NLM Cases of permanent kidney damage, often requiring chronic dialysis or kidney transplantation, have been reported after severe poisoning. Ng PCY, Long BJ, Davis WT, Sessions DJ, Koyfman A. Intern Emerg Med. [7] The most significant effect is accumulation of calcium oxalate crystals in the kidneys which causes kidney damage leading to oliguric or anuric acute kidney failure. Ethylene glycol is metabolised by oxidation forming 2 major toxic metabolites. As it has a toxic effect and, in high doses, can cause seizures and even coma, it has not been authorised for use in the food industry in Europe since 1981. [2] Treatment consists of stabilizing the person, followed by the use of an antidote. Pharmaceutical grade ethanol is usually given intravenously as a 5 or 10% solution in 5% dextrose, but it is also sometimes given orally in the form of a strong spirit such as whisky, vodka, or gin. [9], The most significant source of ethylene glycol is from aircraft de-icing and anti-icing operations, where it is released onto land and eventually to waterways near airports experiencing cold winter climates. [7] That is approximately 224 mL (7.6 oz.) [50][51], Ethylene glycol poisoning is a relatively common occurrence worldwide. Ethylene glycol is a colorless, odorless, sweet-tasting chemical. In fact, one comprehensive lifetime exposure study of workers in ethylene oxide production facilities found no statistically significant excess cancer risk due to ethylene oxide exposure. [1] Diagnosis may be confirmed by measuring ethylene glycol levels in the blood; however, many hospitals do not have the ability to perform this test. [17] People who develop severe central nervous system manifestations or stroke who survive may have long term neurologic dysfunction; in some cases they may recover, although convalescence may be prolonged. Ethylene Glycol is a common component of engine coolant, or antifreeze. Large anion gap acidosis is usually present during the initial stage of poisoning. The impact of bittering agents on pediatric ingestions of antifreeze. The central nervous system is affected early in the course of poisoning as the result of a direct action of ethylene glycol. [4] Deaths from ethylene glycol have been reported as early as 1930. People therefore must be monitored in an intensive care unit. [45] Alternatively, people presenting late with signs and symptoms of coma, hyperkalemia, seizures, or severe acidosis have a poor prognosis. [78], CS1 maint: DOI inactive as of December 2020 (. [7] Urine microscopy can reveal needle or envelope-shaped calcium oxalate crystals in the urine which can suggest poisoning; although these crystals may not be present until the late stages of poisoning. Chronic (long-term) exposure to EtO in humans can cause irritation of the eyes, skin, nose, throat, and lungs, and damage to … [7] The increase in metabolites may cause encephalopathy or cerebral edema. Ethylene Oxide a highly toxic, flammable chemical utilized in the manufacturing of ethylene glycol. Post harvest handlers must do everything they can to maintain the best possible environmental conditions for those delicate parcels.  |  [22] Ethylene glycol is not well absorbed through skin meaning poisoning following dermal exposure is also uncommon. [24], In addition to antidotes, an important treatment for poisoning is the use of hemodialysis. 2014 Jul-Aug;27(4):395-401. doi: 10.1111/sdi.12237. "[12] Since 1994, federal airports must comply with the Glycol Guidelines of the Canadian Environmental Protection Act, monitoring and reporting on concentrations of glycols in surface water. [1][4] The diagnosis may be suspected when calcium oxalate crystals are seen in the urine or when acidosis or an increased osmol gap is present in the blood. It and its toxic byproducts first affect the central nervous system (CNS), then the heart, and finally the … [7] Seizures may occur due to a direct effect. The alleged exposure may be erroneous. Because hemodialysis will also remove the antidotes from the blood, doses of antidotes need to be increased to compensate. for a 20 kg child. [63] Most deaths from ethylene glycol are intentional suicides; deaths in children due to unintentional ingestion are extremely rare.[64]. [14] Accumulation of glycolic acid in the body is mainly responsible for toxicity. [1] Long term outcomes may include kidney failure and brain damage. [7] If hemodialysis is not available, then peritoneal dialysis also removes ethylene glycol, although less efficiently. Keeping pets and small children away from the area when draining the car radiator. Stage 2 (12 to 36 hours) where signs of "alcohol" poisoning appear to resolve, underlying severe internal damage is still occurring. [42], Treatment for antifreeze poisoning needs to be started as soon after ingestion as possible to be effective; the earlier treatment is started, the greater the chance of survival. However, acidosis has a large number of differential diagnosis, including poisoning from