US EPA

1225777 

Journal Article 

A Pilot Study Using a New Point of Care Test for Methanol 

Kapur, BM; Thompson, MA 

2008 

1 

Clinical Toxicology
ISSN: 1556-3650
EISSN: 1556-9519 

Taylor & Francis Ltd., 11 New Fetter Lane London EC4P 4EE UK, [URL:http://taylorandfrancis.metapress.com] 

46 

7 (Aug 2008) 

603. 

Background: Serum methanol concentrations are available at few hospitals. Treatment decisions are made on a history alone or based on surrogate markers, which in themselves may not be available at many facilities. Additionally, surrogates may not be reliable in small or late ingestions. Methods: In a pilot study, to validate a novel point-of-care test (POCT) for methanol, we used the new POCT to determine qualitative methanol presence in sera from patients. Twelve samples with known methanol concentrations as determined by gas chromatography (GC) ranging from 0.8 mmol/L to 106 mmol/L from 2 different overdoses were tested. 5 samples from patients known to have negative methanol concentrations were also tested. Finally, an ethanol standard was used to determine cross reactivity. The testing technician was blinded to the GC results. A second study is underway using a convenience sample of consecutive emergency patients presenting with a decreased level of awareness comparing finger prick POCT results with serum methanol concentrations in the same patients. Results: Preliminary results from the pilot study show good correlation between the two methods. 9 of 11 patient samples, positive by POCT, were also positive by GC. Those 2 that were reported as negative by GC had detectable methanol but were below the reporting limit, suggesting increased sensitivity of the POCT method. There were no false positives or negatives. Spiked ethanol samples showed no cross reactivity. Emergency patient recruitment is ongoing. Discussion: In the real clinical setting, to have a reliable, reproducible point of care bedside test when serum methanol levels are unavailable, would obviate either empiric treatment with ethanol or fomepizole or expensive transfer of the patient to a facility where testing is available. Conclusion: A sensitive point of care bedside methanol test exists which can be used to determine the presence of significant methanol concentrations. Further evaluation of the POCT is needed to understand its place in the treatment of the methanol exposed patient. 

Gas chromatography; Recruitment; Methanol; Carcinoembryonic antigen; Finger; Ethanol; Overdose; Hospitals