Research Article
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Year 2022, Volume: 5 Issue: 4, 949 - 953, 20.07.2022
https://doi.org/10.32322/jhsm.1095045

Abstract

References

  • Ocak T, Utku Murat Kalafat, Baştürk M. Alcohol poisonings: review. Turkiye Klinikleri J Emerg Med-Special Topics 2016; 2; 1: 38-43
  • Rietjens SJ, de Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol? Neth J Med. 2014; 72; 2: 73-9.
  • Gallagher N, Edwards FJ. The Diagnosis and management of toxic alcohol poisoning in the emergency department: a review article.Adv J Emerg Med. 2019; 33: e28.
  • Kruse JA. Methanol and ethylene glycol intoxication. Crit Care Clin 2012; 28: 661-71.
  • Pratumvinit B, Lam L, Kongruttanachok N, et al. Anion gap reference intervals show instrument dependence and weak correlation with albumin levels. Clin Chim Acta 2020; 500: 172-9.
  • Kraut JA. Approach to the Treatment of methanol intoxication. Am J Kidney Dis 2016; 68; 1: 161-7.
  • Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA, American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Methanol Poisoning. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol 2002; 40: 415–46.
  • Greene HR, Krasowski MD. Correlation of osmolal gap with measured concentrations of acetone, ethylene glycol, isopropanol, methanol, and propylene glycol in patients at an academic medical center. Toxicol Rep 2019; 7: 81–8.
  • Bozkurt Babuş S, İraöz G, Köse A, Orekici Temel G, Tiftik RN, Toker İ. Retrospective analysis of methyl alcohol intoxications in emergency department. J Tepecik Educ Res Hosp 2019; 29; 3: 235-40.
  • Kaewput W, Thongprayoon C, Petnak T, et al. Inpatient burden and mortality of methanol intoxication in the United States. Am J Med Sci 2021; 361; 1: 69-74.
  • Jones AW. Clinical and forensic toxicology of methanol. Forensic Sci Rev 2021; 33: 117–43.
  • Liberski S, Kaluzny BJ, Kocięcki J. Methanol-induced optic neuropathy: a still-present problem. Arch Toxico 2022; 96: 431–51.
  • Choi JH, Lee SK, Gil YE. et al. Neurological complications resulting from non-oral occupational methanol poisoning. J Korean Med Sci 2017; 32: 371–6.
  • Gülen M, Satar S, Avcı A, Acehan S, Orhan U, Nazik H. Methanol poisoning in Turkey: Two outbreaks, a single center experience. Alcohol (Fayetteville, N.Y). 2020.
  • Beatty L, Green R, Magee K, Zed PA. systematic review of ethanol and fomepizole use in toxic alcohol ingestions. Emerg Med Int 2013; 2013: 638057.
  • Zakharov S, Pelclova D, Navratil T. et al. Fomepizole versus ethanol in the treatment of acute methanol poisoning: Comparison of clinical effectiveness in a mass poisoning outbreak. Clinical toxicology (Philadelphia, Pa.) 2015; 53: 797–806
  • Zakharov S, Navratil T, Pelclova D. Fomepizole in the treatment of acute methanol poisonings: experience from the Czech mass methanol outbreak 2012-2013. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 158: 641-9.

Methanol poisoning in the emergency department: a retrospective study

Year 2022, Volume: 5 Issue: 4, 949 - 953, 20.07.2022
https://doi.org/10.32322/jhsm.1095045

Abstract

Aim: Massive methanol poisonings have occurred in the past decades, resulting in a large number of deaths. In this study, our aim is to retrospectively analyze methanol poisoning cases admitted to the emergency department between 2019-2021, to evaluate their demographic characteristics, causes of poisoning, clinical and laboratory findings, treatments applied and mortality, and to contribute to the poisoning data of our country.
Material and Method: The cases of methanol poisoning who applied to the emergency department in a 3-year period were analyzed retrospectively. Medical files of patients aged 18 years and older were reviewed. Patients diagnosed with 'methanol poisoning' as a result of the examination were included in the study.
Results: A total of 59 patients were included in the study. 88% (n=52) of the patients with a mean age of 53±10 were male. The presence of neurological symptoms and GCS were associated with mortality among the symptoms of patients presenting to the emergency department (p=0.017, p<0.001, respectively), it was seen that low pH and NaHCO3, and high lactate, serum sodium and anion gap were associated with mortality (p<0.001, p=0.003, p<0.001, p=0.022, respectively, p=0.001)
Conclusion: Methanol poisoning is a disease with high mortality despite the improved treatment possibilities. Lactate level was found to be an independent factor for mortality, and increased lactate levels are associated with poor clinical outcome. There was no difference in mortality between patients treated with ethanol and fomepizole.