methanol, salicylates, iron, isoniazid, paracetamol, theophylline, or from conditions such as uremia or diabetic and alcoholic ketoacidosis. Ethylene is not harmful or toxic to humans; however, at extremely high concentrations it is combu… Ethylene glycol may be swallowed accidentally, or it may be taken deliberately in a suicide attempt or as a substitute for drinking alcohol (ethanol). J.J. Mackenzie, "Prevent Antifreeze Poisoning", in Laurie Halse Anderson, elevated blood concentration of potassium, EU classification of dangerous substances, "College of Veterinary Medicine: Pet Health Topics: Antifreeze Poisoning", "Ethylene glycol: an estimate of tolerable levels of exposure based on a review of animal and human data", "Antifreeze Poisoning in Dogs & Cats (Ethylene Glycol Poisoning)", "Severe ethylene glycol intoxication with multisystem failure", "Government of Canada: Environment Canada: Ethylene Glycol (Final Content)", "Cerebral computed tomography of ethylene glycol intoxication", "Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis", "Fomepizole in the treatment of ethylene glycol poisoning", "Oklahoma Veterinary Medical Association: ASPCA answers questions about antifreeze poisoning", "Ethylene glycol ingestion treated only with fomepizole", "[Fatal chronic oxalosis after sublethal ethylene glycol poisoning]", "Experiences of the Czech toxicological information centre with ethylene glycol poisoning", "Ethylene glycol toxicosis in a free-ranging raccoon (Procyon lotor) from Prince Edward Island", "The Merck Veterinary Manual: Overview of Ethylene Glycol Toxicity", "General properties, irritant and toxic actions of ethylene glycol", "Concise International Chemical Assessment Document 22: Ethylene Glycol: Environmental Aspects", "Preliminary Data Summary: Airport Deicing Operations (Revised)", "Glycol Mitigation Strategies: The Canadian Approach". The term “toxic alcohols” is a collective term that includes methanol, ethylene glycol, and isopropyl alcohol. This page was last edited on 26 December 2020, at 15:11. Ethylene glycol, hazardous substance in the household. As activated charcoal does not adsorb glycols, it is not recommended as it will not be effective at preventing absorption. When using antifreeze products containing ethylene glycol, recommended safety measures include: The most important initial treatment for ethylene glycol poisoning is stabilizing the person. Duration of … [citation needed], Ethylene glycol has a low vapor pressure; it does not evaporate readily at normal temperatures and therefore high concentrations in air or intoxication are unlikely to occur following inhalational exposures. Most ethylene glycol poisonings occur due to the ingestion of antifreeze. If you’re a fruit ripener, then you are aware of the flammable properties of one of our routine tools: ethylene. The toxic mechanism of ethylene glycol poisoning is mainly due to the metabolites of ethylene glycol. [17] Additionally, ethylene glycol was the most common chemical responsible for deaths reported by US poison centers in 2003. [2] Other treatments may include sodium bicarbonate, thiamine, and magnesium. Am J Med. [28] Additionally, the presence of other alcohols such as ethanol, isopropanol, or methanol or conditions such as alcoholic or diabetic ketoacidosis, lactic acidosis, or kidney failure may also produce an elevated osmolal gap leading to a false diagnosis. 1993 Jul-Sep;3(3):277-84. When an individual consumes ethylene glycol, it will be metabolized by the body in the similar way that it metabolizes ethyl alcohol. [2] Hemodialysis may also be used in those where there is organ damage or a high degree of acidosis. StatPearls [Internet] StatPearls Publishing; Treasure Island (FL): 2020. Storing antifreeze in clearly marked original sealed containers, in areas that are inaccessible to pets. [26][27], The increased osmolal gap is caused by the ethylene glycol itself. [46][47][48][49] The most significant long-term complication is related to the kidneys. [3] Those affected are often adults and male. Both these acids accumulate causing acidosis, which can lead to kidney problems and the formation of calcium oxalate (kidney stones). As the metabolism of ethylene glycol progresses there will be less ethylene glycol and this will decrease the blood ethylene glycol concentration and the osmolal gap making this test less useful. [2] When broken down by the body it results in glycolic acid and oxalic acid which cause most of the toxicity. [7] The usefulness of gastric lavage has, however, been questioned, and it is now no longer used routinely in poisoning situations. Because ethanol has a much higher affinity for alcohol dehydrogenase, about a 100-times greater affinity, it successfully blocks the breakdown of ethylene glycol into glycolaldehyde, which prevents the further degradation. Ethylene | CH2=CH2 or (C2H4)n or C2H4 | CID 6325 - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities, safety/hazards/toxicity information, supplier lists, and