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.