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Ethylene glycol
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INDICATIONS 

  EG DOSE: we recommend against ECTR based solely on the reported EG dose

  PLASMA EG CONCENTRATION

      a. Fomepizole is used: we suggest ECTR if EG concentration is > 50 mmol/L (> 310 mg/dL)

      b. Ethanol is used

          i. We recommend ECTR if EG concentration is > 50 mmol/L (> 310 mg/dL)

          ii. We suggest ECTR if EG concentration is 20–50 mmol/L (124–310 mg/dL)

      c. No antidote is available

          i. We recommend ECTR if EG concentration is > 10 mmol/L (> 62 mg/dL)

  OSMOL GAP (calculated as OSMmeasured − OSMcalculated, in SI units and adjusted for ethanol) when there is evidence of EG exposure

      a. Fomepizole is used: we suggest ECTR if the osmol gap is > 50

      b. Ethanol is used

          i. we recommend ECTR if the osmol gap is > 50

          ii. In patients presenting with EG poisoning, we suggest ECTR if the osmol gap is 20–50

      c. No antidote is available: we recommend ECTR if the osmol gap is > 10

  PLASMA GLYCOLATE CONCENTRATION

       a. We recommend ECTR if the glycolate concentration is > 12 mmol/L

       b. We suggest ECTR if the glycolate concentration is 8–12 mmol/L

  ANION GAP (calculated as  Na + K − Cl − HCO3) when there is evidence of EG exposure

       a. We recommend ECTR if the anion gap is > 27 mmol/L

       b. We suggest ECTR if the anion gap is 23–27 mmol/L

  CLINICAL INDICATIONS

      a. Coma: we recommend ECTR

      b. Seizures we recommend ECTR

      c. Kidney Impairment

          i. In patients presenting with CKD (eGFR < 45 mL/min/1.73m2), we suggest ECTR

          ii. In patients with AKI (KDIGO stage 2 or 3), we recommend ECTR

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MODALITY

      a. When all ECTR modalities are available, we recommend using intermittent HD rather than any other type of ECTR

      b. When recommend using CKRT over other types of ECTR if intermittent HD is not available

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CESSATION

      a. We recommend stopping ECTR when the anion gap (calculated as  Na + K − Cl − HCO3) is < 18 mmol/L

      b. We suggest stopping ECTR when the EG concentration is < 4 mmol/L (25 mg/dL)

      c. We suggest stopping ECTR when acid–base abnormalities are corrected

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