Toxicity with which substance is responsible for causing “gasping syndrome” in neonates?
Benzyl alcohol is an aromatic alcohol that is oxidized to benzoic acid, conjugated in the liver with glycine, and excreted in the urine as hippuric acid. This process required for the metabolism of such foreign compounds as benzyl alcohol is diminished in the premature infant. Gershanik and colleagues showed that premature infants who received intravenous preparations containing benzyl alcohol as a preservative accumulated benzyl alcohol in their blood, leading to gasping syndrome, deterioration of multiple organ systems and eventual death.
Gershanik J et al. The Gasping Syndrome and Benzyl Alcohol Syndrome. NEJM. 1982 https://www.nejm.org/doi/full/10.1056/NEJM198211253072206
Submitted by: Mary O’Keefe, PharmD on behalf of the Acute and Intensive Care Section