Abstract
Background
Acute alcohol intoxication is a frequent cause of emergency department (ED) visits.
Evaluating a patient’s alcohol intoxication is commonly based on both a physical examination
and determination of blood alcohol concentration (BAC).
Objective
To demonstrate the feasibility and usefulness of using a last-generation infrared
breath analyzer as a non-invasive and rapid screening tool for alcohol intoxication
in the ED.
Methods
Adult patients suspected of acute alcohol intoxication were prospectively enrolled
over 10 days. Breath alcohol concentrations (BrAC) were measured using a handheld
infrared breath analyzer. BAC was determined simultaneously by automated enzymatic
analysis of a venous blood sample. The relationship between BAC and BrAC values was
examined by both linear regression and Bland-Altman analysis.
Results
The study included 54 patients (mean age 40±14 years, sex ratio M/F of 3/1). Breath and blood alcohol concentrations ranged from
0 to 1.44 mg/L and from 0 to 4.40 g/L (0–440 mg/dL), respectively. The mean individual BAC/BrAC ratio was 2615±387, 95% confidence interval 2509–2714, which is 30% higher than the legal ratio in
France (2000). The correlation between both measurements was excellent: r=0.95 (0.92–0.97). Linear regression revealed BAC=0.026+1.29 (BrAC×2000) and BAC=0.026+0.99 (BrAC×2615). Mean BAC-BrAC differences and limits of agreement were 0.49 g/L [−0.35, 1.34]
(or 49 mg/dL [−35, 134] and 0.01 g/L [−0.68, 0.71] (or 1 mg/dL [−68, 71]), for the
2000 and 2615 ratios, respectively.
Conclusion
The calculated conversion coefficient provided a satisfactory determination of blood
alcohol concentration. Breath alcohol testing, using appropriate BAC/BrAC conversion,
different from the legal BAC/BrAC, could be a reliable alternative for routine screening
and management of alcohol intoxication in the ED.
Keywords
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Article info
Publication history
Published online: March 14, 2012
Accepted:
June 18,
2011
Received in revised form:
May 18,
2011
Received:
January 17,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
