Acute ethylene glycol intoxication. Part II. Diagnosis, treatment, prognosis, and preventions

Acute ethylene glycol (EG) intoxication is a rapidly progressive, life-thre atening emergency with a complex pathophysiology-the key features of which include hyperosmolality, high anion gap metabolic acidosis, and acute oligu ric renal failure. Rapid diagnosis is critical and requires a strong index of suspicion and often repeat analyses. Antidotal therapy is based on preve nting biotransformation of EG to its toxic metabolites; however, intensive physiologic monitoring and aggressive use of intravenous fluids and sodium bicarbonate are also essential components of treatment. Despite advances in our understanding of the pathophysiology and therapy of EG intoxication, m ost animals are presented already in oliguric renal failure and may require hemodialysis or peritoneal dialysis to survive the effects of this intoxic ation.