Should Guidelines for Conventional Hemodialysis Initiation in Acute Methanol Poisoning, Be Revised, When no Fomepizloe is Used?

Abstract

Background: Consumption of home-distilled alcohol may lead to epidemic or sporadic cases of severe acute methanol poisoning. The difficulty of establishing strict indications for hemodialysis in acute methanol poisoning is a widely recognized issue.

Materials and methods: The determination of the clinical, especially hemodialysis, and para clinical factors influencing patient survival in 46 acutely methanol poisoned patients was the aim of this cross sectional retrospective study. Clinical and paraclinical variables compared in surviving and non-surviving patients were hemodialysis and ventilation requirements, the level of consciousness, ABG parameters the serum methanol, creatinine and BUN levels. Only ethanol was used for ADH (Alcohol Dehydrogenize) blockade.

Results: Receiver operative curve characteristics showed that a serum methanol threshold level of 15mg/dl, instead of 25mg/dl, has a better sensitivity and rather the same specificity for predicting patient mortality.

Conclusions: With no fomepizloe and using conventional hemodialysis, lowering the threshold of methanol concentration for hemodialysis initiation, may save lives in acute methanol intoxication.

Keywords: Hemodialysis; Methanol; Poisoning.