Toxicity

There is often a wide range variation in blood methanol concentrations compared with the severity of outcome. A concentration of 220 mg/l caused headache, nausea, vomiting and abdominal pain, these symptoms and retinal oedema were also seen in a patient with a methanol concentration of 300 mg/l (Bennett et al, 1953). However, blood methanol concentrations as high as 9,200 mg/l have been survived without sequelae, as a result of prompt, aggressive treatment (Martens et al., 1982). This difference between levels and outcome may be related to methanol's relatively low order of toxicity compared with its metabolite, formic acid. The severity of outcome appears to be related more to the formic acid concentration and the time to initiation of treatment. Therefore, formic acid concentrations are possibly more useful in estimating the potential toxicity. A high formic acid concentration with metabolic acidosis has been associated with a more severe outcome and the potential for development of neurological sequelae (Anderson et al., 1987; Brent et al., 2001).

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