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

• anion gap metabolic acidosis
  • arterial blood gas
  • chem8 (calculate anion gap)
    • serum Na+
    • serum K+
    • serum bicarbonate (< 10 meq/L)
    • serum chloride
• serum ketones are negative
• serum osmolality, osmolal gap > 10 mOsm/kg H2O
• propylene glycol in serum > 25 mg/dL

Management

• stop lorazepam infusion
• hemodialysis

More general terms

• toxicity; poisoning; overdose

Additional terms

• propylene glycol