Unintentional ethylene glycol ingestions in children

ABSTRACTBackground: Toxic alcohol poisoning may result in severe acidemia and death. Previous work from our regional poison center (RPC) revealed that most pediatric unintentional methanol exposures are benign and do not require alcohol dehydrogenase (ADH) blockade or hemodialysis. Methods: We retro...

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Main Authors: Antonia Nemanich, Sean M. Bryant
Format: Article
Language:English
Published: Taylor & Francis Group 2022-12-01
Series:Toxicology Communications
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/24734306.2022.2045123
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author Antonia Nemanich
Sean M. Bryant
author_facet Antonia Nemanich
Sean M. Bryant
author_sort Antonia Nemanich
collection DOAJ
description ABSTRACTBackground: Toxic alcohol poisoning may result in severe acidemia and death. Previous work from our regional poison center (RPC) revealed that most pediatric unintentional methanol exposures are benign and do not require alcohol dehydrogenase (ADH) blockade or hemodialysis. Methods: We retrospectively reviewed all ethylene glycol (EG) cases in patients less than 6 years of age reported to our RPC over a 19 year period. We included unintentional ingestions with measured EG concentrations. Results: Twenty-nine cases met inclusion criteria. EG concentrations were undetectable in 25 cases (86%). No patient became symptomatic or acidemic. No EG concentration warranted treatment with ADH inhibition or hemodialysis. However, 21 patients (72%) received fomepizole or ethanol. Fifteen patients (52%) transferred from a community hospital to a pediatric specialty hospital. All 27 children admitted to the hospital went to a pediatric intensive care unit (PICU) while awaiting EG results. Conclusions: No child during the 19-year period required either antidote or hemodialysis. Unintentional EG exposures in typical pediatric patients may warrant nothing more than repeat laboratory testing (electrolytes, pH) to exclude evolving toxicity. Timely availability of EG laboratory test results would likely reduce unnecessary and expensive use of antidote, transport, and PICU resources.
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spelling doaj.art-778879e8213d4de280a280323a0cd19c2023-06-13T12:55:24ZengTaylor & Francis GroupToxicology Communications2473-43062022-12-0161424510.1080/24734306.2022.2045123Unintentional ethylene glycol ingestions in childrenAntonia Nemanich0Sean M. Bryant1Illinois Poison Center, Cook County Health, Toxikon Consortium, Chicago, IL, USAIllinois Poison Center, Cook County Health, Toxikon Consortium, Chicago, IL, USAABSTRACTBackground: Toxic alcohol poisoning may result in severe acidemia and death. Previous work from our regional poison center (RPC) revealed that most pediatric unintentional methanol exposures are benign and do not require alcohol dehydrogenase (ADH) blockade or hemodialysis. Methods: We retrospectively reviewed all ethylene glycol (EG) cases in patients less than 6 years of age reported to our RPC over a 19 year period. We included unintentional ingestions with measured EG concentrations. Results: Twenty-nine cases met inclusion criteria. EG concentrations were undetectable in 25 cases (86%). No patient became symptomatic or acidemic. No EG concentration warranted treatment with ADH inhibition or hemodialysis. However, 21 patients (72%) received fomepizole or ethanol. Fifteen patients (52%) transferred from a community hospital to a pediatric specialty hospital. All 27 children admitted to the hospital went to a pediatric intensive care unit (PICU) while awaiting EG results. Conclusions: No child during the 19-year period required either antidote or hemodialysis. Unintentional EG exposures in typical pediatric patients may warrant nothing more than repeat laboratory testing (electrolytes, pH) to exclude evolving toxicity. Timely availability of EG laboratory test results would likely reduce unnecessary and expensive use of antidote, transport, and PICU resources.https://www.tandfonline.com/doi/10.1080/24734306.2022.2045123Ethylene glycolpediatricsunintentionalpoison center
spellingShingle Antonia Nemanich
Sean M. Bryant
Unintentional ethylene glycol ingestions in children
Toxicology Communications
Ethylene glycol
pediatrics
unintentional
poison center
title Unintentional ethylene glycol ingestions in children
title_full Unintentional ethylene glycol ingestions in children
title_fullStr Unintentional ethylene glycol ingestions in children
title_full_unstemmed Unintentional ethylene glycol ingestions in children
title_short Unintentional ethylene glycol ingestions in children
title_sort unintentional ethylene glycol ingestions in children
topic Ethylene glycol
pediatrics
unintentional
poison center
url https://www.tandfonline.com/doi/10.1080/24734306.2022.2045123
work_keys_str_mv AT antonianemanich unintentionalethyleneglycolingestionsinchildren
AT seanmbryant unintentionalethyleneglycolingestionsinchildren