Introduction: Discussion: Management of children exposed to tastes of DEG is a conundrum for poison centers. It ranges from obs to admission/fomepizole. In 79/80 cases there were no abnormal labs and no more than minor effects. The one variant ingestion included antifreeze. Limits of this data include sample size, retrospective data, and lack of extended follow up. However, this review argues that children with a taste of DEG will suffer no adverse outcomes. A large prospective cohort study would strengthen this conclusion.
Conclusion : This 80 patient series indicates that children exposed to taste amounts of DEG will not have major adverse effects. Diethylene glycol (DEG), in brake fluid, can cause life threatening renal failure. Less is known about management of DEG as compared to the more commonly encountered toxic alcohols. In 2008, there were 1,292 DEG-related calls to poison centers. One issue that plagues providers is what to recommend for children who ingest small amounts. We report a 10-year poison center review of pediatric DEG exposures.
Methods: A search was done of poison center cases from January 2000 through January 2010 for patients under 6 years old with oral exposures to DEG of small or unknown volumes. Cases were examined for location, symptoms, labs, treatment, and outcome.
Results : Eighty-nine cases met initial inclusion criteria; nine were excluded (wrong fluid logged [1]; eye exposure only [2]; amount greater than a taste mouthful [2]; potentially toxic but follow up not possible due to lack of parent/hospital cooperation [4]). Of the 80 cases left, 49 were observed at home, 23 sent home from the ED and 11 admitted. There were seven transferred to tertiary care. For outcomes, 69 were nontoxic/no effect, 10 minor effects (MiE) and 1 major effect (MaE). Of the MiE five had GI upset alone, one cough/GI upset, two oral irritation, one drowsy, and one eye irritation. The MaE child had cyanosis and AMS, but ingested antifreeze as well. No patients developed renal failure or death. Fomepizole was used in five cases (four no effects, one MiE). Supportive care only was provided in eight cases; the other 67 were observed only. Chem panels were done in 24 cases; all were normal except the anion gap in the MaE case. All 16 serum osmolalities done were normal. The three DEG levels obtained were negative.