Illescas Alisa C, Argyropoulos Christos P, Combs Sara A, Shaffi Saeed K, Xu Zhi Q, Aragon Michael A, Teixeira J Pedro
Department of Internal Medicine, University of New Mexico School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131 USA.
Division of Nephrology, University of New Mexico School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131 USA.
Ren Replace Ther. 2021;7(1):43. doi: 10.1186/s41100-021-00362-8. Epub 2021 Aug 3.
In May and June 2020, an outbreak of methanol poisoning arose in the southwest United States linked to ingestion of contaminated hand sanitizer imported during the coronavirus disease 2019 pandemic, ultimately resulting in over a dozen hospitalizations and at least four deaths in New Mexico and Arizona. In this report, we describe one of these cases in which profound methanol intoxication was successfully treated with the Tablo® Hemodialysis System, the first reported case of toxic alcohol poisoning treated with this novel device. We carry out a formal regression analysis of the serial methanol levels obtained in this case to conservatively estimate that intermittent hemodialysis with Tablo achieved a clearance of methanol of 239 mL/min (95% confidence interval, 173-305 mL/min), a clearance that is well within the previously published standard of care. We conclude by reviewing both the treatment of toxic alcohol poisoning and the determinants of small molecule clearance with hemodialysis, emphasizing the importance of optimizing the dialytic treatment of intoxications with extended treatment times and the use of high-efficiency dialyzers.
2020年5月和6月，美国西南部爆发了甲醇中毒事件，此次事件与在2019冠状病毒病大流行期间进口的受污染洗手液摄入有关，最终导致新墨西哥州和亚利桑那州十几人住院，至少四人死亡。在本报告中，我们描述了其中一例使用Tablo®血液透析系统成功治疗严重甲醇中毒的病例，这是首例使用这种新型设备治疗有毒酒精中毒的报告病例。我们对该病例中获得的系列甲醇水平进行了正式回归分析，以保守估计使用Tablo进行间歇性血液透析的甲醇清除率为239毫升/分钟（95%置信区间，173 - 305毫升/分钟），该清除率完全在先前公布的治疗标准范围内。我们通过回顾有毒酒精中毒的治疗以及血液透析中小分子清除的决定因素来得出结论，强调通过延长治疗时间和使用高效透析器来优化中毒的透析治疗的重要性。
