• Shahriar Zehtabchi, Richard Sinert, Bonny J Baron, Lorenzo Paladino, and Kabir Yadav.
• Department of Emergency Medicine, Downstate Medical Center, State University of New York, Brooklyn, NY 11203, USA. zehtab@yahoo.com
• Clin Toxicol (Phila). 2005 Jan 1; 43 (3): 161-6.

ObjectiveEmergency physicians frequently treat ethanol-intoxicated trauma patients. In patients with apparently minor injuries, the presence of metabolic acidosis is often attributed to serum ethanol. We tested whether there is justification for the bias that ethanol reliably explains the acidosis commonly seen in alcohol-intoxicated patients.MethodsProspective, observational.Inclusion CriteriaEthanol-intoxicated patients admitted to the emergency department (ED) following significant trauma mechanisms, in whom diagnostic evaluation revealed only minor injury.Exclusion CriteriaMajor trauma (blood transfusions, drop in Hct > 10 points over 24 h, or Injury Severity Score [ISS] >5) or positive urine toxicology screen.DefinitionsEthanol Intoxication: (Blood Alcohol Level (BAL) > or =80 mg/dl), Acidosis: BD < or = -3.0 mMol/L; Lactic Acidosis (LAC >2.2 mMol/L). Data were reported as mean+/-SD. Data were compared by t-tests or Fishers exact test as appropriate (alpha= 0.05, 2 tails) and correlations by Pearson correlation coefficient.Results192 patients were studied (84% male) with a mean age of 31.7+/-15.6 years. Acidosis was observed in 19.3% (CI 95%, 14.5% to 25.0%) of all study patients. We observed significant (p<0.001) difference in prevalence of acidosis in ethanol intoxicated (42%) compared to nonintoxicated (1%) patients. Comparing the two study groups, patients with ethanol intoxication had lower BD (-2.24+/-2.74 vs. -0.05+/-2.35, p<0.001) and higher LAC (2.69+/-1.48 vs. 2.00+/-1.78, p=0.02). However, ethanol levels did not correlate significantly with BD (p=0.50) or LAC (p=0.14).ConclusionEthanol intoxication is associated with acidosis, which does not correlate with BD or LAC. The complexity of pathogenesis of acidosis in ethanol intoxication justifies further diagnostic evaluation of these patients in order to rule out other causes of acidosis.

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