Clinical Research Directory

Inclusion Criteria: • Patients presenting with suspected methanol poisoning or metabolic acidosis of unknown cause, including: * Children aged 16-17 years, who are willing to provide assent. * Parents/Guardians of children who are able and willing to provide consent. * Adults (aged 18 years with no upper age limit) who are willing to provide informed consent. * Participants who lack capacity to consent for themselves but who have a relative who is willing and able to provide informed consent on behalf of the participant. Suspected methanol poisoning will be based on clinician judgement using the following typical indicators of possible methanol ingestion: 1. History of: * Intake of illegal/bootleg/spurious alcohol, and/or * Other patients admitted with confirmed/suspected methanol poisoning and/or * Time from intake to symptoms \>6-12 h 2. Symptoms/clinical findings * Coma, and/or * Hyperventilation (respiratory rate \[RR\] \>20/min) and/or dyspnea, and/or * Visual disturbances (blurred vision, blindness), and/or * Gastrointestinal symptoms (vomiting, abdominal pain), and/or * Chest pain, and/or * Severe/unusual 'hang-over': Feeling very sick the following day, and/or * Pseudopapillitis Metabolic acidosis of unknown origin will be based on the following features: * Metabolic acidosis of unknown origin = origin not identified. The acidosis is not of unknown origin if the metabolic acidosis can be explained by another cause eg. lactic acidosis (e.g. where base deficit \[BD\] = 15 mM \[i.e., base excess (BE) = -15 mM\] and lactate is 12-15mM). * An initial ABG shall be drawn. If the BD is \>15mM (BE\<-15mM), the patient shall be included (as long as "unknown origin" - see above). If the patient has a BD between 5-15, the acidosis is only moderate, and there is time to do the "fluid trial" (see below). If the acidosis improves within 1-2 hours after the fluid trial, the acidosis is unlikely to be because of methanol and the patient should not be included. If the acidosis does not improve, the patient should be included. Exclusion Criteria: * • Children aged 16-17 years, who are unwilling to provide assent. * Parents/Guardians of children who are unable or unwilling to provide consent. * Adults (aged 18 years with no upper age limit) who are unwilling to provide informed consent. * Participants who lack capacity to consent for themselves and who do not have a relative who is willing and able to provide informed consent on behalf of the participant (i.e. unaccompanied unconscious patients and others) * Individuals previously recruited to the study.