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Acute iron poisoning: clinical picture, intensive care needs and outcome.
Indian Pediatr ; 2003 Dec; 40(12): 1177-82
Article in En | IMSEAR | ID: sea-9680
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.
Subject(s)
Full text: 1 Index: IMSEAR Main subject: Severity of Illness Index / Female / Humans / Male / Intensive Care Units, Pediatric / Survival Analysis / Child / Child, Preschool / Iron Chelating Agents / Acute Disease Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Country/Region as subject: Asia Language: En Journal: Indian Pediatr Year: 2003 Type: Article
Full text: 1 Index: IMSEAR Main subject: Severity of Illness Index / Female / Humans / Male / Intensive Care Units, Pediatric / Survival Analysis / Child / Child, Preschool / Iron Chelating Agents / Acute Disease Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Country/Region as subject: Asia Language: En Journal: Indian Pediatr Year: 2003 Type: Article