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2.
Int J Mol Sci ; 23(8)2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35457220

RESUMO

In nature, plants develop in complex, adaptive environments. Plants must therefore respond efficiently to environmental stressors to maintain homeostasis and enhance their fitness. Although many coordinated processes remain integral for achieving homeostasis and driving plant development, reactive oxygen species (ROS) function as critical, fast-acting orchestrators that link abiotic and biotic responses to plant homeostasis and development. In addition to the suite of enzymatic and non-enzymatic ROS processing pathways that plants possess, they also rely on their microbiota to buffer and maintain the oxidative window needed to balance anabolic and catabolic processes. Strong evidence has been communicated recently that links ROS regulation to the aggregated function(s) of commensal microbiota and plant-growth-promoting microbes. To date, many reports have put forth insightful syntheses that either detail ROS regulation across plant development (independent of plant microbiota) or examine abiotic-biotic feedbacks in plant microbiomes (independent of clear emphases on ROS regulation). Here we provide a novel synthesis that incorporates recent findings regarding ROS and plant development in the context of both microbiota regulation and plant-associated microbes. Specifically, we discuss various roles of ROS across plant development to strengthen the links between plant microbiome functioning and ROS regulation for both basic and applied research aims.


Assuntos
Microbiota , Venenos , Retroalimentação , Plantas/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Estresse Fisiológico/fisiologia
3.
Sci Rep ; 12(1): 5917, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35396467

RESUMO

A group of natural poisons from various animals, plants and microorganic sources can be extracted, produced and processed. Following ten years of field and laboratory research and studies, resulted from the creation of the first live collection of Iranian nettle ecotypes (LCINs) at the University of Zanjan, the feasibility of fresh and live extraction of nettle poison in pristine and untouched conditions was examined. In this study, the ability of tree tissues to absorb, hunt and sink nettle hairs, including styrofoam, nanofabric and sponge of the same length (15 cm) and same diameter (4 cm) having the same size of pores, was studied in four selected nettle ecotypes, including ecotypes of Mashhad, Mazandaran, Gilan and Zanjan provinces, Iran. For all four ecotypes on the three studied surfaces, the mean number of fully stuck and sunken needles, broken and sunken needles on the surface tissue, pores torn by plant needles and pores containing pale green liquid were counted and fully scrutinized. The results showed that sponges can be a suitable texture for hunting nettle hairs for extracting fresh and raw live venom of approximately 5 ml on a sponge source for 5 min. Based on GCMS analysis of total venom extraction resulting profile from the studied protocols had more than 10 compounds including some important sulfur containing such as: 2,2-dimethyl-propyl 2,2-dimethylpropanesulfinyl sulfone and 2-ethylthiolane, S,S-dioxide, etc. In this method, there is no need to remove the plant and stem. Its unique advantage is in continuous poison harvests during the 6-month growing season. Based on published research, this is the first report of live extraction of nettle medicinal poison.


Assuntos
Venenos , Urtica dioica , Animais , Irã (Geográfico)
4.
Emerg Med Clin North Am ; 40(2): 251-264, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35461622

RESUMO

Numerous drugs and toxins can cause metabolic acidosis. The treating clinician should be aware of the many compounds that can produce metabolic acidosis following an accidental exposure, an overdose, or with therapeutic use. Awareness and comprehension of those substances associated with metabolic acidosis will facilitate the diagnosis and treatment of poisoned patients.


Assuntos
Acidose , Overdose de Drogas , Venenos , Acidose/induzido quimicamente , Acidose/diagnóstico , Causalidade , Overdose de Drogas/diagnóstico , Overdose de Drogas/terapia , Humanos , Venenos/uso terapêutico
5.
Emerg Med Clin North Am ; 40(2): 431-441, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35461632

RESUMO

When evaluating a potentially poisoned patient, there is no substitute for a thorough history and physical examination. Clues from the examination are generally more likely to be helpful than a "shotgun" laboratory approach that involves indiscriminate testing of blood or urine for multiple agents. When used appropriately, diagnostic tests may be of help in the management of the intoxicated patient. When a specific toxin or even class of toxins is suspected, requesting qualitative or quantitative levels may be appropriate. The purpose of this review is to examine the role of common diagnostic tests in the evaluation of the poisoned patient.


