NHẬN XÉT CÁC BIỆN PHÁP ĐIỀU TRỊ NGỘ ĐỘC CẤP METHANOL TẠI TRUNG TÂM CHỐNG ĐỘC BỆNH VIỆN BẠCH MAI

Abstract

Fomepizol is not available in Vietnam, therefore, the treatment of methanol poisoning focuses on the main measures: resuscitation, dialysis, aggressive use of bicarbonate and oral ethanol. Objective: to evaluate the rates, characteristics and outcomes of the treatment measures applied to patients with acute methanol poisoning at the Poison Control Center (PCC). Subjects and Methods: A observational study included 107 methanol poisoned patients treated at the PCC of Bach Mai Hospital from January 2016 to July 2019. Results: The applied treatment measures for acute methanol intoxication were mechanical ventilation (78.5%); using vasopressors (43.9%). The rate of patients required ventilation and using vasopressors were higher in the fatal group than that in the survival group (p<0.01). Bicarbonate was used to rapidly correct acidosis in 99.1% of the patients. The percentage of using bicarbonate more than 500mEq and the amount of bicarbonate to be used in the fatal group was higher than the survival group (p <0.05); 82.2% of patients received 20% orally ethanol, the average amount of ethanol was 1093.8 ml; 99.1% of patients need dialysis, of which 90.7% were intermittent hemodialysis and 8.4% were CVVH. Average duration of hemodialysis was 7.6 ± 3.34 hours. The mortality rate of methanol poisoning was high (41.1%). Conclusion: acute methanol poisoning was life-threatening and the treatment required a combination of aggressive resuscitation measures, use of antidotes and dialysis.