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Ethylene glycol
Last reviewed: 05.07.2025
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Ethylene glycol (CH 2 OHCH 2 OH) is a dihydric alcohol widely used in heat exchangers, antifreeze compounds and as an industrial solvent. When taken orally, ethylene glycol is rapidly absorbed in the stomach and intestines. It is excreted unchanged by the kidneys (20-30%) and oxidized in the liver (approximately 60%). Like other alcohols, ethylene glycol is metabolized by liver alcohol dehydrogenase to form glycolaldehyde, glyoxal and oxalate. Oxalate can be deposited in the renal tubules, causing acute renal failure. The half-life of ethylene glycol is approximately 3 hours, and a lethal dose is considered to be 100 ml.
In the clinical picture of ethylene glycol poisoning, three stages are distinguished:
- stage I (from 30 minutes to 12 hours) is characterized by disorders of the central nervous system, such as transient excitation, followed by depression, stupor, coma, convulsions;
- stage II (from 12 to 24 hours) is manifested by disorders of the cardiovascular and respiratory systems (tachypnea, cyanosis, pulmonary edema) and progressive depression of the central nervous system;
- Stage III (48-72 hours) is characterized by the development of acute renal failure, in addition, generalized convulsions are possible.
A concentration of ethylene glycol in the blood serum above 20 mg% is considered toxic, and above 200 mg% is considered fatal.
Severe metabolic acidosis, increased myoglobin concentration, CC activity, osmolarity, decreased calcium concentration, and the presence of large amounts of oxalates in the urine are noted. Antifreezes often contain fluorescein, so fluorescence of urine can be detected when illuminated with a Wood's lamp.
Hemodialysis is indicated for all patients with blood ethylene glycol concentrations greater than 50 mg%, development of renal failure or severe metabolic acidosis.
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