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1.
Emergencias (St. Vicenç dels Horts) ; 27(3): 169-173, jun. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-139123

RESUMO

Objetivo. Analizar el rendimiento de un punto de corte de 3 μg/mL en la determinación de paracetamol urinario (PCTo) como método de cribado para detectar paracetamol en posibles sobreingestas en población pediátrica. Método. Estudio de caso-control, observacional, analítico y prospectivo realizado en una unidad de cuidados intensivos pediátricos (UCIP). Se seleccionó una muestra compuesta por aquellos pacientes ingresados en UCIP, considerando el grupo de casos aquellos con administración pautada de una dosis terapéutica endovenosa de paracetamol y un grupo control sin administración del fármaco. Se recogió una muestra de orina dentro de la primera hora y una segunda muestra pasadas 4 horas de la dosis del fármaco. En todos se determinó PCTo cuantitativamente. Se comparó la proporción de pacientes con PCTo _ 3 μg/mL. Se calcularon sensibilidad, especificidad y valores predictivos. Resultados. Se incluyeron 40 niños de edades entre 1 mes y 19 años (20 en cada grupo). No se obtuvo ningún paciente de control con PCTo positiva. La sensibilidad de la prueba en la primera orina recogida fue del 95% (IC 95%: 85,5-100%) y su especificidad del 100%. El valor predictivo positivo fue 100%, y el negativo del 95,2% (IC 95%: 86,1-100%). En las segundas orinas recogidas todos los valores de rendimiento del test fueron del 100%. Conclusión. La detección de PCTo antes de las 4 horas es útil para descartar la ingesta de paracetamol en población pediátrica. Se requieren estudios que permitan validar el nuevo punto de corte de 3 μg/mL para su posible inclusión en el algoritmo de sospecha de intoxicación aguda (AU)


Objective. To analyze the diagnostic yield of a cut-point of 3 μg/mL for paracetamol in urine to screen for poisoning in children. Methods. Prospective case–control observational study in a pediatric intensive care unit (PICU). All enrolled patients had been admitted to the PICU. Cases were children receiving a therapeutic dose of intravenous paracetamol. Controls were not receiving paracetamol. Urine samples were collected early in the morning and 4 hours after a dose of paracetamol was received by case patients. Paracetamol concentration was measured in all samples. We compared the percentages of cases and controls who had a concentration of 3 μg/mL or more. The sensitivity, specificity, and predictive values of the cut-point were calculated. Results. Forty children aged between 1 month and 19 years (20 per matched group) were enrolled. Paracetamol was not detected in any of the control samples. The sensitivity of the test in early morning urine was 95% (95% CI, 85.5%–100%); specificity was 100%. The positive predictive value was 100%; the negative predictive value was 95.2% (95% CI, 86.1%–100%). Paracetamol was detected in all of the second samples collected from cases. Conclusions. Measuring the paracetamol concentration in urine within 4 hours of dosing is useful to rule out prior intake of paracetamol and overdosing in PICU patients. Studies to validate the new cut-point of 3 μg/mL for paracetamol in urine are required with a view to possibly including it in a diagnostic protocol for suspected acute poisoning (AU)


Assuntos
Criança , Feminino , Humanos , Masculino , Acetaminofen/uso terapêutico , Sensibilidade e Especificidade , Valor Preditivo dos Testes , Envenenamento/complicações , Amostras de Medicamentos , Acetaminofen/toxicidade , Programas de Rastreamento/métodos , Estudos de Casos e Controles , Estudos Prospectivos , Cuidados Críticos/métodos
2.
Emergencias ; 27(3): 169-173, 2015 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-29077309

RESUMO

OBJECTIVES: To analyze the diagnostic yield of a cut-point of 3 µg/mL for paracetamol in urine to screen for poisoning in children. MATERIAL AND METHODS: Prospective case-control observational study in a pediatric intensive care unit (PICU). All enrolled patients had been admitted to the PICU. Cases were children receiving a therapeutic dose of intravenous paracetamol. Controls were not receiving paracetamol. Urine samples were collected early in the morning and 4 hours after a dose of paracetamol was received by case patients. Paracetamol concentration was measured in all samples. We compared the percentages of cases and controls who had a concentration of 3 µg/mL or more. The sensitivity, specificity, and predictive values of the cut-point were calculated. RESULTS: Forty children aged between 1 month and 19 years (20 per matched group) were enrolled. Paracetamol was not detected in any of the control samples. The sensitivity of the test in early morning urine was 95% (95% CI, 85.5%-100%); specificity was 100%. The positive predictive value was 100%; the negative predictive value was 95.2% (95% CI, 86.1%-100%). Paracetamol was detected in all of the second samples collected from cases. CONCLUSION: Measuring the paracetamol concentration in urine within 4 hours of dosing is useful to rule out prior intake of paracetamol and overdosing in PICU patients. Studies to validate the new cut-point of 3 µg/mL for paracetamol in urine are required with a view to possibly including it in a diagnostic protocol for suspected acute poisoning.

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