Assuntos
Envenenamento , Venenos , Toxicologia , Humanos , Envenenamento/diagnóstico , Envenenamento/terapia
6.
PLoS One ; 17(4): e0266767, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35482773

RESUMO

BACKGROUND: Poisoning commonly occurs among children due to their curiosity, where they tend to explore and investigate their surroundings. They frequently put what they find into their mouths as they do not understand the danger and probably cannot read the warning label. As this issue has not been extensively studied in Malaysia; hence, a retrospective analysis of records was carried out to determine the profile of phone call enquiries regarding poisoning among children at the National Poison Centre (NPC). METHODOLOGY: The records of all cases of poisoning among children below the age of 18 years were retrospectively reviewed over a period of 10 years from 2006 to 2015. The data on the cases were analysed according to age group and gender, the circumstances and the toxic agent implicated in the poisoning. RESULTS: During the 10-year study period, 13,583 calls that met the criteria for this study were referred to the NPC. Of these calls, 62.2% involved children between the age of 0 to 5 years, 9% were children aged between 6 to 12 years, and 28.8% were children between 13 to 18 years. Unintentional poisoning accounted for 96.7% of the incidents involving children between the age of 0 to 5 years, although among the children who were between the age of 13 to 18 years, 76% of the cases were intentional. In all the cases involving children, pharmaceutical agents were the most frequent source of the poisoning. More than 95% of the cases were exposed to poisoning through the oral route. CONCLUSION: Poisoning in children between the age of 0 to 5 years was mainly unintentional, while poisoning in children between the age of 13 to 18 years was mainly intentional, where pharmaceutical and household agents were responsible for more than two-thirds of the poisoning cases. Most of these incidents could have been prevented if protective measures, such as child-resistant enclosures, had been implemented and if the parents and guardians had been educated about preventive measures, such as keeping poisoning agents out of the reach of children.


Assuntos
Venenos , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Malásia/epidemiologia , Preparações Farmacêuticas , Estudos Retrospectivos
7.
Subst Use Misuse ; 57(7): 1097-1103, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35450512

RESUMO

BACKGROUND: In 2014, the Drug Enforcement Administration rescheduled hydrocodone combination products to Schedule II to reduce nonmedical use and diversion. METHODS: The impact of rescheduling was assessed using quarterly data from 2011 through 2019 from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System Poison Center Program and IQVIATM Longitudinal Prescription Data. Trends and immediate changes in prescriptions dispensed and misuse exposures before and after rescheduling involving hydrocodone, oxycodone, and other Schedule II opioid analgesics were calculated using segmented regression. RESULTS: Hydrocodone prescriptions were stable pre-rescheduling, decreased by 2.7% (95% CI: -3.6%, -1.8%, p < 0.0001) per quarter post-rescheduling. Misuse exposures involving hydrocodone were decreasing by 3.2% (95% CI: -3.9%, -2.4%, p < 0.0001) per quarter pre-rescheduling and decreased by 4.9% (95% CI: -5.5%, -4.2%, p < 0.0001) post-rescheduling. Immediate decreases in hydrocodone prescriptions and misuse exposure rates in 2014Q4 compared to 2014Q3 were significant and different from oxycodone or other Schedule II opioids. Schedule II opioid analgesics prescriptions in aggregate were stable prior to rescheduling, decreased by 10.8% (95%CI: -14.0%, -7.6%, p < 0.0001) immediately after the rescheduling, and decreased by 2.3% per quarter (95% CI: -3.1%, -1.5%, p < 0.0001) subsequently. Misuse exposures involving these opioids were decreasing by 3.3% (95% CI: -4.1%, -2.5%, p < 0.0001) prior to rescheduling then by 2.8%, (95% CI: -3.4%, -2.2%, p < 0.0001) after rescheduling. The immediate change in misuse was not significant. CONCLUSIONS: Rescheduling corresponded with changes in hydrocodone prescribing and misuse not offset by increases in other Schedule II opioid analgesics. Misuse exposures for hydrocodone and comparators were decreasing prior to rescheduling with little change post-intervention.


