Missed scientific abstract from the 2004 CAEP/ACMU scientific assembly

Erratum

CJEM 2004;6(4):239

The CAEP research abstract published on this page was inadvertently missed during the compilation of the May issue of CJEM. This abstract was awarded a poster presentation. The Research Committee apologies for any inconvenience this may have caused.

Management of toxic alcohol ingestions after the introduction of Fomepizole

Green RS, Department of Emergency Medicine, Dalhousie University, Halifax, NS

INTRODUCTION: Ethylene glycol and methanol ingestions are relatively uncommon but potentially lethal overdoses. Traditional management of toxic alcohol ingestions is directed at minimizing the generation of toxic metabolites by alcohol dehydrogenase (ADH) with ethanol infusions, and hemodialysis (HD) for toxin removal. Recently, an alternative agent for ADH blockade was introduced into clinical practice. The purpose of this study was to review the management of toxic alcohol ingestions in a tertiary care referral center after the introduction of fomepizole. METHODS: Data was collected on all patents treated for a toxic alcohol ingestion for a 1 year period after the introduction of fomepizole to hospital formulae. Patients were identified by ED, pharmacy, hemodialysis and ICU databases. The patients medical records were reviewed, and data was recorded on a predetermined computerized data collection form. RESULTS: Overall, twenty one (21) toxic ingestions (14 methanol; 7 ethylene glycol) were identified over the one year period. Fomepizole was used for ADH blockade in 10/21 patients; ETOH infusions in 16/21 patients (combined ETOH and fomepizole use in 5/21). All patients were admitted to an intensive care unit and all received hemodialysis. On preliminary analysis, there was no apparent difference in time from ingestion to ED presenataion, serum pH, serum bicarbonate, or serum creatinine between groups treated with fomepizole or ETOH infusions. In addition, there was no apparent difference in the need for HD, ICU admission, ICU LOS, or total LOS. CONCLUSIONS: Despite theoretical advantages, the addition of fomepizole to the management of toxic alcohol ingestions does not seem to change the need for HD or ICU admission. Further study is needed to determine the role fomepizole in tertiary care centers.