Treatment of acute ethanol poisoning in alcoholic fatty liver disease

Abstract

The high level of alcohol consumption in our country inevitably leads to a large number of acute ethanol poisonings. Among acute chemical poisonings, including fatal cases, poisoning from alcohol-containing products occupies a leading position. The hospital mortality rate for ethanol poisoning in Russia averages 3.0%. The majority of fatal poisonings occur among people of working age, with the peak mortality rate between 45 and 59 years. The severity of the patient's condition is determined not only by the dose of poison ingested but also by damage to organs and systems due to chronic alcohol intoxication. Those who die from acute ethanol poisoning have underlying alcohol-related pathologies, including alcoholic liver disease (91.6%) and alcoholic heart disease (75.9%). Alcoholic fatty liver disease is found in 90% of patients who abuse alcohol and is usually a precursor to more severe forms of liver damage, such as alcoholic hepatitis and cirrhosis. The goal of this study was to improve the effectiveness of treatment for acute ethanol poisoning in patients with alcoholic fatty liver disease. The study methodology consisted of a prospective, open-label, randomized, comparative trial of the effectiveness of treatment in patients with acute ethanol poisoning (T-51.0) and alcoholic fatty liver disease (K-70.0). Patients with acute ethanol poisoning and alcoholic fatty liver disease were found to have severe metabolic disorders and a high risk of developing alcoholic delirium. For the first time, metabolic correction using the combined hepatoprotective drug Remaxol was shown to maintain liver function, restore carbohydrate metabolism, prevent deterioration of protein metabolism, correct antioxidant disorders, and reduce the risk of developing alcoholic delirium. The antioxidant efficacy of ademetionine has been demonstrated. A hepatoprotective therapy regimen has been developed, taking into account the specific somatogenic period of acute ethanol poisoning.