Evaluation of brain death due to methanol intoxication

Abstract

Objective: Intoxication may mimic brain death and cause brain death. In the literature, brain death due to methanol intoxication is limited to case reports. In this report, patients with methanol intoxication who had findings of imminent brain death were evaluated. Materials and Methods: The study population consisted of patients with methanol intoxication treated in the adult intensive care unit (ICU) between October 2014 and October 2020. The records in the hospital automation system of patients with methanol intoxication were evaluated retrospectively. According to the outcomes, the patients were divided into two groups: survivors and patients who had imminent brain death. Results: Eighteen patients with methanol intoxication were investigated. The brainstem reflexes disappeared in seven patients who were in a coma. The imminent brain death rate of patients with methanol intoxication was 39%. Patients who had imminent brain death had lower Glasgow Coma Scale scores during ICU admission and a higher ratio of pathologic neuroimaging findings due to methanol intoxication (P < 0.05). According to the clinical criteria and ancillary tests, four patients were declared brain dead. The brain death rate of patients with methanol intoxication was 22%. One of four patients with brain death was an organ donor. The liver was transplanted from our donor. Conclusion: Treatment should be initiated immediately in cases of methanol intoxication. Patients who do not respond well to treatment should be followed closely in terms of brain death. Based on published data and our personal experience, organ donations can be performed after appropriate investigations in brain death cases due to methanol intoxication.