First-order alcohol elimination in severe alcohol intoxication in an adolescent: a case report.

We report a case of severe ethanol intoxications in a 14-year-old boy whose starting blood alcohol concentration was 490 mg/dL. The intoxication led to coma with hypoventilation, hypoxemia, hypothermia, and a life-threatening situation. Elimination of ethanol followed nonlinear first-order concentration-dependent pharmacokinetics. Fluid balance was disturbed because of marked diuresis, and respirator treatment was needed. The treatment of fluid balance and the risk of hypoxemia in severe alcohol poisoning are emphasized.