Fomepizole in the treatment of acute methanol poisonings: experience from the Czech mass methanol outbreak 2012-2013
Jazyk angličtina Země Česko Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
25482738
DOI
10.5507/bp.2014.056
Knihovny.cz E-zdroje
- MeSH
- antidota terapeutické užití MeSH
- dospělí MeSH
- epidemický výskyt choroby MeSH
- ethanol terapeutické užití MeSH
- fomepizol MeSH
- lidé středního věku MeSH
- lidé MeSH
- methanol otrava MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mortalita v nemocnicích MeSH
- prospektivní studie MeSH
- pyrazoly terapeutické užití MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- antidota MeSH
- ethanol MeSH
- fomepizol MeSH
- methanol MeSH
- pyrazoly MeSH
OBJECTIVE: During an outbreak of mass methanol poisonings in the Czech Republic in 2012-2013, fomepizole was applied as an alternative antidote to ethanol. We present the laboratory data, clinical features, adverse reactions, and treatment outcomes in all patients treated with fomepizole. METHODS: Combined retrospective and prospective case series study in 25 patients, median age 50 (16-73) years, 18 males and 7 females. RESULTS: There were 24% fatalities, 36% survivors without health impairment, and 40% survivors with sequelae. All the patients who died were comatose on admission; the mortality was 50% among patients in a coma. The median intensive care unit length of stay was six (2-22) days. The median total dose of fomepizole was 2 (1-9) g. Complications were observed in 7/25 cases: aspiration pneumonia (4), sepsis (2), bleeding (2), malignant arrhythmia (1), delirium tremens (1), and rebound of acidosis (1). The patients who survived without impairment were less acidotic than those who died or survived with sequelae (P<0.01). No difference in serum methanol and formate was found between the three groups. CONCLUSION: There is no evidence whether fomepizole is a more efficient antidote than ethanol with regards to the hospital mortality. The possibility of delirium tremens in the patients with a history of chronic alcohol abuse has to be taken in consideration. The benefits of fomepizole were indirect: no need to monitor serum ethanol's level during the hemodialysis in severely poisoned patients and less working overload on ICU doctors treating several poisoned patients simultaneously.
Citace poskytuje Crossref.org
Severe Methanol Poisoning with Supralethal Serum Formate Concentration: A Case Report