Isopropanol poisoning can lead to a wide range of serious complications affecting multiple organ systems, primarily due to its toxic effects on the central nervous system, cardiovascular system, respiratory system, and gastrointestinal tract. When isopropanol (also known as isopropyl alcohol) is ingested, inhaled, or absorbed in large amounts, it can cause acute toxicity with potentially life-threatening consequences.
The most immediate and common complication is **central nervous system (CNS) depression**. Isopropanol acts as a CNS depressant, leading to symptoms such as dizziness, headache, confusion, drowsiness, and in severe cases, stupor or coma. This depression results from the direct toxic effect of isopropanol and its metabolite acetone on brain function. The CNS effects can impair consciousness and protective reflexes, increasing the risk of aspiration and respiratory failure.
**Respiratory complications** are significant in isopropanol poisoning. Depressed consciousness can lead to hypoventilation or apnea, reducing oxygen intake and causing hypoxia. Additionally, vomiting induced by gastrointestinal irritation can lead to aspiration pneumonia if stomach contents enter the lungs. Respiratory distress may also arise from chemical pneumonitis caused by aspiration of isopropanol itself.
The **cardiovascular system** is also vulnerable. Isopropanol poisoning can cause hypotension (low blood pressure) due to vasodilation and myocardial depression. Tachycardia (rapid heart rate) is common as a compensatory response. Severe poisoning may lead to arrhythmias or cardiovascular collapse, especially if combined with hypoxia or electrolyte imbalances.
Gastrointestinal complications include **severe irritation and inflammation** of the mucous membranes. Ingestion often causes nausea, vomiting, abdominal pain, and sometimes hemorrhagic gastritis. Repeated vomiting increases the risk of dehydration and electrolyte disturbances, which can further complicate the clinical picture.
Metabolically, isopropanol is metabolized in the liver to acetone, which itself is toxic and can cause **metabolic disturbances**. Unlike methanol or ethylene glycol poisoning, isopropanol poisoning typically does not cause metabolic acidosis, but acetone accumulation can contribute to ketosis and altered mental status.
Other complications include **ocular and dermal irritation** if isopropanol contacts the eyes or skin. Eye exposure can cause severe irritation, redness, and pain, while skin contact may provoke mild irritation but generally does not cause serious damage.
In severe cases, **renal impairment** may develop, although this is less common than with other toxic alcohols. The kidneys can be affected indirectly through hypotension and hypoxia or directly by toxic metabolites.
Treatment complications can arise if poisoning is not promptly recognized and managed. Supportive care is critical, including airway protection, respiratory support, fluid resuscitation to correct hypotension and dehydration, and monitoring for cardiac arrhythmias. Hemodialysis may be required in severe cases to remove isopropanol and acetone from the bloodstream.
In summary, isopropanol poisoning can cause a cascade of complications involving the brain, lungs, heart, digestive tract, and metabolic systems. The severity depends on the amount ingested and the timeliness of medical intervention. Without prompt treatment, these complications can progress rapidly to coma, respiratory failure, cardiovascular collapse, and death.