Assuntos
Hidrocodona , Venenos , Analgésicos , Analgésicos Opioides/uso terapêutico , Substâncias Controladas , Prescrições de Medicamentos , Humanos , Oxicodona , Padrões de Prática Médica
10.
Chemosphere ; 298: 134201, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35257710

RESUMO

Whether chronic exposure to environmental doses of polycyclic aromatic hydrocarbons (PAHs) can lead to neurotoxic effects is still unclear. Hence, the neurotoxic effects of perinatal and juvenile exposure to 16 priority-controlled PAHs were investigated. The mice were treated with 0, 0.5, 18.75, 50, 1875 µg/kg/day of PAHs corresponding to various population exposure concentrations from gestation to postnatal day 60. Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and hippocampal and cortical neurotransmitter levels were determined using liquid chromatography-tandem mass spectrometry. Typical indicators or outcome of neurotoxicity, including, spatial learning and memory ability, hippocampal long-term potentiation (LTP) and dendritic spine density were evaluated via Morris water maze tests, electrophysiological experiments and Golgi-Cox assays, respectively. The results showed that exposure to different levels of PAH could not increase oxidative DNA damage level. Mice exposed to 0.5, 50 and 1875 µg/kg/day PAHs had significantly longer escape latency than the control group only on the 1st day (p < 0.05). The number of platform crossings and the time spent in target quadrant were similar between the control and the PAHs-exposed mice. Compared with the control mice, only those exposed to 50 µg/kg/day PAHs had significantly lower LTP in hippocampal CA1 region and dendritic spine density in hippocampal DG region (p < 0.05). Except for serotonin, no significant difference in hippocampal and cortical neurotransmitter concentrations was observed between the control and PAHs-exposed groups. Taken together, perinatal and juvenile exposure to environmental doses of PAHs had no profound effect on spatial learning and memory abilities, hippocampal LTP, dendritic spines density, and neurotransmitter levels. These unexpected findings were quite different from previous in vivo studies which commonly used 2-3 orders of magnitude higher PAHs doses to treat animals. Thus, the environmental dose is a crucial reference for future toxicological research to reveal the actual toxic mechanisms and human health effects of PAHs exposure.


Assuntos
Venenos , Hidrocarbonetos Policíclicos Aromáticos , 8-Hidroxi-2'-Desoxiguanosina , Animais , Feminino , Camundongos , Neurotransmissores , Estresse Oxidativo , Hidrocarbonetos Policíclicos Aromáticos/análise , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Gravidez
11.
Environ Pollut ; 303: 119098, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35248623

RESUMO

This study reports the results obtained from toxicological analyses of different types of baits referred to the laboratory of the Toxicology Area (Faculty of Veterinary Medicine, Cáceres, Spain) over a 17-year period (2002-2018). These baits were suspicious materials found in the environment of the region of Extremadura (Western Spain), where such malpractices are a problem to be addressed, as wide livestock farming and hunting activities are combined with a significant wealth of wildlife (especially birds of prey). A total of 246 baits, including 32 commercial chemical products to be used in baits, were analysed. Samples from 183 cases were received and classified according to the material used for their preparation and the toxic substance found. Overall, the most common bait consisted of meat preparations (56.3% of cases) intended to eliminate predators considered 'annoying' for livestock and hunting practices, such as carnivores and scavengers. It should be noted that contact baits (as fenthion-impregnated perches) were also detected (7.6%). Regarding the substances detected, anticholinesterase compounds (organophosphates and carbamates) were the most commonly used substances for the preparation of baits (detected in 85.3% of positive baits). Moreover, 8% of the positive baits presented more than one toxic substance in their composition. Due to the types of toxic compounds and the methods used to prepare the baits, this study shows that the malicious use of highly toxic substances in the environment to kill wildlife is a common and current issue and poses a serious risk to different species.


Assuntos
Animais Selvagens , Venenos , Animais , Aves , Gado , Estudos Retrospectivos , Espanha
12.
Chem Res Toxicol ; 35(3): 522-528, 2022 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-35258279

RESUMO

Ethyl ester flavor additives are used in e-liquids to produce a citrus flavor. Although these compounds are considered safe as flavor additives, this only applies to oral consumption and not vaping operations, where they can decompose into potentially harmful compounds including carboxylic acids. Further decomposition of these carboxylic acids is expected to produce ketene, which is a strong respiratory poison that can cause fatal lung damage at low concentrations. This study develops a kinetic model of the thermal decomposition of ethyl ester flavor additives and simulates the decomposition of these compounds under vaping conditions. These results show that under normal operating conditions, it is unlikely for any harmful compounds to be present in-lung. However, at higher operating temperatures, there is the potential for acetic and butanoic acid to be present in the lungs at concentrations that cause irritation, and where repeated exposure may lead to bronchitis. At more extreme operating conditions it is possible for harmful levels of ketene to be produced such that it could cause fatal or severely detrimental effects upon repeated exposure. These high temperatures can be reached under "dry" operating conditions that arise as a result of improper use, particularly in user-modified e-cigarettes.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Venenos , Vaping , Ésteres , Aromatizantes/análise , Vaping/efeitos adversos
13.
PLoS One ; 17(3): e0264540, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35275922

