Quang Tri doctor: 'Beer infusion to detoxify alcohol because the hospital does not have ethanol available'

Doctor Le Van Lam, Head of the Department of Intensive Care and Anti-Poisoning, Quang Tri General Hospital, was the one who decided to use beer infused into the stomach of patient Nguyen Van Nhat to detoxify methanol (industrial alcohol). This solution is included in medical guidelines around the world as well as the protocol of the Ministry of Health.

Mr. Nhat, 48 years old, was one of four people poisoned by methanol after a Christmas party on December 24, 2018. The methanol content in Mr. Nhat's blood sample was up to 2,100 mg/liter, more than 10 times the poisoning threshold. The alcohol used at the party had a methanol content more than 1,100 times the permitted threshold. One person died after being hospitalized. The remaining three people are in critical condition and coma.

Usually, in addition to continuous blood filtration, intravenous fluids, and mechanical ventilation, doctors also infuse ethanol into the patient's body to prevent metabolic toxicity. The ethanol used by doctors is a medical ethanol preparation, prepared for infusion into the patient.

"This time, Quang Tri Hospital did not have medical ethanol available, and the patient's condition was critical, so the doctors decided to quickly use alcohol and beer containing ethanol to detoxify, combined with blood filtration to save the patient," said Dr. Lam.

Initially, doctors thought of using alcohol to infuse into the Japanese patient's digestive tract. However, "we were concerned that we did not know if the alcohol was real or fake, where it was produced, or what its origin was. If we infused fake alcohol into the patient, it would be very dangerous," said Dr. Lam.

Finally, the doctors decided to use beer. Although beer has a low ethanol content, the origin and label clearly state the concentration, so you can rest assured when using it. At the same time, the doctor calculated the concentration of beer to use according to the patient's condition to have enough ethanol to detoxify.

After deciding on the beer infusion plan, Dr. Lam met with the patient's family to explain and advise. Mr. Nhat's wife, Ms. Le Thi Ai Suong, supported this method. Ms. Suong herself went to the hospital to buy 10 cans of beer to infuse into her husband. The doctors immediately infused the patient with three cans of beer, or nearly a liter. Every hour after that, Mr. Nhat was infused with another can of beer.

After finishing the initial 10 cans of beer, Mrs. Suong bought 10 more cans of beer. In total, patient Nhat was transfused with 15 cans of beer, equivalent to 5 liters. The next morning, the patient began to show signs of recovery.

Dr. Lam explained that alcohol consists of two types: ethyl and methyl (methanol). When entering the body, the liver prioritizes metabolizing ethyl and creating non-toxic products. Methyl is metabolized later but forms formic aldehyde. At high concentrations, this substance will cause poisoning, with a very high risk of death.

Mr. Nhat was hospitalized when his body ran out of ethyl and he fell into a coma due to formic aldehyde poisoning. Therefore, in order to limit the conversion of methyl into formic aldehyde, the doctor gave him an infusion of ethanol. The addition of ethyl made his liver prioritize the conversion of ethyl and stop converting methyl. This gave the doctors more time to filter the patient's blood and detoxify him.

"Methylic acid that stays in the body for a long time without being metabolized will be gradually eliminated through urine, reducing toxins in the body. This is the basis for saving the patient's life," Dr. Lam shared.

The patient gradually recovered and was discharged from the hospital on January 9. A day later, his wife and family sent flowers and a thank you letter to the medical staff at Quang Tri General Hospital.

Ms. Suong said: "During the 9 days Mr. Nhat was in the hospital, in the family's desperate fear because they thought he could not be saved, the doctors and nurses were extremely dedicated, thoughtful, and extremely warm-hearted."

Mr. Nhat also said that one day after being discharged from the hospital, his health is now stable and progressing well.

"My family will never forget this grace of rebirth," Mr. Nhat and Mrs. Suong shared.