylene glycol comprend le blocage de l’alcool deshydrogenase par l’ethanol IV ou le fomepizole. On manque cependant d’information actualisee sur l’administration IV de l’ethanol dans ce contexte. Objectif : Evaluer l’efficacite de l’administration IV de l’ethanol jumelee a l’hemodialyse dans le traitement de l’intoxication par le methanol et l’ethylene glycol. Methodes : Les dossiers medicaux des patients intoxiques par le methanol ou l’ethylene glycol qui ont recu un traitement IV a l’ethanol pendant au moins six heures ont ete examines. Les patients ont ete retenus si leur concentration plasmatique initiale de methanol ou d’ethylene glycol etait d’au moins 6,2 ou 3,2 mmol/L, respectivement, ou si les valeurs de laboratoire indiquaient une intoxication. Les criteres d’evaluation etaient les suivants : deces a l’hopital, trouble visuel secondaire a l’intoxication par le methanol, dysfonctionnement renal secondaire a l’intoxication par l’ethylene glycol, hypoglycemie secondaire a l’administration IV d’ethanol et obtention d’une concentration plasmatique d’ethanol superieure a 22 mmol/L. Resultats : En tout, 27 patients ont satisfait aux criteres d’admissibilite et 25 d’entre eux ont survecu. Des 27 patients, 26 ont ete mis sous hemodialyse concomitante. Deux des 11 patients intoxiques par l’ethylene glycol ont presente un dysfonctionnement renal et un de ces patients a necessite une dialyse prolongee. Aucun trouble visuel secondaire a l’intoxication par le methanol n’a ete rapporte et aucun episode d’hypoglycemie n’a ete observe chez tous les patients pendant la perfusion d’ethanol. Les concentrations d’ethanol de 56 % de tous les echantillons seriques obtenus durant le traitement etaient superieures au seuil de 22 mmol/L. Conclusion : L’administration IV d’ethanol jumelee a l’hemodialyse semble etre sure et efficace dans le traitement des patients intoxiques par le methanol et l’ethylene glycol.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".