RESUMO

Poison frogs bioaccumulate alkaloids for chemical defense from their arthropod diet. Although many alkaloids are accumulated without modification, some poison frog species can metabolize pumiliotoxin (PTX 251D) into the more potent allopumiliotoxin (aPTX 267A). Despite extensive research characterizing the chemical arsenal of poison frogs, the physiological mechanisms involved in the sequestration and metabolism of individual alkaloids remain unclear. We first performed a feeding experiment with the Dyeing poison frog (Dendrobates tinctorius) to ask if this species can metabolize PTX 251D into aPTX 267A and what gene expression changes are associated with PTX 251D exposure in the intestines, liver, and skin. We found that D. tinctorius can metabolize PTX 251D into aPTX 267A, and that PTX 251D exposure changed the expression level of genes involved in immune system function and small molecule metabolism and transport. To better understand the functional significance of these changes in gene expression, we then conducted a series of high-throughput screens to determine the molecular targets of PTX 251D and identify potential proteins responsible for metabolism of PTX 251D into aPTX 267A. Although screens of PTX 251D binding human voltage-gated ion channels and G-protein coupled receptors were inconclusive, we identified human CYP2D6 as a rapid metabolizer of PTX 251D in a cytochrome P450 screen. Furthermore, a CYP2D6-like gene had increased expression in the intestines of animals fed PTX, suggesting this protein may be involved in PTX metabolism. These results show that individual alkaloids can modify gene expression across tissues, including genes involved in alkaloid metabolism. More broadly, this work suggests that specific alkaloid classes in wild diets may induce physiological changes for targeted accumulation and metabolism.


Assuntos
Alcaloides , Artrópodes , Venenos , Alcaloides/farmacologia , Animais , Anuros/genética , Citocromo P-450 CYP2D6
14.
J Chem Ecol ; 48(4): 384-400, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35352271

RESUMO

The sequestration by neotropical poison frogs (Dendrobatidae) of an amazing array of defensive alkaloids from oribatid soil mites has motivated an exciting research theme in chemical ecology, but the details of mite-to-frog transfer remain hidden. To address this, McGugan et al. (2016, Journal of Chemical Ecology 42:537-551) used the little devil poison frog (Oophaga sylvatica) and attempted to simultaneously characterize the prey mite alkaloids, the predator skin alkaloids, and identify the mites using DNA sequences. Heethoff et al. (2016, Journal of Chemical Ecology 42:841-844) argued that none of the mite families to which McGugan et al. allocated the prey was thought to possess alkaloids. Heethoff et al. concluded from analyses including additional sequences that the mite species were unlikely to be close relatives of the defended mites. We re-examine this by applying more appropriate phylogenetic methods to broader and denser taxonomic samples of mite sequences using the same gene (CO1). We found, over trees based on CO1 datasets, only weak support (except in one case) for branches critical to connecting the evolution of alkaloid sequestration with the phylogeny of mites. In contrast, a well-supported analysis of the 18S ribosomal gene suggests at least two independent evolutionary origins of oribatid alkaloids. We point out impediments in the promising research agenda, namely a paucity of genetic, chemical, and taxonomic information, and suggest how phylogenetics can elucidate at a broader level the evolution of chemical defense in prey arthropods, sequestration by predators, and the impact of alkaloids on higher-order trophic interactions.


Assuntos
Alcaloides , Artrópodes , Ácaros , Venenos , Alcaloides/química , Animais , Anuros/genética , Artrópodes/genética , Humanos , Ácaros/genética , Filogenia
15.
J Law Med Ethics ; 50(1): 124-138, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35243983

RESUMO

Dr. Caleb Williams Saleeby was the author of Parenthood and Race Culture, one of the first monographs on eugenics and the book that popularized the term "racial poison." The goal of eradicating the racial poisons and the harm they caused - particularly infant morbidity and mortality - provided common ground for early 20th century reformers, and their concerns fed the growing support for legal prohibition of alcohol.


