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Ethylene glycol
Last reviewed: 20.11.2021
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Ethylene glycol (CH 2 OCHH 2 OH) is a dihydric alcohol widely used in heat exchangers, antifreeze compositions and as an industrial solvent. When ingested, ethylene glycol is rapidly absorbed into the stomach and intestines. It is excreted unchanged by kidneys (20-30%) and oxidized in the liver (approximately 60%). Like other alcohols, ethylene glycol is metabolized by alcohol to liver dehydrogenase with the formation of glycol aldehyde, glyoxal and oxalate. Oxalate can be deposited in the tubules of the kidneys, causing arthritis. The half-life of ethylene glycol is approximately 3 hours, a dose of 100 ml is considered fatal.
In the clinical picture of poisoning with ethylene glycol, three stages are distinguished:
- Stage I (from 30 minutes to 12 hours) is characterized by disorders from the side of the central nervous system, such as transient excitation, followed by oppression, stupor, coma, convulsions;
- Stage II (from 12 to 24 hours) is manifested by cardiovascular and respiratory system disorders (tachypnea, cyanosis, pulmonary edema) and progressive depression of CNS activity;
- Stage III (48-72 hours) is characterized by the development of acute renal failure, in addition, generalized convulsions are possible.
The concentration of ethylene glycol in blood serum above 20 mg% is considered toxic, and above 200 mg% is lethal.
They note severe metabolic acidosis, increased myoglobin concentration, QA activity, osmolarity, decreased calcium concentration, and a large amount of oxalate in the urine. The composition of antifreeze often includes fluorescein, so you can detect fluorescence of urine when it is illuminated with a Wood lamp.
Conduction of hemodialysis is indicated to all patients with an ethylene glycol concentration in the blood of more than 50 mg%, development of renal failure or severe metabolic acidosis.
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