Triethylene Glycol Poisoning Treated with Intravenous Ethanol Infusion

Vassiliadis, John; Graudins, Andis; Dowsett, Robert P

doi:10.1081/clt-100102455

Cited by 19 publications

(7 citation statements)

References 10 publications

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“…The association of systemic symptoms (acute headache, dizziness, drowsiness and tiredness) with glycol fog use is consistent with our finding that 61% of the mean proportion of the total aerosol mass was small enough to reach the gas exchange region of the lungs. In previous case reports of poisonings from triethylene and propylene glycol (two of the glycol compounds found in this study) [Teschke et al, 2005], subjects presented with mild CNS depression, lethargy, and drowsiness [Vassiliadis et al, 1999;Brooks and Wallace, 2002;Guillot et al, 2002].…”

Section: Discussionmentioning

confidence: 94%

Effects of theatrical smokes and fogs on respiratory health in the entertainment industry

et al. 2005

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Section: Discussionmentioning

confidence: 94%

Effects of theatrical smokes and fogs on respiratory health in the entertainment industry

et al. 2005

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“…As with all toxic alcohol exposures, the aim of therapy is to recognize the poisoning early in its course and to prevent the development of acidemia and renal failure. Specific therapies to block alcohol dehydrogenase conversion of DEG to its toxic metabolites, such as intravenous ethanol infusion or fomepizole, should be employed (23,24). Hemodialysis should be instituted as soon as possible to remove DEG, its metabolites, and to treat any metabolic acidemia that is present.…”

Section: Discussionmentioning

confidence: 99%

Delayed Neurologic Sequelae Resulting from Epidemic Diethylene Glycol Poisoning

Alfred¹,

Coleman²,

Harris³

et al. 2005

LCLT

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“…Only two reports of human poisoning could be found in the medical literature [8,10]. Neither of these reports mentioned or calculated a toxic or lethal dose.…”

Section: Comparison Of Testing Results To Deg and Teg Levels Found Inmentioning

confidence: 99%

“…TEG is an ethylene glycol derivative that has been used in certain brake fluid formulations. It has been reported to cause coma and metabolic acidosis when ingested in extremely large amounts [8][9][10]. It is important to note that although TEG may have some inherent toxicity at large doses and was found as a co-contaminant in medication samples from the Nigeria DEG mass poisoning, the majority of toxicity is most likely due to DEG.…”

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confidence: 99%

Diethylene Glycol in Health Products Sold Over-the-Counter and Imported from Asian Countries

Schier

Barr

et al. 2010

J. Med. Toxicol.

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Diethylene glycol (DEG), a chemical that has been implicated in multiple medication-associated mass poisonings, can result in renal and neurological toxicity if ingested. Three previous such mass poisonings implicated Chinese manufacturers as the origin of contaminated ingredients. No literature exists on potential DEG or triethylene glycol (TEG), a related compound, contamination of health products imported from Asian countries to the USA. Our primary objective was to quantitatively assess the amount of DEG present in a convenience sampling of these health products. The study's secondary objectives were to: (1) evaluate for, and quantify TEG levels in these samples; (2) compare DEG and TEG levels in these products directly to levels in medications implicated in previous similar mass poisonings; and (3) to estimate DEG dose (in mg/kg) based on the manufacturer's instructions and compare these values to toxic doses from past mass poisonings and the literature. A quantitative assessment of DEG and TEG was performed in a convenience sampling of over-the-counter health products imported from Asian countries. Results were converted to volume to volume (v/v) % and compared with DEG levels in medications implicated in previous mass poisonings. Estimated doses (based on the manufacturer's instructions) of each product with detectable levels of DEG for a 70 kg adult were compared to toxic doses of DEG reported in the literature. Seventeen of 85 (20%) samples were not able to be analyzed for DEG or TEG due to technical reasons. Fifteen of 68 (22%) samples successfully tested had detectable levels of DEG (mean, 18.8 μg/ml; range, 0.791-110.1 μg/ml; and volume to volume (v/v) range, 0.00007-0.01%). Two of 68 (3%) samples had TEG levels of 12.8 and 20.2 μg/ml or 0.0012% and 0.0018% TEG v/v. The product with the highest DEG% by v/v was 810 times less than the product involved in the Panama DEG mass poisoning (8.1%). The lowest reported toxic dose from a past DEG mass poisoning (14 mg/kg) was more than 150 times higher than the highest daily dose estimated in our study (0.09 mg/kg). Sixty-eight of 85 (80%) samples were able to be successfully analyzed for DEG and TEG. DEG and TEG were detectable in 15/68 (22%) and 2/68 (3%) samples, respectively. Based on current standards, these levels probably do not represent an acute public health threat. Additional research focusing on why DEG is found in these products and on the minimum amount of DEG needed to result in toxicity is needed.

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Triethylene Glycol Poisoning Treated with Intravenous Ethanol Infusion

Abstract: Pure triethylene glycol poisoning results in coma and metabolic acidemia and may be treated with alcohol dehydrogenase inhibitors such as ethanol.

Cited by 19 publications

References 10 publications

Effects of theatrical smokes and fogs on respiratory health in the entertainment industry

Effects of theatrical smokes and fogs on respiratory health in the entertainment industry

Delayed Neurologic Sequelae Resulting from Epidemic Diethylene Glycol Poisoning

Diethylene Glycol in Health Products Sold Over-the-Counter and Imported from Asian Countries

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