ethylene glycol

toxicity

metabolism to glycolaldehyde then to glycolic, glyoxylic and oxalic acids.
Glycolic acid is cleared by the kidney and is largely responsible for the marked acidosis seen in severe cases

clinical features

  • Metab acidosis
    • initially high osmolar gap → osmolar gap ↓ while anion gap ↑
  • Falsely high lactate (cross reactivity with toxic alcohols)
  • ↑ RR

antidote

toxbase says treat until EG levels undetectable