more. Additionally, as a side effect of the first two steps of metabolism, an increase in the blood concentration of lactic acid occurs contributing to lactic acidosis. [7] It is only used in the presence of a toxic dose of another poison or drug. [23], As many of the clinical signs and symptoms of ethylene glycol poisoning are nonspecific and occur in many poisonings the diagnosis is often difficult. Oxalic acid binds with calcium to form calcium oxalate crystals which may deposit and cause damage to many areas of the body including the brain, heart, kidneys, and lungs. [73] The process of biodegrading of glycols also increases the risk to organisms, as oxygen levels become depleted in surface waters (p. Ethylene glycol intoxication: evaluation of kinetics and crystalluria. [44] Less commonly it has been used as a means of homicide. If patients start off with a baseline osmolality on the lower end of normal, they could have a clinically significant ethylene glycol intoxication with a normal osmolal gap. According to OSHA (Occupational Safety and Health Administration), Ethylene Oxide (ETO) is a human-made, highly toxic, colorless, flammable gas that, at room temperature, produces a sweet odor. [7], Fomepizole is a potent inhibitor of alcohol dehydrogenase; similar to ethanol, it acts to block the formation of the toxic metabolites. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Jun 26. The primary treatments are either ethanol or fomepizole and, occasionally, dialysis. [73] Another study found the toxicity to aquatic and other organisms was relatively low, but the oxygen-depletion effect of biodegradation was more serious (p. [77] Airports that discharge the collected aircraft deicing fluid directly to waters of the U.S. must also meet numeric discharge requirements for chemical oxygen demand. -. It is the simplest alkene (a hydrocarbon with carbon-carbon double bonds).. NIH Am J Emerg Med. Ingestion of this liquid can lead to shock or even death. [17], The orally lethal dose in humans has been reported as approximately 1.4 mL/kg of pure ethylene glycol. -, White NC, Litovitz T, Benson BE, Horowitz BZ, Marr-Lyon L, White MK. Clin Pediatr (Phila) 2009 Nov;48(9):913-21. Ethylene glycol binds with water, so it can be rinsed and diluted. The toxicity of ethylene glycol comes from its metabolism to glycolic acid and oxalic acid. The formation of acid metabolites also causes inhibition of other metabolic pathways, such as oxidative phosphorylation. [18][19][20] In the EU classification of dangerous substances it is 'harmful' (Xn) while more toxic substances are classified as 'toxic' (T) or 'very toxic' (T+). [64][66][67] Three follow up studies targeting limited populations or suicidal persons to assess the efficacy of bittering agents in preventing toxicity or death have, however, shown limited benefit of bittering ethylene glycol preparations in these two populations. [16], Ethylene glycol involved in aircraft de-icing and anti-icing operations is released onto land and eventually to waterways. The primary danger is its sweet taste, so children and animals can eat it, and it is toxic. The toxic metabolic by-products of ethylene glycol metabolism cause a build-up of acid in the blood (metabolic acidosis). of 50% ethylene glycol for an 80 kg adult and 56 mL (2 oz.) In cats, this stage occurs 12–24 hours after consuming antifreeze; in dogs, at 36–72 hours after consuming antifreeze. CNS depression begins soon after exposure, lasting for up to 12 hours after ingestion. [36], Following decontamination and the institution of supportive measures, the next priority is inhibition of further ethylene glycol metabolism using antidotes. [2], Signs of ethylene glycol poisoning depend upon the time after ingestion. The glycolic acid is then metabolized to glyoxylic acid and finally to oxalic acid. Ethylene glycol poisoning is poisoning caused by drinking ethylene glycol. [26] People receiving ethanol therapy also require frequent blood ethanol concentration measurements and dosage adjustments to maintain a therapeutic ethanol concentration. [12] In 2006, approximately 1540 kilotonnes of ethylene glycol were manufactured in Canada by three companies in Alberta, with most of the production destined for export. 245). Ethylene (IUPAC name: ethene) is a hydrocarbon which has the formula C 2 H 4 or H 2 C=CH 2.It is a colorless flammable gas with a faint "sweet and musky" odour when pure. 12). In this situation stabilization of the person including airway management with intubation should be performed in preference to gastrointestinal decontamination. Although a naturally occurring plant hormone, ethylene can be dangerous, especially when handled incorrectly. Ashurst JV, Nappe TM. Ethylene glycol is a toxic compound. Clipboard, Search History, and several other advanced features are temporarily unavailable. Please enable it to take advantage of the complete set of features! It’s rare, but it’s real. This site needs JavaScript to work properly. Ethylene Oxide gases are hazardous substances utilized in the production of ethylene glycol used in numerous products, including pharmaceuticals, polyurethane foam, adhesives, detergents, textiles, … However, a normal osmolar gap does not rule out ethylene glycol exposure because of wide individual variability. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. -, Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Hemodialysis is usually indicated in people with severe metabolic acidosis (blood pH less than 7.3), kidney failure, severe electrolyte imbalance, or if the person's condition is deteriorating despite treatment. The term “toxic alcohols” is a collective term that includes methanol, ethylene glycol, and isopropyl alcohol. 1988 Jan;84(1):145-52. Ethylene oxide gas is toxic, carcinogenic, and very explosive. ETHYLENE page 2 of 6 This Fact Sheet is a summary source of information of all potential and most severe health hazards that may result from exposure. Ethanol acts by competing with ethylene glycol for alcohol dehydrogenase, the first enzyme in the degradation pathway. [24] Intubation and respiratory support may be required in severely intoxicated people; people with hypotension require treatment with intravenous fluids and possibly vasopressors. In an effort to prevent poisoning, often a bittering agent called denatonium benzoate, known by the trade name Bitrex, is added to ethylene glycol preparations as an adversant to prevent accidental or intentional ingestion. [32][unreliable source?]. The presence of a large osmolal gap supports a diagnosis of ethylene glycol poisoning. [7] Sodium bicarbonate should be used cautiously as it can worsen hypocalcemia by increasing the plasma protein binding of calcium. [7][8], The most common source of ethylene glycol is automotive antifreeze or radiator coolant, where concentrations are high. Copyright © 2020, StatPearls Publishing LLC.  |  [5] Antifreeze products sometimes have a substance to make it bitter added to discourage drinking by children and other animals but this has not been found to be effective. At room temperature, ethylene oxide is a flammable colorless gas with a sweet odor. [68] Similarly, White found that adding bittering agents did not decrease the frequency or severity of antifreeze poisonings in children under the age of 5. [7] The rate-limiting step in this cascade is the conversion of glycolic to glyoxylic acid. EO sterilization cycles must be designed to avoid conditions or parameters that may be explosive. If antifreeze is placed in toilets, ensuring the lid is down and the door closed. Ethylene glycol in itself is not According to OSHA (Occupational Safety and Health Administration), Ethylene Oxide (ETO) is a human-made, highly toxic, colorless, flammable gas that, at room temperature, produces a sweet odor. If hypocalcemia occurs it can be treated with calcium replacement although calcium supplementation can increase the precipitation of calcium oxalate crystals leading to tissue damage. Ethylene glycol in biological fluids can be determined by gas chromatography. [77] Large new airports may be required to collect 60 percent of aircraft deicing fluid after deicing. -, Jacobsen D, Hewlett TP, Webb R, Brown ST, Ordinario AT, McMartin KE. [64] These studies did not focus on poisoning of domestic pets or livestock, for example, or inadvertent exposure to bittered antifreeze among a large population (of non-preschool age children). I-3). Without oxalic acid formation, the nephrotoxic effects can be avoided, but the ethylene glycol is still present in the body. This depression appears similar to ethanol intoxication, but without the characteristic odor of alcohol. Colorless, odorless, flammable, toxic gaseous cyclic ether with a sweet ether-like smell. [64][68][69] Specifically, Mullins finds that bittering of antifreeze does not reduce reported cases of poisoning of preschoolers in the US state of Oregon. It is poisonous if swallowed. Epub 2018 Feb 9. Ethylene explosions in Ripening Rooms Are an Event to Avoid. [7], The kidney toxicity of ethylene glycol occurs 24 to 72 hours post ingestion and is caused by a direct cytotoxic effect of glycolic acid. [2], More than 5000 cases of poisoning occur in the United States each year. https://en.wikipedia.org/w/index.php?title=Ethylene_glycol_poisoning&oldid=996426608, Toxic effects of substances chiefly nonmedicinal as to source, CS1 maint: DOI inactive as of December 2020, Articles with dead external links from September 2017, Articles with permanently dead external links, Short description is different from Wikidata, Articles with unsourced statements from July 2019, Articles lacking reliable references from October 2012, Wikipedia articles needing clarification from March 2012, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License, Stage 1 (30 minutes to 12 hours) consists of. [60] In the United States there were 5816 cases reported to poison centers in 2002. [13] The metabolic effects occur 12 to 36 hours post ingestion, causing primarily metabolic acidosis which is due mainly to accumulated glycolic acid. [69] Additionally, another study by White found that suicidal persons are not deterred by the bittered taste of antifreeze in their attempts to kill themselves. 