Acute alcohol intoxication in a 15‐day‐old neonate

Zaitsu, Masafumi; Inada, Yukiko; Tashiro, Kensuke; Hayashi, Chiduru; Doi, Hirohito; Hamasaki, Yuhei; Matsuo, Muneaki

doi:10.1111/ped.12134

Cited by 13 publications

(11 citation statements)

References 14 publications

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“… 7 , 16 Incidental alcohol concentrations in newborn infants that cause severe physical symptoms or death have been reported at BACs greater than or equal to 43 mg/dL. 17 , 18 However, these studies observed the toxic effects caused by a single or intermittent high-concentration alcohol exposure. Therefore, the risk of intoxication cannot be applied to cases of sustained low-concentration exposure found in infants in incubators.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Alcohol Exposure From Alcohol-Based Disinfectants Among Premature Infants in Neonatal Incubators in Japan

et al. 2023

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ImportanceThe risk of premature infants in neonatal incubators exposed to evaporated alcohol from alcohol-based disinfectants (ABDs) is unknown.ObjectiveTo assess alcohol concentrations in the peripheral blood of premature infants and neonatal incubators.Design, Setting, and ParticipantsA quality improvement study comparing 2 different populations before and after introduction of ABD practice (ABD-PRAC) was conducted in a neonatal intensive care unit of a single tertiary hospital in Japan. Participants included premature infants who were born before 34 weeks of gestational age and received medical care in neonatal incubators. The study consisted of 3 periods: (1) September 1, 2020, to August 1, 2021 (prospective observation of pre–ABD-PRAC, (2) August 2 to August 22, 2021 (introduction of ABD-PRAC to medical staff and parents in the neonatal intensive care unit), and (3) August 23, 2021, to March 31, 2022 (prospective observation of post–ABD-PRAC). No follow-up studies were initiated.InterventionsAn ABD-PRAC that aimed to reduce alcohol evaporation from ABDs inside neonatal incubators was instituted: (1) place alcohol preps in the incubator just before use and remove them from the incubator as soon as possible and (2) withhold placing hands into the incubators until 60 seconds after using ABDs for disinfection (applied only to family members).Main Outcomes and MeasuresBlood alcohol concentration and evaporated alcohol concentrations in neonatal incubators.ResultsDisinfectant practice was assessed among 28 infants during the pre–ABD-PRAC (17 infants [10 girls]; median gestational age at birth, 29.4 [IQR, 26.3-30.3] weeks) and post–ABD-PRAC (11 infants [3 girls]; median gestational age at birth, 30.0 [IQR, 25.3-32.2] weeks) study periods. The median blood alcohol concentration was 7.0 (IQR, 5.4-9.3) mg/dL pre–ABD-PRAC and 4.2 (IQR, 2.5-7.2) mg/dL post–ABD-PRAC. The median evaporated alcohol concentration inside neonatal incubators during pre–ABD-PRAC during the day was 23.6 (IQR, 15.9-36.5) ppm and, at night, was 13.2 (IQR, 8.9-19.4) ppm; during post–ABD-PRAC, the concentration was 9.4 (IQR, 6.0-16.0) ppm during the day and 5.7 (IQR, 3.6-9.7) ppm at night. The introduction of ABD-PRAC at 22 weeks’ corrected gestational age was associated with a lower blood alcohol concentration in premature infants: regression coefficient value, −8.3 (95% CI, −12.0 to −4.7).Conclusions and RelevanceIn this study, alcohol evaporated from ABDs was absorbed by premature infants in neonatal incubators. The findings suggest that introduction of ABD-PRAC was associated with lower alcohol concentrations in neonatal incubators and in the blood of premature infants.

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Section: Discussionmentioning

confidence: 99%

Assessment of Alcohol Exposure From Alcohol-Based Disinfectants Among Premature Infants in Neonatal Incubators in Japan

et al. 2023

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“…Ethanol intoxication is uncommon in children, especially neonates [ 7 ]. According to previous reports, the clinical symptoms of acute ethanol intoxication are non-specific, and can be confused with other diseases, such as encephalitis, hydrocephalus, and anaphylactic shock [ 7 , 8 ].Therefore, we reported a case of acute ethanol intoxication in a 25-day-old newborn boy to raise awareness of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Unintentional mixing of alcohol in formula is another way for neonates to consume ethanol. In Japan, a case [ 8 ] was reported where sake (Japanese wine prepared from fermented rice) was mixed in a 15-day-old newborn girl’s formula. The clinical features of the girl were flushed skin, tachycardia and low blood pressure indicating circulatory failure, somnolence and metabolic acidosis.…”

Section: Discussionmentioning

confidence: 99%

Neonatal acute ethanol intoxication during the epidemic of COVID-19: a case report

et al. 2022

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Background After the outbreak of COVID-19, many families equip with 75% ethanol to inactivate the SARS-CoV-2, which increases the risk of exposure to ethanol. Case presentation We reported a 25-day-old newborn who was diagnosed with neonatal acute ethanol intoxication with a presenting complaint of accidental consumption about 15 ml formula milk containing 75% ethanol. His main clinical manifestations were irritability, flushed skin, tachycardia, tachypnea, and toxicology analysis detected ethanol. After timely gastric lavage and intravenous fluid replacement, he was cured and discharged. Conclusions During the COVID-19 epidemic, high concentration ethanol used for inactivating SARS-COV-2 should be placed reasonably and neonatal feeding safety should be emphasized. Timely diagnosis and symptomatic treatment are essential for the prevention and management of acute ethanol intoxication in newborns.

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“…In adults, serum ethanol concentrations of 50 to 100 mg/dL can lead to acidosis, central nervous system disturbances, respiratory distress, hypoglycemia, and coma. Concentrations generally peak 30 to 60 minutes after exposure [ 6 ]. As our patient presented over eight hours after the predicted exposure, the peak ethanol concentration most likely was significantly higher than the 125 mg/dL found on the initial point of care glucose.…”

Section: Discussionmentioning

confidence: 99%

Hypoglycemia and Ketosis in the Setting of Pediatric Ethanol Intoxication: A Case Report

Compton¹,

Masoud²,

McCray³

et al. 2022

Cureus

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Acute alcohol intoxication is a common presentation to emergency departments. The intoxication of young pediatric patients is extremely rare. We present a case of a two-year-old female who presented to the emergency department with altered mentation, incontinence, and hypoglycemia. Over the next two days, the patient was treated with fluid replacement, and her hypoglycemia was managed. She was then discharged with no complications. While infant ethanol intoxication has a relatively low mortality rate, it can still be potentially fatal due to complications. Few studies have examined the morbidity associated with these presentations. This case demonstrates the importance of prompt identification and management to avoid a catastrophic outcome. Further research on the enzyme kinetics and long-term effects of early ethanol exposure resulting in hypoglycemia and ketosis is warranted.

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Acute alcohol intoxication in a 15‐day‐old neonate

Cited by 13 publications

References 14 publications

Assessment of Alcohol Exposure From Alcohol-Based Disinfectants Among Premature Infants in Neonatal Incubators in Japan

Assessment of Alcohol Exposure From Alcohol-Based Disinfectants Among Premature Infants in Neonatal Incubators in Japan

Neonatal acute ethanol intoxication during the epidemic of COVID-19: a case report

Hypoglycemia and Ketosis in the Setting of Pediatric Ethanol Intoxication: A Case Report

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