Clinical Outcomes of Methanol Intoxication Outbreak Managed with Hemodialysis at Nopparat Rajathanee Hospital: Case Series and Literature Review
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Abstract
Following a mass methanol poisoning outbreak from illicit liquor in Bangkok in August 2024, hemodialysis became the primary life-saving treatment due to the unavailability of fomepizole in Thailand. This case series describes the baseline characteristics, biochemical parameters, treatment modalities, and clinical outcomes of patients with methanol poisoning treated with hemodialysis at a quaternary care hospital under the Ministry of Public Health in Bangkok, Thailand. Between August 22 and September 3, 2024, a total of 17 confirmed cases of methanol intoxication were identified. Most patients (94.1%) were male. The most common presenting symptoms were dyspnea (94.1%) and blurred vision (70.6%). Laboratory findings demonstrated severe metabolic acidosis, with a median pH of 7.08, serum bicarbonate of 4.0 mEq/L, and an anion gap of 35.0 mEq/L. All patients (100%) underwent intermittent hemodialysis, while 35.3% required additional continuous renal replacement therapy. The median door-to-dialysis time was 6 hours. The survival rate was 76.5% (13 cases), and the mortality rate was 23.5% (4 cases). Permanent disability occurred in 29.4% (5 cases), including permanent visual impairment (17.6%) and neurological deficits (11.7%). Early initiation of hemodialysis, combined with effective resource management during a mass casualty event, was a critical factor in achieving clinical outcomes comparable to international benchmarks
despite limited access to antidotes.
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This article is published under CC BY-NC-ND 4.0 license, which allows for non-commercial reuse of the published paper as long as the published paper is fully attributed. Anyone can share (copy and redistribute) the material in any medium or format without having to ask permission from the author or the Nephrology Society of Thailand.
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