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Neurocritical Care

, Volume 30, Issue 1, pp 226–228 | Cite as

Poisoning with Ethanol and 2-Propanol-Based Hand Rubs: Give Caesar What Belongs to Caesar!

  • Bruno MégarbaneEmail author
  • Antoine Villa
Letter to the Editor

To the Editor,

We read with great interest the practical pearl report by Henry-Lagarrigue and colleagues [1] and would like to comment on their interpretation of their poisoned patient’s features. The authors reported a massive ingestion of alcohol hand rub (composition: 43% ethanol and 16% 2-propanol) in a 33-year-old depressed woman resulting in a profound coma with a transient mild lactate elevation (initial blood concentration: 3.4 mmol/l and peak blood concentration: 4.8 mmol/l). Outcome was favorable following airway support with mechanical ventilation for 6 h. The authors attributed the deep coma to ethanol and the observed transient hyperlactatemia to the liver alcohol dehydrogenase (ADH)-mediated metabolism of 2-propanol, reported to be a two-step pathway: transformation of 2-propanol to propylene glycol and oxidation of propylene glycol to lactic and pyruvic acids.

At least four other cases of 2-propanol-based hand rub ingestions causing significant toxicity have been...

Notes

Acknowledgments

The authors would like to acknowledge Jenny Lu, MD, from Toxikon Consortium, Chicago, USA for her review of this manuscript.

Conflict of Interest Statement

None.

References

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Réanimation Médicale et Toxicologique, Hôpital Lariboisière, INSERM U705Université Paris-DiderotParisFrance
  2. 2.Centre Antipoison, Hôpital Fernand WidalUniversité Paris-DiderotParisFrance

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