2010;53(1):19-23. [12] It is also used in manufacturing polyester products. Hemodialysis is used to enhance the removal of unmetabolized ethylene glycol, as well as its metabolites from the body. Initially it is metabolized by alcohol dehydro… The management of severe toxic alcohol ingestions at a tertiary care center after the introduction of fomepizole. Ethylene is used as an anesthetic, a refrigerant, and to make other chemicals as polymers and plastics. [37][38] It is the only antidote approved by the U.S. Food and Drug Administration for the treatment of ethylene glycol poisoning. USA.gov. Traditionally, gastric lavage or nasogastric aspiration of gastric contents are the most common methods employed in ethylene glycol poisoning. Ethylene glycol (C2H6O2) is a toxic alcohol that is found in various household and industrial agents. Explosions can be horrific in magnitude, and extreme care must be taken. Epub 2014 Apr 9. 2018 Apr;13(3):375-383. doi: 10.1007/s11739-018-1799-9. [1], Early treatment increases the chance of a good outcome. Those who have either worked at plants where ethylene oxide is found or residents that live near plants that emit ethylene oxide have filed lawsuits against various companies who they say are responsible … Costing US$1,000 per gram, an average course used in an adult poisoning would cost approximately $3,500 to $4,000. These toxic substances also affect the cardiopulmonary system and can cause renal failure. Ethylene glycol toxicity is a type of toxic leukoencephalopathy.Ethylene glycol, best known as a component of antifreeze, has been ingested both deliberately and accidentally, resulting in … [76] Considering factors such as the "seasonal nature of releases, ambient temperatures, metabolic rates and duration of exposure", Environment Canada stated in 2014 that "it is proposed that ethylene glycol is not entering the environment in a quantity or concentration or under conditions that have or may have an immediate or long-term harmful effect on the environment or its biological diversity". Trends in toxic alcohol exposures in the United States from 2000 to 2013: a focus on the use of antidotes and extracorporeal treatments. [9] Some people put antifreeze into their cabin's toilet to prevent it from freezing during the winter, resulting in toxicities when animals drink from the toilet. [58][59] Children or animals may be exposed by accidental ingestion; children and animals often consume large amounts due to ethylene glycol having a sweet taste. The person' serum osmolality is measured by freezing point depression and then compared with the predicted osmolality based on the person's measured sodium, glucose, blood urea nitrogen, and any ethanol that may have been ingested. [52] In Australia there were 17 cases reported to the Victorian poison center and 30 cases reported to the New South Wales poison center in 2007. [6][43] Cats must be treated within 3 hours of ingesting of antifreeze to be effective, while dogs must be treated within 8–12 hours of ingestion. Seizures may occur due to a direct effect. Ethylene oxide (EO) is an environmental pollutant and is toxic to humans. Clin Toxicol (Phila) 2017 Dec;55(10):1072-1252. Ethylene glycol is toxic and, if ingested, can cause fatal poisoning. Poisoning of a raccoon was diagnosed in 2002 in Prince Edward Island, Canada. In: StatPearls [Internet]. [1] Toxicity and death may occur after drinking even a small amount. When considering the control of environmental conditions, dont overlook the destructive power of ethylene gas Mother Natures silent killer. [7], Other laboratory abnormalities may suggest poisoning, especially the presence of a metabolic acidosis, particularly if it is characterized by a large anion gap. Ethylene glycol is chemically broken down in the body into toxic compounds. HHS Caprolactam – removed from the list of hazardous air pollutants in June 1996 - Federal Register - June 18, 1996 (61 FR 30816). The antidotes for ethylene glycol poisoning are ethanol and fomepizole. This antidotal treatment forms the mainstay of management of ethylene glycol poisoning. Poison control centers often use more than a lick or taste in a child or more than a mouthful in an adult as a dose requiring hospital assessment. Repeated or prolonged exposure to the substance can produce targe t organs What is ethylene oxide? Ethylene vinyl acetate is a type of plastic — a polymer with a wide variety of uses, both residential and industrial. Exposures are generally observed due to accidental or intentional ingestions, with its sweet taste lending to accidental toxic exposures, whereas intentional exposures may be motivated by suicide attempt or desire for inebriation in the absence of ethanol. [35] Ipecac-induced vomiting is not recommended. [1] It may be drunk accidentally or intentionally in a suicide attempt. Similar to ethanol, it causes intoxication, followed by drowsiness or coma. As ethylene glycol is rapidly absorbed, gastric decontamination is unlikely to be of benefit unless it is performed within 60 minutes of ingestion.  |  Its adverse effects include intoxication, hypoglycemia in children, and possible liver toxicity. [24] It is most reliably diagnosed by the measurement of the blood ethylene glycol concentration. A similar result was found in Michigan when the state analyzed the population near a … [29] Finally, many commercial radiator antifreeze products have fluorescein added to enable radiator leaks to be detected using a Wood's lamp. Ghannoum M, Hoffman RS, Mowry JB, Lavergne V. Semin Dial. Ethylene oxide is a gas that is used in many countries for the disinfection of heat-sensitive foodstuffs. The U.S. Environmental Protection Agency generally puts substances which are lethal at more than 30 g to adults in Toxicity Class III. However, it is very useful as a chemical and can be found in many household items such as detergents, cosmetics, etc. [10] The toxic mechanism of ethylene glycol poisoning is mainly due to the metabolites of ethylene glycol. What are the stability and reactivity hazards of ethylene … [44] People who present early to medical facilities and have prompt medical treatment typically will have a favorable outcome. The safe transportation of perishable products, whether fruits, vegetables or fresh cut flowers from the field to the consumer is tricky business. [14][41] Hemodialysis also has the added benefit of correcting other metabolic derangements or supporting deteriorating kidney function. [15], Ethylene glycol has been shown to be toxic to humans[16] and is also toxic to domestic pets such as cats and dogs. The first to form is glycolic acid which is further oxidised to oxalic acid. Ethylene is not toxic, but is a simple asphyxiant. Toxic Inhalation of Ethylene Glycol: A Pharmacological Improbability To the Editor: Poison center specialists and medical toxicologists are often confronted with unusual exposures or exposure histories. [25] Many hospital laboratories do not have the ability to perform this blood test and in the absence of this test the diagnosis must be made based on the presentation of the person. [9] Other sources of ethylene glycol include windshield deicing agents, brake fluid, motor oil, developing solutions for hobby photographers, wood stains, solvents, and paints. 2007 Sep;25(7):799-803. doi: 10.1016/j.ajem.2007.01.017. [10][24] Often both antidotal treatment and hemodialysis are used together in the treatment of poisoning. Been shown to be highly effective in the presence of a large osmolal gap supports a diagnosis of …... Term that includes methanol, ethylene oxide Results in glycolic acid is then oxidized to acid. Dogs, at 15:11 congress classified it as a chemical and can be administered orally as well as metabolites. Kidney damage, often requiring chronic dialysis or kidney transplantation, have been since... 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Publishing ; 2020 Jan. 2020 Jun 26 or fomepizole and, occasionally, dialysis 2020. Refrigerant, and extreme care must be monitored in an intensive care unit that corresponds to osmolal... This is not toxic exposure to the kidneys pure substance: an emergency medicine review poison or drug then to. Generally requires supportive care, close laboratory monitoring and antidotal therapy of gastric contents are the nervous! And management: an emergency medicine review drinking ethylene glycol poisoning is a type of —! Mainly responsible for toxicity and 4 mL for a 20 kg child may cause encephalopathy or edema. Oz. alcohols” is a common component of engine coolant, or.. Industrial agents take advantage of the toxicity [ 47 ] [ 24,! Used as a pesticide and a sterilizing agent which is further oxidised to acid... Appears similar to ethanol intoxication, vomiting and abdominal pain [ 36 ] [ 37 ] fomepizole has shown... Signs of ethylene glycol exposures can cause renal failure ethanol, it intoxication..., the nephrotoxic effects can be rinsed and diluted, if the person including airway management with intubation should considered. Be rinsed and diluted containers, in addition to antidotes, an treatment! Used cautiously as it can worsen hypocalcemia by increasing the plasma protein binding of calcium oxalate ( kidney )! 5816 cases reported to poison centers in 2002 rate-limiting step in this cascade is the measurement of the set! Hormone, ethylene oxide ( EO ) is a type of plastic — a polymer with a variety!, close laboratory monitoring and antidotal therapy this depression appears similar to intoxication... Include a decreased level of consciousness, headache, and magnesium supporting deteriorating kidney function What! An adult poisoning would cost approximately $ 3,500 to $ 4,000 treatment typically will have a outcome!

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