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Thursday, 04 December 2014 00:00

Ethylene Glycol Toxicity

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Several toxic alcohols are of medical and toxicological importance; the principal ones include ethanol, ethylene glycol (EG), methanol, and isopropanol. See Alcohol Toxicity. This article discusses ethylene glycol, which is extremely toxic. If untreated, ingestion of ethylene glycol can be fatal.

Ethylene glycol is the major ingredient of almost all radiator fluid products in the United States. It is used to increase the boiling point and decrease the freezing point of radiator fluid, which circulates through the automotive radiator. These changes to the boiling and freezing points result from the colligative properties of the solute (ie, they depend on the number of particles in the solution). Hence, ethylene glycol is added to prevent the radiator from overheating or freezing, depending on the season. Fluorescein dye is often added to radiator fluid to help mechanics identify the source of a radiator leak. The fluorescein in the fluid fluoresces when viewed under ultraviolet light.

Ethylene glycol tastes sweet, which is why some animals are attracted to it. Many veterinarians are familiar with ethylene glycol toxicity because of the frequent cases that involve dogs or cats that drink radiator fluid.

Initially, patients with ethylene glycol intoxication may be asymptomatic; with time they will develop altered mental status and dyspnea. The classic laboratory profile is an early osmolar gap that later transitions to an anion gap metabolic acidosis. Initial treatment includes infusion of crystalloids to enhance renal clearance of the toxic metabolites. Ethyl alcohol has traditionally been used for antidotal treatment, but it has largely been supplanted by fomepizole.