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clinical investigations in critical care: Kevin C. Wilson, Christine Reardon, Arthur C. Theodore, and Harrison W. Farber Propylene Glycol Toxicity: A Severe Iatrogenic Illness in ICU Patients Receiving IV Benzodiazepines: A Case Series and Prospective, Observational Pilot Study Chest 2005; 128: 1674-1681 [Abstract] [Full text] [PDF]

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Propylene glycol toxicity

Heikki Savolainen   (15 September 2005)

Propylene glycol toxicity 15 September 2005
Heikki Savolainen, Professor Ministry of Social Affairs & Health, Tampere, Finland Send letter to journal: Re: Propylene glycol toxicity heikki.savolainen{at}stm.fi Heikki Savolainen	The technical and pharmaceutical propylene glycol used as an excipient for lipid-soluble IV drugs is a racemic mixture of two optical isomers, namely D- and L-forms (1). L-propylene glycol is dehydrogenated to L-lactic acid, a physiological intermediate, while D-propylene glycol gives rise to D-lactate which is only slowly metabolized by the mitochondrial D-lactate dehydrogenase. Therefore, metabolic acidosis could be an important factor in the nervous system complications of the drug. The determination of urinary D-lactate could reveal this danger. 1. Laitinen J, Liesivuori J, Savolainen H. Biological monitoring of occupational exposure to 1-methoxy-2-propanol. J Chromatogr Biomed Appl 694: 93-8 (1997)