Abstract
The objective of the present study was to report the data from the mass methanol poisoning in the Czech Republic in 2012 addressing the general epidemiology, treatment, and outcomes, and to present a protocol for the use of fomepizole ensuring that the antidote was provided to the most severely poisoned patients in the critical phase. A combined prospective and retrospective case series study of 121 patients with confirmed methanol poisoning.
From a total of 121 intoxicated subjects, 20 died outside the hospital and 101 were hospitalized. Among them, 60 survived without, and 20 with visual/CNS sequelae, whereas 21 patients died.
Continuous hemodialysis was used more often than intermittent hemodialysis, but there was no significant difference in mortality rate between the two. Due to limited stockpiles of fomepizole, ethanol was administered more often; no difference in mortality rate was found between the two.
Severity of metabolic acidosis, state of consciousness, and serum ethanol on admission were the only significant parameters associated with mortality.No difference in the effect of mode of dialysis and type of antidote on mortality rate was found. A pre-defined recommendation on hospital triage for fomepizole administration can be useful in mass outbreaks with limitations in availability of fomepizole and possible risk of working overload of medical personnel treating several critically poisoned patients simultaneously.