Pharmacotherapy
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To systematically review English-language articles on fomepizole administration in patients with ethylene glycol poisoning. ⋯ Fomepizole is an effective alcohol dehydrogenase inhibitor that decreases production of ethylene glycol metabolites. Reduced mortality and morbidity are undetermined because of the small number of patients evaluated to date. Data on comparative efficacy of fomepizole versus ethanol and data on administration of fomepizole in children are limited.
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It is often difficult to isolate the origin of acute weakness in the critically ill population because of multiple etiologies. Aminoglycosides, corticosteroids, and neuromuscular blockers frequently are implicated as the source of acute weakness. Recently, critical illness polyneuropathy (CIP), a syndrome of unknown etiology, was added to the differential diagnosis. ⋯ Early studies of CIP, which were mostly retrospective, underestimated its frequency due to the complexity of the diagnosis and unfamiliarity with the syndrome. Prospective studies have explored the causality and clinical outcomes of CIP Clinical outcomes of patients with CIP include difficulty weaning from mechanical ventilation, increased length of stay, prolonged recovery, and an overall mortality rate of 26-71%. The association of CIP with sepsis, multiorgan failure, and drugs is still unclear.