Yoğun bakım ihtiyacı olan pediatrik zehirlenme hastalarının değerlendirilmesi

Serhan Özcan, Seçil Akay, İrem Bozkurt, Emel Uyar, Oktay Perk, Ayla AKCA ÇAĞLAR
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Abstract

Purpose: Our study was planned to reach out intoxication patient’s clinical characteristics, treatment modalities and outcomes of those patients followed up in pediatric intensive care unit. Materials and method: We examined patients admitted to our hospital or transferred from another medical center to our PICU, diagnosed with intoxication from 01 January 2019 to 31 December 2021, retrospectively. We collected patient’s demographic data. Glasgow Coma Scale score at admission, medical treatments applied to patients’ mechanical ventilation requirement, hemodialysis and plasmapheresis applied was recorded. Outcomes evaluated by survival, days in PICU and days in hospital. We divided study group as adolescent group (>120-month-old) and non-adolescent group (<120-month-old). All collected variables were compared between two groups. Results: During study period 114 patients included into the study. Most of the patients were in adolescent age group (52.6%). If we examined intoxication causes, in adolescent patient’s suicide was major cause of intoxication. In patients below <120-month-old unintentional intoxication was the main reason. Antipsychotics, antidepressants and analgesics were the most common medication causes of intoxication respectively. Mechanical ventilation applied to 4 patients. 5 patients were hemodialyzed. Plasmapheresis performed to 5 patients. All patients were survived. Median days in PICU was 1 day. Median days in hospital was 3 days. Conclusion: In our study, 2.8% of all PICU admissions were intoxications. Antipsychotics, antidepressants and analgesics were the most common medication causes of intoxications. Antidepressants intake were seen in higher rates in adolescent age group. Antidepressant prescription and drug control should be more carefully in adolescent age group.
目的:了解小儿重症监护病房中毒患者的临床特点、治疗方式及随访结果。材料和方法:回顾性分析2019年1月1日至2021年12月31日期间入住我院或从其他医疗中心转至我院PICU的中毒患者。我们收集了病人的人口统计数据。记录患者入院时格拉斯哥昏迷评分、机械通气、血液透析、血浆置换等用药情况。结果以生存、PICU住院天数和住院天数评估。我们将研究组分为青少年组(>120月龄)和非青少年组(<120月龄)。对两组间收集的所有变量进行比较。结果:研究期间114例患者纳入研究。患者以青少年居多(52.6%)。如果我们检查中毒原因,青少年患者自杀是中毒的主要原因。在<120月龄的患者中,意外中毒是主要原因。抗精神病药、抗抑郁药和镇痛药分别是最常见的中毒原因。4例患者采用机械通气。5例患者进行血液透析。5例患者行血浆置换。所有患者均存活。PICU中位天数为1天。住院天数中位数为3天。结论:在我们的研究中,2.8%的PICU入院患者是中毒。抗精神病药、抗抑郁药和镇痛药是导致中毒的最常见药物。青少年服用抗抑郁药的比例较高。在青少年群体中,抗抑郁药处方和药物控制应更加谨慎。
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