Clinical Review of Toxic Alcohol Poisoning Cases in Korea

독성 알코올 중독 환자에 대한 고찰

  • Rhee, Nu-Ga (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Chung, Sung-Phil (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Park, In-Cheol (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Lee, Kyeong-Ryong (Department of Emergency Medicine, Konkuk University School of Medicine) ;
  • Kim, Hyun-Jin (Department of Emergency Medicine, College of Medicine, Konyang University) ;
  • Kim, Gun-Bea (Department of Emergency Medicine, National Health Insurance Corporation Ilsan Hospital) ;
  • Cho, Young-Soon (Department of Emergency Medicine, College of Medicine, Soonchunhyang University) ;
  • Kwon, In-Ho (Department of Emergency Medicine, Inje University Haeundae Paik Hospital) ;
  • Kim, Seung-Whan (Department of Emergency Medicine, Chungnam National University Hospital)
  • 이누가 (연세대학교 의과대학 응급의학교실) ;
  • 정성필 (연세대학교 의과대학 응급의학교실) ;
  • 박인철 (연세대학교 의과대학 응급의학교실) ;
  • 이경룡 (건국대학교 의학전문대학원 응급의학교실) ;
  • 김현진 (건양대학교 의과대학 응급의학교실) ;
  • 김건배 (국민건강보험일산병원 응급의학과) ;
  • 조영순 (순천향대학교 의과대학 응급의학교실) ;
  • 권인호 (인제대학교 해운대백병원 응급의학과) ;
  • 김승환 (충남대학교 의과대학 응급의학교실)
  • Received : 2012.01.06
  • Accepted : 2012.04.23
  • Published : 2012.06.16

Abstract

Purpose: Toxic alcohols are responsible for accidental and suicide motivated poisonings, resulting in death or permanent sequelae for the afflicted patients. Major therapeutic modalities in these cases include treatment with alcohol dehydrogenase inhibitors and extracorporeal elimination. There have been a number of case reports of toxic alcohol intoxication in Korea. The purpose of this study was to review the clinical characteristics of patients suffering toxic alcohol intoxication. Methods: We retrospectively reviewed the medical records of patients who presented with toxic alcohol intoxication at 8 emergency departments (ED) from Jun 2005 to Nov 2011. Patients who ingested methanol, isopropyl alcohol, ethylene glycol, and other alcohols except ethanol, were included in this study. The clinical characteristics of these patients were analyzed to include anion and osmolar gap, and estimated concentration of alcohol in the body. Results: During the study period, 21 patients were identified who had ingested toxic alcohol (methanol; 12 patients, ethylene glycol; 9 patients). At ED arrival, the mean anion gap was $18.7{\pm}6.9$ and the osmolar gap was elevated in 13 patients. Oral and IV ethanol were administrated to 11 patients in order to inhibit alcohol dehydrogenase. Extracorporeal elimination procedures such as hemodialysis were performed in 9 patients. There were no fatalities, but the one patient suffered permanent blindness. Conclusion: This study found that ethylene glycol and methanol were the substances ingested which produced toxic alcohol intoxication. The patients presented with high anion gap metabolic acidosis and were typically treated with oral ethanol and hemodialysis.

Keywords