Substance
Ethylene glycol

Pathology
Metabolism to oxalic, glyoxylic, and glycolic acids; conversion to lactate, increasing the lactic acid level; calcium oxalate crystal formation and deposition in tissues; metabolite toxicity to kidneys, CNS, and lungs.

Symptoms
Nausea, vomiting, excitability, hypotension, abdominal cramps, weakness, metabolic acidosis, ataxia, vertigo, arrhythmias, stupor, coma, death from respiratory or renal failure with uremia.

Emergency Measures
Maintain airway, breathing, and circulation. Provide ethanol, folic acid, 4-methylpyrazole, pyridoxine, and thiamine. Hemodialysis will remove ethylene glycol from the blood in cases of severe toxicity.

Comments
Outcomes vary; in general, comatose patients have a poor prognosis.