Wildenauer René, Kobbe Philipp, Waydhas Christian
Department of General Surgery, University of Würzburg, Germany.
Technol Health Care. 2010;18(3):203-6. doi: 10.3233/THC-2010-0582.
Up-to-date no indicator for hemodialysis in severe ethanol intoxication is available. In these cases, the benefits have to outweigh the risks and costs of hemodialysis. In this case report, a suicidal patient had ingested 250 ml of 95% ethanol and was found in deep coma. In literature, some cases, especially of adolescents, are described with severe ethanol poisoning and blood ethanol levels above 740 mg/dL. Hemodialysis, if initiated, decreased ethanol levels significantly as compared to peritoneal dialysis, charcoal or gastric lavage and reduced also clinical costs. While recommendations exist for starting dialysis in ethylene glycol or methanol intoxications, no algorithm is available to determine the situations when hemodialysis is required in ethanol intoxication. The osmole gap may serve as an indicator to differentiate, which patients need haemodialysis - right now, the decision depends upon the physicians experience or preference.
目前尚无针对严重乙醇中毒进行血液透析的指标。在这些情况下，血液透析的益处必须超过其风险和成本。在本病例报告中，一名自杀患者摄入了250毫升95%的乙醇，被发现处于深度昏迷状态。在文献中，描述了一些病例，尤其是青少年，患有严重乙醇中毒且血液乙醇水平高于740毫克/分升。与腹膜透析、活性炭或洗胃相比，若启动血液透析，乙醇水平会显著降低，同时也降低了临床成本。虽然对于乙二醇或甲醇中毒开始透析有相关建议，但尚无确定乙醇中毒时何时需要进行血液透析的算法。渗透压间隙可作为区分哪些患者需要血液透析的指标——目前，这一决定取决于医生的经验或偏好。
