Blutalkohol 2005 - BADS (Bund gegen Alkohol und Drogen im ...

278
Verner/Schneider/Gebel/Panning/Wiese/Tröger/Breitmeier,
Blood ethanol concentrations and inebriation symptoms following percutaneous ethanol injection
therapy (PEIT) carried out on patients suffering from hepatocellular carcinoma
Fig. 2: Positiv relationship between the maximum of the blood ethanol concentration and
the amount of ethanol administered in all 14 patients. Solid line indicates the theoretic
curve based on the 3-parameter logistic model: y=A/(1+B*exp(–C*x)), where x is the
amount of administered ethanol, and y is the maximal blood ethanol concentration.
The theoretic curve indicates the model of a non-linear regression analysis, which fitted
the data best. This non-linear logarithmic model demonstrates the most accurate match
compared to all other linear and non-linear models tested. The coefficient of determination
for the nonlinear logarithmic model was R 2 = 0.417 and r = 0.6432.
Discussion
To our knowledge, the systemic effects of ethanol by patients with HCC undergoing
percutaneous ethanol injection have not been studied. In many other publications [24, 25,
26, 27, 28, 29], where healthy, mostly male test persons are given amounts of alcohol intravenously
in a dose that has been defined in advance and where the intervals at which
blood is taken, has also been defined. In our cases the procedure of ethanol instillation has
been carried out on hospitalised patients suffering from hepatocellular carcinoma. In the
form of high volume ethanol therapy (PEI) it was injected directly into the tumour using
ultrasound as a guide. It must be taken into consideration that in order to analyse the data
the alcohol has to be injected directly into the liver (tumour), resulting thus in the avoidance
of gastric or rather hepatic first-pass-effects in the liver. The alcohol will then flow
directly from the tumour via the hepatic veins, or through direct puncture of the hepatic
veins instead of the tumour into the vascular system. This explains the partly rapid increase
of the blood ethanol concentration with an extremly fast distribution of ethanol in
the body, especially into the central nervous system, which leads to substantial inebriation
symptoms by the patients subsequent to percutaneous ethanol injection therapy. In our
BLUTALKOHOL VOL. 42/2005