Unintentional ethylene glycol ingestions in children

Abstract

ABSTRACT Background: 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.