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METHANOL POISONING: MANAGEMENT OF ACIDOSIS WITH COMBINED HEMODIALYSIS AND PERITONEAL DIALYSIS
Author(s) -
Humphery Timothy J.
Publication year - 1974
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1974.tb93369.x
Subject(s) - medicine , peritoneal dialysis , metabolic acidosis , acidosis , anesthesia , respiratory acidosis , bradycardia , hemodialysis , methanol poisoning , intensive care medicine , surgery , blood pressure , heart rate , chemistry , organic chemistry , methanol
The management of a seaman who ingested a large quantity of methanol is described. Key diagnostic features were acidosis, tachypnœa, optic papillitis, dilated pupils, altered sensorium, and a formaldehyde odour present in the expired air and urine. Therapy included intravenous bicarbonate for correction of severe metabolic acidosis, intravenous ethyl alcohol, and combined simultaneous peritoneal and hæmodialysis. Problems encountered were bradycardia with arrhythmia, managed with atropine; respiratory arrest managed with diazepam, endotracheal Intubation, ventilatory support, and later tracheostomy; and severe hypokalæmia. Future cases should be regarded as medical emergencies and transferred to centres with facilities for rapid blood‐gas, acid‐base, and potassium measurements, and at which peritoneal dialysis and hæmodialysis with simultaneous ventilatory support are available. With early recognition and rapid treatment preservation of sight can be expected and late neurological deficits avoided.