Studies on cases with lethal level of blood alcohol.

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  • “致死量”の血中アルコールが検出された症例の検討

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Thirty-three patients treated at the Critical Care and Emergency Center of Iwate Medical University between January 1, 1983 and March 31, 1994 had blood alcohol levels of at least 400mg/dl and no major complications on admission. We investigated the consciousness level, vital signs, hematological parameters and blood alcohol elimination rate in these patients as well as the procedures used in treating them to assess the pathological condition in which blood alcohol level is dangerously high and to define the necessary treatment and considerations. The subjects comprised 29 men and 4 women, with a mean age of 42.1±12.1 years. Nine patients whose blood alcohol level was at least 500mg/dl had a consciousness level of 100 or more as determined on the Japan coma scale (JCS); 4 of these showed JCS300. Of these 9 patients, 3 were found to have mydriasis and 2 to have pupillary inequality. The light reflex was absent in 2 and delayed in 4 of these 9 patients. All patients with blood alcohol levels of under 500mg/dl showed a quick light reflex, with the consciousness level varying according to the case. No life-threatening signs were seen in systolic blood pressure, mean heart rate or respiratory rate. Slight hypothermia was found in 20 patients, hypoxemia in 16 and increased PaCO2 in 6. The blood alcohol elimination rate was -22.5mg/dl/hr. All patients were improved enough to leave the hospital through fluid therapy and respiratory care alone. Although respiratory failure and hypothermia are considered life-threatening conditions in heavy drinkers, they seem unlikely to be fatal if proper respiratory care is given in a medical facility.

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