Assuntos
Eugenia (Ciência) , Venenos , Eugenia (Ciência)/história , História do Século XX , Humanos
16.
Front Biosci (Landmark Ed) ; 27(3): 93, 2022 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-35345325

RESUMO

BACKGROUND: Inhibition of human topoisomerase I (TOP1) by camptothecin and topotecan has been shown to reduce excessive transcription of PAMP (Pathogen-Associated Molecular Pattern)-induced genes in prior studies, preventing death from sepsis in animal models of bacterial and SARS-CoV-2 infections. The TOP1 catalytic activity likely resolves the topological constraints on DNA that encodes these genes to facilitate the transcription induction that leads to excess inflammation. The increased accumulation of TOP1-DNA covalent complex (TOP1cc) following DNA cleavage is the basis for the anticancer efficacy of the TOP1 poisons developed for anticancer treatment. The potential cytotoxicity and mutagenicity of TOP1 targeting cancer drugs pose serious concerns for employing them as therapies in sepsis prevention. METHODS: In this study we set up a novel yeast-based screening system that employs yeast strains expressing wild-type or a dominant lethal mutant recombinant human TOP1. The effect of test compounds on growth is monitored with and without overexpression of the recombinant human TOP1. RESULTS: This yeast-based screening system can identify human TOP1 poisons for anticancer efficacy as well as TOP1 suppressors that can inhibit TOP1 DNA binding or cleavage activity in steps prior to the formation of the TOP1cc. CONCLUSIONS: This yeast-based screening system can distinguish between TOP1 suppressors and TOP1 poisons. The assay can also identify compounds that are likely to be cytotoxic based on their effect on yeast cell growth that is independent of recombinant human TOP1 overexpression.


Assuntos
COVID-19 , Venenos , Animais , DNA Topoisomerases Tipo I/química , DNA Topoisomerases Tipo I/genética , DNA Topoisomerases Tipo I/metabolismo , Humanos , SARS-CoV-2 , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo
17.
J Exp Zool A Ecol Integr Physiol ; 337(5): 537-546, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35201668

RESUMO

Sequestration of chemical defenses from dietary sources is dependent on the availability of compounds in the environment and the mechanism of sequestration. Previous experiments have shown that sequestration efficiency varies among alkaloids in poison frogs, but little is known about the underlying mechanism. The aim of this study was to quantify the extent to which alkaloid sequestration and modification are dependent on alkaloid availability and/or sequestration mechanism. To do this, we administered different doses of histrionicotoxin (HTX) 235A and decahydroquinoline (DHQ) to captive-bred Adelphobates galactonotus and measured alkaloid quantity in muscle, kidney, liver, and feces. HTX 235A and DHQ were detected in all organs, whereas only DHQ was present in trace amounts in feces. For both liver and skin, the quantity of alkaloid accumulated increased at higher doses for both alkaloids. Accumulation efficiency in the skin increased at higher doses for HTX 235A but remained constant for DHQ. In contrast, the efficiency of HTX 235A accumulation in the liver was inversely related to dose and a similar, albeit statistically nonsignificant, pattern was observed for DHQ. We identified and quantified the N-methylation of DHQ in A. galactonotus, which represents a previously unknown example of alkaloid modification in poison frogs. Our study suggests that variation in alkaloid composition among individuals and species can result from differences in sequestration efficiency related to the type and amount of alkaloids available in the environment.


Assuntos
Alcaloides , Venenos , Alcaloides/química , Animais , Anuros/fisiologia , Metilação , Quinolinas
18.
Vet Rec ; 190(3): 93, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35119725

Assuntos
Venenos , Animais
19.
Sci Total Environ ; 822: 153581, 2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35104517