References

  • Ocak T, Utku Murat Kalafat, Baştürk M. Alcohol poisonings: review. Turkiye Klinikleri J Emerg Med-Special Topics 2016; 2; 1: 38-43
  • Rietjens SJ, de Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol? Neth J Med. 2014; 72; 2: 73-9.
  • Gallagher N, Edwards FJ. The Diagnosis and management of toxic alcohol poisoning in the emergency department: a review article.Adv J Emerg Med. 2019; 33: e28.
  • Kruse JA. Methanol and ethylene glycol intoxication. Crit Care Clin 2012; 28: 661-71.
  • Pratumvinit B, Lam L, Kongruttanachok N, et al. Anion gap reference intervals show instrument dependence and weak correlation with albumin levels. Clin Chim Acta 2020; 500: 172-9.
  • Kraut JA. Approach to the Treatment of methanol intoxication. Am J Kidney Dis 2016; 68; 1: 161-7.
  • Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA, American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Methanol Poisoning. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol 2002; 40: 415–46.
  • Greene HR, Krasowski MD. Correlation of osmolal gap with measured concentrations of acetone, ethylene glycol, isopropanol, methanol, and propylene glycol in patients at an academic medical center. Toxicol Rep 2019; 7: 81–8.
  • Bozkurt Babuş S, İraöz G, Köse A, Orekici Temel G, Tiftik RN, Toker İ. Retrospective analysis of methyl alcohol intoxications in emergency department. J Tepecik Educ Res Hosp 2019; 29; 3: 235-40.
  • Kaewput W, Thongprayoon C, Petnak T, et al. Inpatient burden and mortality of methanol intoxication in the United States. Am J Med Sci 2021; 361; 1: 69-74.
  • Jones AW. Clinical and forensic toxicology of methanol. Forensic Sci Rev 2021; 33: 117–43.
  • Liberski S, Kaluzny BJ, Kocięcki J. Methanol-induced optic neuropathy: a still-present problem. Arch Toxico 2022; 96: 431–51.
  • Choi JH, Lee SK, Gil YE. et al. Neurological complications resulting from non-oral occupational methanol poisoning. J Korean Med Sci 2017; 32: 371–6.
  • Gülen M, Satar S, Avcı A, Acehan S, Orhan U, Nazik H. Methanol poisoning in Turkey: Two outbreaks, a single center experience. Alcohol (Fayetteville, N.Y). 2020.
  • Beatty L, Green R, Magee K, Zed PA. systematic review of ethanol and fomepizole use in toxic alcohol ingestions. Emerg Med Int 2013; 2013: 638057.
  • Zakharov S, Pelclova D, Navratil T. et al. Fomepizole versus ethanol in the treatment of acute methanol poisoning: Comparison of clinical effectiveness in a mass poisoning outbreak. Clinical toxicology (Philadelphia, Pa.) 2015; 53: 797–806
  • Zakharov S, Navratil T, Pelclova D. Fomepizole in the treatment of acute methanol poisonings: experience from the Czech mass methanol outbreak 2012-2013. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 158: 641-9.
There are 17 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Guner Yurtsever 0000-0002-6803-1239

Cüneyt Arıkan 0000-0001-6823-5357

Hüseyin Acar 0000-0002-1905-7133

Omay Sorgun 0000-0002-0376-7173

Ejder Saylav Bora 0000-0002-2448-2337

Publication Date July 20, 2022
Published in Issue Year 2022 Volume: 5 Issue: 4

Cite

AMA Yurtsever G, Arıkan C, Acar H, Sorgun O, Bora ES. Methanol poisoning in the emergency department: a retrospective study. J Health Sci Med / JHSM. July 2022;5(4):949-953. doi:10.32322/jhsm.1095045

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Prof. Murat KEKİLLİ (MD)

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