PMID: 18717147Aug 23, 2008Paper

Poisoning necessitating pediatric ICU admissions: size of pupils does matter

Journal of the National Medical Association
Kam-Lun Ellis HonPak-Cheung Ng

Abstract

Childhood poisonings are common, but usually trivial, and infrequently necessitate intensive care unit (ICU) admissions. A retrospective record review was conducted to analyze the pattern of severe poisoning-associated ICU admissions at a teaching hospital between May 2002 and December 2007. Six cases (4 boys and 2 girls, aged 2 months to 11 years) of drug poisoning-associated ICU admissions were identified. Methadone was the culprit in 3 boys and 1 girl, resulting in respiratory failure, depressed conscious state and pinpoint pupils. As relevant exposure history was not immediately apparent, diagnosis at the emergency department was only made correctly in 2 patients. Phenobarbitone overdose occurred in 1 girl with past history of phenobarbitone overdose as a clue. She was also considered to have pinpoint pupils that were unresponsive to naloxone. Features consistent with cholinergic toxidrome, including small pupils, and increased secretion occurred in an infant fed with milk prepared with an herbal broth suspected to have been adulterated with a pesticide. Atropine as an antidote was used when the child was in the pediatric ICU. All children made an uneventful recovery following their short ICU stay. Life-threatening poisonin...Continue Reading

Citations

Dec 24, 2009·Clinical and Experimental Dermatology·K L Ellis Hon, T F Leung
Jan 6, 2015·The American Journal of Case Reports·Ilse Gradwohl-MatisMartin W Duenser
Apr 7, 2010·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Ahmad Tashakori, Reza Afshari
Dec 31, 2009·International Journal of Pediatrics·Kam-Lun Ellis Hon, Alexander K C Leung
Oct 23, 2010·International Journal of Dermatology·Kam Lun HonTing Fan Leung
Jul 30, 2014·Anesthesiology·Mark D RollinsMerlin Larson
Aug 27, 2010·Indian Journal of Pediatrics·Supraja ChandrasekarRajiv Aggarwal
May 20, 2015·Anesthesia and Analgesia·Merlin D Larson, Matthias Behrends
Dec 6, 2019·Pediatric Emergency Care·Hamidreza RiasiForod Salehi

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