Search
propylene glycol intoxication
Etiology:
- large doses of propylene glycol generally as a diluent for IV lorazepam
- IV lorazepam doses > 1 mg/kg/day (166 mg/day)
Pathology:
- acute renal failure
- metabolic acidosis
Laboratory:
1) anion gap metabolic acidosis
a) arterial blood gas
b) chem8 (calculate anion gap)
1] serum Na+
2] serum K+
3] serum bicarbonate (< 10 meq/L)
4] serum chloride
2) serum ketones are negative
3) serum osmolality, osmolal gap > 10 mOsm/kg H2O [1]
4) propylene glycol in serum > 25 mg/dL
Management:
- stop lorazepam infusion
- hemodialysis
Related
propylene glycol
General
toxicity; poisoning; overdose
References
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018