RESUMO

Wildlife around cities bioaccumulate multiple harmful environmental pollutants associated with human activities. Exposure severity can vary based on foraging behaviour and habitat use, which can be examined to elucidate exposure pathways. Carnivores can play vital roles in ecosystem stability but are particularly vulnerable to bioaccumulation of pollutants. Understanding the spatial and dietary predictors of these contaminants can inform pollutant control, and carnivores, at the top of food webs, can act as useful indicator species. We test for exposure to toxic organochlorines (OCs), including dichloro-diphenyl-trichloroethane (DDT) and polychlorinated biphenyls (PCBs), in a medium-sized felid, the caracal (Caracal caracal), across the peri-urban and agricultural landscapes of the city of Cape Town, South Africa. Concentrations in both blood (n = 69) and adipose tissue (n = 25) were analysed along with detailed spatial, dietary, demographic, and physiological data to assess OC sources and exposure risk. The analysis revealed widespread exposure of Cape Town's caracals to organochlorines: detection rate was 100% for PCBs and 83% for DDTs in blood, and 100% for both compounds in adipose. Caracals using human-transformed areas, such as vineyards and areas with higher human population and electrical transformer density, as well as wetland areas, had higher organochlorine burdens. These landscapes were also highly selected foraging areas, suggesting caracals are drawn into areas that co-incidentally increase their risk of exposure to these pollutants. Further, biomagnification potential was higher in individuals feeding on higher trophic level prey and on exotic prey. These findings point to bioaccumulation of OC toxicants and widespread exposure across local food webs. Additionally, we report possible physiological effects of exposure, including elevated white blood cell and platelet count, suggesting a degree of immunological response that may increase disease susceptibility. Cape Town's urban fringes likely represent a source of toxic chemicals for wildlife and require focused attention and action to ensure persistence of this adaptable mesocarnivore.


Assuntos
Hidrocarbonetos Clorados , Venenos , Bifenilos Policlorados , Animais , Ecossistema , Monitoramento Ambiental , Humanos , Hidrocarbonetos Clorados/análise , Poluentes Orgânicos Persistentes , Venenos/análise , Bifenilos Policlorados/análise , África do Sul
20.
Crit Care Med ; 50(4): 655-664, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34995213

RESUMO

OBJECTIVES: To describe the use of extracorporeal membrane oxygenation (ECMO) in the management of pediatric poisoning in the United States and to identify predictors of mortality. DESIGN: Retrospective cohort study. SETTING: Data reported to the Extracorporeal Life Support Organization by 76 U.S. ECMO centers from 2003 to 2019. PATIENTS: Pediatric patients (0-18 yr) receiving ECMO for poisoning. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During our study period, 86 cases of acute poisoning were identified and included in the analysis. The median age was 12.0 year and 52.9% were female. The most commonly reported substance exposures were hydrocarbon (n = 17; 19.8%), followed by chemical asphyxiants (n = 14; 16.3%), neuroactive agents (n = 14; 16.3%), opioid/analgesics (n = 13; 15.1%), and cardiovascular agents (n = 12; 14.0%). Single substance exposures were reported in 83.7% of the cases. The intention of the exposure was unknown in 65.1%, self-harm in 20.9% and 10.5% was unintentional exposure. Fifty-six patients (65.1%) survived. Venoarterial ECMO was used more frequently than venovenous ECMO, and its use increased significantly during the study period (p < 0.01). A bimodal distribution of ECMO support was observed among two age groups: less than or equal to 3 years (n = 34) and 13-17 years (n = 41). Hemodynamic and metabolic parameters improved for all patients with ECMO. Persistent systolic hypotension, acidemia/metabolic acidosis, and elevated Pao2) after 24 hours of ECMO support were associated with mortality. Time from PICU admission to ECMO cannulation was not significantly different between survivors (24.0 hr; interquartile range [IQR], 11.0-58.0 hr) and nonsurvivors (30.5 hr; IQR, 10.0-60.2 hr; p = 0.58). ECMO duration and PICU length of stay were significantly longer in survivors than in nonsurvivors (139.5 vs 70.5 hr; p = 0.007 and 25.0 vs 4.0 d; p = 0.002, respectively). CONCLUSIONS: ECMO may improve the hemodynamic and metabolic status of poisoned pediatric patients. Persistent hypotension, acidemia/acidosis, and elevated Pao2 after 24 hours of ECMO were associated with mortality.


Assuntos
Oxigenação por Membrana Extracorpórea , Hipotensão , Venenos , Criança , Oxigenação por Membrana Extracorpórea/efeitos adversos , Feminino , Humanos , Hipotensão/epidemiologia , Hipotensão/etiologia , Hipotensão/terapia , Masculino , Oxigênio , Sistema de Registros , Estudos Retrospectivos , Estados Unidos/epidemiologia
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