Charcoal is probably not useful unless there is a suspicion of co-ingestion. Ethanol has been recognized as an antidote for ethylene glycol poisoning since the 1960's. Alcohol dehydrogenase has a much greater affinity for ethanol than for ethylene glycol and the presence of ethanol inhibits the production of the toxic metabolites of ethylene glycol. The level of ethanol should be checked frequently to be sure it is adequate. Hypoglycemia may occur, particularly in children, and should be followed.
Dialysis is the definitive treatment for ethylene glycol intoxication.
Hemodialysis can remove ethylene glycol, as well as the toxic metabolites of ethylene glycol. Ethanol therapy should be continued during dialysis and the amount of ethanol used must be increased. This decreases some of the systemic complications but must be closely followed to insure electrolyte abnormalities do not occur. In addition to the above treatment it is important to provide adequate fluids to maintain adequate urine output. Once the patient has been well hydrated lasix may be used to help maintain the urine output.