Article Text

HAEMOFILTRATION AS A TREATMENT MODALITY FOR ACUTE SEVERE ALCOHOL INTOXICATION: CASE REPORT
  1. V Palanivel1,
  2. M A Anjay1,
  3. S Pradhan2,
  4. H Stuart3
  1. 1Department of Paediatrics, James Paget University Hospital, Great Yarmouth, Norfolk, UK
  2. 2Department of Neonatology, Addenbrooke’s Hospital, Cambridge, UK
  3. 3Department of Anaesthetics, James Paget University Hospital, Great Yarmouth, Norfolk, UK

Abstract

Objective We report a case of an adolescent girl who had extremely high ethanol levels, successfully managed by haemofiltration.

Methods Case report.

Results A 15-year-old girl was brought deeply comatose to casualty in a district general hospital. She had consumed large amounts of alcohol at a party. On examination she was hypothermic with a Glasgow coma scale score of 3/15. She was intubated and transferred to the intensive therapy unit. The initial ethanol level was 570 mg/dl (>450 mg/dl is considered to be potentially fatal). The levels rose to 807 mg/dl in one hour. As haemodialysis was not immediately available and the patient was haemodynamically unstable, arteriovenous haemofiltration was instituted. The ethanol level dropped dramatically to 244 mg/dl in a few hours. She was successfully extubated and made an uneventful recovery.

Conclusions In recent times, an increasing number of adolescents are being admitted following the consumption of alcohol. Acute ethanol intoxication can be life threatening. The National Poisons Information Service in the UK suggests haemodialysis when ethanol levels are more than 500 mg/dl. Haemofiltration produces less haemodynamic instability when compared with haemodialysis and is better at removing high molecular weight molecules. In our case haemofiltration resulted in a rapid lowering of the alcohol concentration. We present this as the first case in which haemofiltration has been used successfully for severe alcohol intoxication in children. Survival following such high levels of ethanol has seldom been reported in paediatrics.

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