Changes in indicators of the autonomic nervous system in acute poisoning with 1,4-butanediol complicated by withdrawal syndrome

Introduction. The article presents an assessment of the functional state of the autonomic nervous system in patients with acute 1,4-butanediol poisoning complicated by withdrawal syndrome using pupillometry. Purpose of the study: to analyze changes in the indicators of the autonomic nervous system in patients with acute 1,4-butanediol poisoning complicated by withdrawal syndrome.

Material and methods. In the course of the work, a prospective examination of 30 patients with acute 1,4-butanediol poisoning, complicated by withdrawal syndrome, aged 19 to 39 years (median age was 25.3 [20.1; 24.9] years) was carried out. All patients were treated at the Center for the Treatment of St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine. Pupullometry was performed using the hardware-software complex KSRZRts-01. Statistical processing of the obtained results was carried out in the program Statistica for Windows (version 10).

Results. In the course of the study, patients with acute poisoning with 1,4-butanediol develop a neurovegetative variant of AS, manifested by signs of parasympathicotonia, expressed in changes in the bioelectrical activity of the brain in the form of irritation of cortical-subcortical structures with rapid exhaustion and instability of the functional tone of cortical neurons, cognitive impairment, ideation and motor retardation, deviations of pupillometry parameters (decrease in the initial pupil diameter and constriction amplitude, increase in the time of onset of the pupillary reaction).

limitations. In the study of the effect of 1,4-butanediol on the indicators of the autonomic nervous system in the course of a prospective examination of 30 male patients of the Center for the Treatment of St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine with acute poisoning by a toxicant, it was found that there were significant changes in the parameters of this system in the withdrawal period.

Conclusion. The indicators revealed during the study prove the predominance of the neurovegetative variant of the withdrawal syndrome with a characteristic change in the bioelectrical activity of the brain, cognitive functions and pupillometry parameters.

Compliance with ethical standards. The study was approved by the Local Ethics Committee of the I.I. Dzhanelidze St. Petersburg Research Institute of SP Protocol No. 1 of 12.02.2021.

Author contribution:
Lodyagin A.N. — concept and design of the study, collection and processing of material, statistical processing, writing the text, editing;
Sinenchenko A.G. — collection and processing of material, statistical processing, writing the text;
Kutsalo A.L. — collection and processing of material, statistical processing;
Batotsyrenov B.V. — concept and design of the study, editing;
Sinenchenko G.I. — concept and design of the study, writing the text;
Kuznetsov S.V. — writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. 

Conflict of interest. The authors acknowledge that there are no known conflicts of interest related to this publication.

Funding. The study was not sponsored.

Received: January 23, 2023 / Accepted: May 26, 2023 / Published: June 30, 2023