Enhanced elimination
The rate of ethanol elimination in most patients is 2 to 4 mmol/hour (0.01 to 0.02%/hour), which is roughly equivalent to metabolising one standard drink per hour1. Patients with ethanol tolerance can metabolise ethanol at even higher rates. Haemodialysis is effective at enhancing elimination of ethanol by 3 to 4 times, but it is rarely required as almost all patients recover with supportive care alone.
A possible indication for haemodialysis for ethanol intoxication is hypotension requiring the use of inotropes and an ethanol concentration greater than 98 mmol/L (0.45%); discuss the use of haemodialysis with a clinical toxicologist.
1 A standard drink in Australia contains 10 g of ethanol; this is the amount in 285 mL of full-strength beer, 100 mL of wine, 60 mL of fortified wine or 30 mL of spirits. For a visual representation of standard drinks in Australia, see the National Health and Medical Research Council Standard drinks guide.Return