Article Text

SEVERE ACUTE POISONING OF CHILDREN IN A TERTIARY PEDIATRIC INTENSIVE CARE UNIT: REPORT OF A SINGLE CENTER EXPERIENCE
  1. A Khaldi1,
  2. A Bouziri1,
  3. K Kazdaghli1,
  4. A Hamdi1,
  5. S Belhadj1,
  6. K Menif1,
  7. N BenJaballah1
  1. 1Pediatric Intensive Care Unit, Children’s Hospital, Tunis, Tunisia

Abstract

Objective To describe the demographic characteristics, clinical course, and outcome of children with acute severe poisoning (SAP) leading to PICU admission.

Methods A retrospective study of all cases of children admitted to a tertiary PICU for poisoning between 1998 and 2007 was performed. Circumstances of poisoning, clinical charts and outcome of patients were reviewed.

Results 108 patients with SAP (3% of total admission) were admitted. Median age was 6 years (7 days–14 years) and 66.6% occurred between 2 and 6 years. SAP was due to drug ingestion in 55.5% of cases. Salicylate was the most frequent drug resulting in SAP (28%). Domestic and agricultural products were identified in 42% of cases and organophosphate was the most frequent cause (29.6%). The most common route of exposure was oral ingestion (93.5%). Therapeutic errors was noted in 3.7%. Indications for PICU admission were: coma (48%), respiratory failure (37%), and potentially SAP (18.5%). Gastrointestinal decontamination was used in 79.6% of patients, with activated charcoal in 77.7%. Three patients died, one from carbon monoxide poisoning and two from Atractylis gummifera. Median length of stay in survival patients was 2 days (1–12).

Conclusions Drugs and organophosphate ingestion was the major cause of SAP with a maximal risk between 2 and 6 years old children. Mortality is low and seems to be related to the cause of PAS.

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