Pediatric Intoxication Cases Followed in the PICU; 2-year Experience

Keskin, Halil; Kara, Mustafa; Akat, Hülya; Ceviz, Naci

doi:10.4274/cayd.galenos.2018.19484

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…In the study conducted by Keskin et al patients were divided into two groups: those with and those without indication for intensive care admission. Patients who were admitted to intensive care were found to have higher PRISM III score and lower GCS score than the other group [18] . In a multicenter study conducted in the USA, mortality was associated with high PRISM III score in a group of 12.021 intoxication cases followed in the PICU [7] .…”

Section: Discussionmentioning

confidence: 81%

“…In our study, 38.4% of the patients were under 5 years old, and 51.2% of our cases were girls. The literature shows varying levels of gender distribution with slight differences [8,10,11,17,18] . The average age of childhood intoxication cases in our country has been reported to vary between 5.2 years and 8.4 years [8,12,18,19] .…”

Section: Discussionmentioning

confidence: 99%

“…The literature shows varying levels of gender distribution with slight differences [8,10,11,17,18] . The average age of childhood intoxication cases in our country has been reported to vary between 5.2 years and 8.4 years [8,12,18,19] . In our study, the average age of intoxication cases considerably higher than prior publications from our country (10.8 ± 6.4 years).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that the average duration of PICU stay in intoxication cases ranged from 20 hours to 2 days [8,[11][12][13]18,24] and the average hospital stay from 20 hours to 3.5 days [8,11,13,18,31] . In our study, mean LOS at PICU was 4.3 days and mean LOS at hospital was 5.8 days.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective Evaluation of Intoxication Cases Followed in Pediatric Intensive Care: A 5-Year Experience

Duyu¹

2020

Haydarpasa Numune Med J

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Introduction: This study was designed to investigate the demographic, epidemiologic and clinical characteristics of cases admitted to the pediatric intensive care unit (PICU) with a diagnosis of intoxication. Methods: Inpatient intoxication cases who were treated in the PICU between May 2015 and May 2020 were analyzed retrospectively. Results: A total of 86 patients were included in the study. The average age was 10.8 ± 6.4 years and 53.5% of the cases were aged between 13-18 years. In terms of gender, 48.8% of the cases were male. Almost half of the (53.5%) intoxications occurred due to attempted suicide, 39.6% were accidental, 4.6% were due to substance abuse and 2.3% were due to incorrect drug dosage. Pharmaceutical agents were responsible for intoxication in the majority (79.1%) of patients, and among these, central nervous system (CNS) drugs were the most common (41.8%). Carbon monoxide poisoning was the most common nonpharmaceutical agent cause (8.1%). The agents that caused the intoxication were taken orally in 91.8% of cases. The average time from consumption to admission was 239±423.9 minutes. Gastric lavage was applied to 41.9% of the cases and activated charcoal was applied to 44.1%. Mechanical ventilation support was given to 32.6% of the patients. The most common findings were CNS symptoms (in 54.6% of patients). The mean length of stay (LOS) in PICU was 4.3±6.7 days and LOS in the hospital was 5.8±7.1 days. Mortality rate was 1.2%. Discussion and Conclusion: Knowing the epidemiology of intoxication is of great importance for rapid and correct treatment. Multicenter comprehensive studies are needed to reveal risk factors related to mortality.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Retrospective Evaluation of Intoxication Cases Followed in Pediatric Intensive Care: A 5-Year Experience

Duyu¹

2020

Haydarpasa Numune Med J

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Initial clinical and laboratory parameters triaging non-pharmaceutical acute pediatric poisoned patients for potential adverse outcomes: a three-year retrospective study

El-Sarnagawy

Ghonem

Helal

2023

Toxicology Research

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Identifying high-risk pediatric patients with non-pharmaceutical poisoning is crucial to avoid prospective complications and decrease the evident hospital economic burden. Although the preventive strategies have been well studied, determining the early predictors for poor outcomes remains limited. Therefore, this study focused on the initial clinical and laboratory parameters as a triage of non-pharmaceutical poisoned children for potential adverse outcomes taking the causative substance effects into account. This retrospective cohort study included pediatric patients admitted to Tanta University Poison Control Center from January 2018 to December 2020. Sociodemographic, toxicological, clinical, and laboratory data were retrieved from the patient’s files. Adverse outcomes were categorized into mortality, complications, and intensive care unit (ICU) admission. Out of enrolled 1,234 pediatric patients, preschool children constituted the highest percentage of the patients investigated (45.06%), with a female predominance (53.2%). The main non-pharmaceutical agents included pesticides (62.6%), corrosives (19%), and hydrocarbons (8.8%), mainly associated with adverse consequences. The significant determinants for adverse outcomes were pulse, respiratory rate, serum bicarbonate (HCO3), Glasgow Coma Scale, O2 saturation, Poisoning Severity Score (PSS), white blood cells (WBCs), and random blood sugar. The cutoffs of serum HCO3 < 17.55 mmol/l, WBCs >8,650 cells/microliter, and PSS > 2 points were the best discriminators for mortality, complications, and ICU admission, respectively. Thus, monitoring these predictors is essential to prioritize and triage pediatric patients who require high-quality care and follow-up, particularly in aluminum phosphide, sulfuric acid, and benzene intoxications.

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Evaluation of the Demographic and Clinical Characteristics of Patients Followed up a Tertiary Pediatric Intensive Care Unit

ÇETİN

Laloğlu

Ceviz

et al. 2022

Sakarya Medical Journal

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Objective: To evaluate the demographic and clinical characteristics of the patients that presented to our pediatric intensive care unit (PICU) between January 1, 2016 and December 31, 2018 and were followed up for at least 24 hours. Materials and Methods: In this study, 876 admission files of patients who were followed up at PICU between January 01, 2016 and December 31, 2018 were examined. The data of 751 admissions belonging to 640 patients with complete archive records and patient information forms were included in the study. Results: Forty-three percent of the 640 patients were female, and 32.4% of the total 751 admissions were referrals from different hospitals in our city or region for advanced intensive care. Although all cases requiring intensive care, internal or surgical, were hospitalized, the most common reason for admission was infectious diseases. Parameters individually associated with mortality were the presence of chronic disease, need for mechanical ventilation, need for blood products, need for inotropic support, and need for renal replacement therapy. None of the patients who were followed up due to poisoning and airway obstruction died. The highest mortality rate was seen in the hematological-oncological patient group, including end-stage cases. Conclusion: Our PICU provides an important health service in our region for all critically ill children. The mortality rates were within the values reported for Turkey. To obtain better outcomes, it is necessary to strengthen medical staff in our clinic and develop the palliative care centers in our region.

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Pediatric Intoxication Cases Followed in the PICU; 2-year Experience

Cited by 4 publications

References 11 publications

Retrospective Evaluation of Intoxication Cases Followed in Pediatric Intensive Care: A 5-Year Experience

Retrospective Evaluation of Intoxication Cases Followed in Pediatric Intensive Care: A 5-Year Experience

Initial clinical and laboratory parameters triaging non-pharmaceutical acute pediatric poisoned patients for potential adverse outcomes: a three-year retrospective study

Evaluation of the Demographic and Clinical Characteristics of Patients Followed up a Tertiary Pediatric Intensive Care Unit

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