Acute iron poisoning: clinical picture, intensive care needs and outcome.
Indian Pediatr
;
2003 Dec; 40(12): 1177-82
Article
Dans Anglais
| IMSEAR
| ID: sea-9680
ABSTRACT
In this retrospective study, we examined the prevalence of acute iron poisoning among children attending Pediatric Emergency service of a teaching hospital, and studied their clinical profile, treatment and outcome to define intensive care needs. During the 5 years' study period of 27125 patient visits to Pediatric Emergency, 337 (1.2%) were for accidental poisoning. Of these 21(7%) patients had iron poisoning; 18 were transferred to PICU. Three patients were asymptomatic, others had vomiting (n =15, 83%), diarrhoea (n =13, 72%), malena (n = 8, 44%), and hemetemesis (n=6, 33%) generally within 6 hours of ingestion. Nine progressed to shock and/or impaired consciousness; two had acute liver failure. Dose of ingested iron and clinical signs were most useful guide to iron toxicity and management decisions; serum iron did not help. Gastric lavage yielded fragments of iron tablets in 10 patients. On desferrioxamine infusion Vin-rose colour urine was not seen in 31% even in presence of high serum iron. Shock responded to normal saline (33 +/- 15 mL/kg) and dopamine (10 +/- 4 microg/kg/min) within 4-24 hours in 7 of 9 patients. Presence of shock or acute liver failure with coagulopathy and/or severe acidosis predicted all the four deaths. Desferrioxamine infusion and supportive care of shock was the mainstay.
Texte intégral:
Disponible
Indice:
IMSEAR (Asie du Sud-Est)
Sujet Principal:
Indice de gravité de la maladie
/
Femelle
/
Humains
/
Mâle
/
Unités de soins intensifs pédiatriques
/
Analyse de survie
/
Enfant
/
Enfant d'âge préscolaire
/
Agents chélateurs du fer
/
Maladie aigüe
Type d'étude:
Etude d'étiologie
/
Etude d'incidence
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Pays comme sujet:
Asie
langue:
Anglais
Texte intégral:
Indian Pediatr
Année:
2003
Type:
Article
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