RESUMO
Acute drug overdosing is an important cause of organ dysfunction and metabolic derangements and the patients often require intensive care. This study aims to determine the clinical pattern of severe drug overdose as well as the factors influencing the duration of intensive care. The clinical characteristics and course of consecutive adult patients admitted with a diagnosis of acute drug poisoning in the ICU of a tertiary hospital in Oman from January 2007 to December 2008 were reviewed retrospectively from the electronic case records. Acute drug poisoning [n=29] constituted 3.9% of admissions to the ICU. Mean age was 29.38 +/- 7.9 years. They were brought in by their relatives [72%] or the state services [24%]. Accidental poisoning was noted in 21 patients [72%] and suicidal overdosing in 6 [21%]. The commonest drug was an opioid [65.5%]. Glasgow Coma Scale score of = 8 was recorded in 18 [62.1%]. Sixty two percent of patients required mechanical ventilation. The prominent complications were hypotension in 9 [31%], pulmonary in 19 [65.5%], hepatic in 18 [62.1%] and renal in 12 [41.4%] patients. The major electrolytes abnormalities were low bicarbonate in 11 [37.9%], hyponatremia in 5 [17.2%] and hypokalemia in 4 [13.8%]. Patients stayed in the ICU for 1 to 20 days [median-2 days]. Factors associated with a longer ICU stay included hypotension upon arrival [p=0.048] and the need for mechanical ventilation on the first [p=0.001] and second [p=0.001] days of hospitalization. There was no mortality. Early and prompt intensive medical therapy in acute drug poisoning can favorably influence the outcome. In addition, the presence of hypotension and requirement of mechanical ventilation on the first two days of hospitalization were responsible for prolonged ICU stay
Assuntos
Humanos , Masculino , Feminino , Adulto , Overdose de Drogas/etiologia , Cuidados Críticos , Unidades de Terapia Intensiva , Analgésicos Opioides , Estudos RetrospectivosRESUMO
The retrospective data on childhood poisoning from eight regional hospitals in India has been reviewed. The demographic features and types of poisonings encountered have been compared. The analysis of the data indicated that pediatric poisonings constituted 0.23-3.3% of the total poisoning. The mortality ranged from 0.64-11.6% with highest being from Shimla. Accidental poisoning was common involving 50-90% of children below 5 years of age and males outnumbered the females. Suicidal poisoning was seen after 13 years of age and was due to drugs and household chemicals. One of the hospitals in Delhi recorded a very high incidence (66.6%) of drug poisoning in children. The drugs consumed belonged to phenothiazines, antiepileptics and antipyretics. Iron poisoning was seen in younger children. Kerosene was one of the causes of accidental poisoning at all hospitals except Shimla and rural Maharashtra were probably wood charcoal is widely used. Pesticide poisoning was more prevalent in Punjab and West Bengal whereas plant poisoning was very common in Shimla. Significant number of snake envenomation has been recorded from rural Maharashtra. Other less common accidental poisonings in children included alcohol, corrosives, heavy metals, rodenticides, detergents and disinfectants. Thus various regions in the country showed some variation in types and frequency of childhood poisoning which could be attributed to different geographical and socio-economic background.