Patient selection: suspected or probable ethylene glycol ingestion
Molecular weight: 62.07 g
Criteria for therapy with fomepizole - one of the following:
(1) serum ethylene glycol concentration > 62 mg/dL (10 mmol/L)
(2) documented or suspected ingestion with osmolal gap > 25 mOsm per kg H2O (after subtraction of any effect from ethanol)
(3) documented or suspected ingestion with >= 2 of the following:
(3a) arterial pH < 7.3
(3b) serum bicarbonate < 20 mmol/L
(3c) presence of urinary oxalate crystals
where:
• Criteria II and IIIC in the paper for osmolal gap are the same.
Observations:
(1) The absence of an elevated osmolal gap does not exclude ethylene glycol poisoning.
(2) Therapy should be started without delay if a toxic alcohol cannot be excluded as the cause.
