Model of Hirsch et al for Estimatiing the Dialysis Time Required for a Patient Who Has Ingested a Toxic Alcohol

 

Patient selection: ingestion of a toxic alcohol (methanol, eithylene glycol)

 

Protocol: intravenous ethanol infusion with ethanol added to dialysate fluid (see paper for details)

 

Target: To predict number of hours of dialysis required to get the blood alcohol level to 5 mmol/L

 

Parameters:

(1) initial concentration of the toxic alcohol in mmol/L

(2) total body water in liters

(3) dialysis machine manufacturer’s specified urea clearance at the observed blood pump speed in mL/min

 

k =

= 0.8 * (urea clearance)

 

number of hours of dialysis to reach target concentration =

= (-1) * (total body water) * LN(5 / (initial concentration)) / (0.06 * k)

 

This equation may be modeled on the Kt/V for dialysis. Total body water is the distribution volume for urea.