Poisonings requiring admission to the pediatric intensive care unit: A 5-year review

K. M. Even, C. C. Armsby, S. T. Bateman

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Background. Poisonings represent a significant number of preventable admissions to the pediatric intensive care unit (PICU), but data about poisonings requiring PICU-level care are limited. Objectives. To identify the demographics of patients admitted with poisonings and characterize their clinical courses related to their poisoning. Methods. All poisonings over a 5-year period (2008-2012) at an academic medical center in New England were retrospectively reviewed using electronic medical records in an observational case series. Poisonings were identified using key search terms within an admissions database. Results. There were 273 admissions for poisonings, which represent 8% of total PICU admissions over this time period. The poisonings were unintentional in 148 (54%) cases and intentional in 125 (46%). The vast majority of poisonings occurred in patients either 3 years or below (N = 121, 44%) or 13 years or above (N = 124, 45%). Most (96%) admissions were for less than 48 h and 41% were for less than 24 h. Mean PICU length of stay was 1.2 + 0.7 days. A total of 468 substances were ingested in 54 different drug classes, with analgesics and antidepressants being the most common. Eighty-five (31%) poisonings were polypharmaceutical. The most commonly used therapies were naloxone, activated charcoal, and benzodiazepines. Twenty-seven patients (10%) received mechanical ventilation. There was one fatality, an adolescent with a polypharmacy overdose in a suicide attempt. Conclusion. Pediatric poisonings are a significant percentage of admissions to the PICU. The majority of poisonings are non-fatal, require supportive care, close monitoring, and some specific treatment. Drug classes causing poisonings have changed to a higher percentage of opioids in younger patients and atypical antidepressants in adolescents.

Original languageEnglish (US)
Pages (from-to)519-524
Number of pages6
JournalClinical Toxicology
Volume52
Issue number5
DOIs
StatePublished - Jun 2014

Fingerprint

Intensive care units
Pediatric Intensive Care Units
Pediatrics
Poisoning
Second-Generation Antidepressive Agents
Electronic medical equipment
Charcoal
Naloxone
Benzodiazepines
Pharmaceutical Preparations
Opioid Analgesics
Antidepressive Agents
Analgesics
Polypharmacy
Monitoring
New England
Electronic Health Records
Artificial Respiration
Suicide
Length of Stay

All Science Journal Classification (ASJC) codes

  • Toxicology

Cite this

Even, K. M. ; Armsby, C. C. ; Bateman, S. T. / Poisonings requiring admission to the pediatric intensive care unit : A 5-year review. In: Clinical Toxicology. 2014 ; Vol. 52, No. 5. pp. 519-524.
@article{4fb54e6708e44110bbec6e3fe1631150,
title = "Poisonings requiring admission to the pediatric intensive care unit: A 5-year review",
abstract = "Background. Poisonings represent a significant number of preventable admissions to the pediatric intensive care unit (PICU), but data about poisonings requiring PICU-level care are limited. Objectives. To identify the demographics of patients admitted with poisonings and characterize their clinical courses related to their poisoning. Methods. All poisonings over a 5-year period (2008-2012) at an academic medical center in New England were retrospectively reviewed using electronic medical records in an observational case series. Poisonings were identified using key search terms within an admissions database. Results. There were 273 admissions for poisonings, which represent 8{\%} of total PICU admissions over this time period. The poisonings were unintentional in 148 (54{\%}) cases and intentional in 125 (46{\%}). The vast majority of poisonings occurred in patients either 3 years or below (N = 121, 44{\%}) or 13 years or above (N = 124, 45{\%}). Most (96{\%}) admissions were for less than 48 h and 41{\%} were for less than 24 h. Mean PICU length of stay was 1.2 + 0.7 days. A total of 468 substances were ingested in 54 different drug classes, with analgesics and antidepressants being the most common. Eighty-five (31{\%}) poisonings were polypharmaceutical. The most commonly used therapies were naloxone, activated charcoal, and benzodiazepines. Twenty-seven patients (10{\%}) received mechanical ventilation. There was one fatality, an adolescent with a polypharmacy overdose in a suicide attempt. Conclusion. Pediatric poisonings are a significant percentage of admissions to the PICU. The majority of poisonings are non-fatal, require supportive care, close monitoring, and some specific treatment. Drug classes causing poisonings have changed to a higher percentage of opioids in younger patients and atypical antidepressants in adolescents.",
author = "Even, {K. M.} and Armsby, {C. C.} and Bateman, {S. T.}",
year = "2014",
month = "6",
doi = "10.3109/15563650.2014.909601",
language = "English (US)",
volume = "52",
pages = "519--524",
journal = "Clinical Toxicology",
issn = "1556-3650",
publisher = "Informa Healthcare",
number = "5",

}

Poisonings requiring admission to the pediatric intensive care unit : A 5-year review. / Even, K. M.; Armsby, C. C.; Bateman, S. T.

In: Clinical Toxicology, Vol. 52, No. 5, 06.2014, p. 519-524.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Poisonings requiring admission to the pediatric intensive care unit

T2 - A 5-year review

AU - Even, K. M.

AU - Armsby, C. C.

AU - Bateman, S. T.

PY - 2014/6

Y1 - 2014/6

N2 - Background. Poisonings represent a significant number of preventable admissions to the pediatric intensive care unit (PICU), but data about poisonings requiring PICU-level care are limited. Objectives. To identify the demographics of patients admitted with poisonings and characterize their clinical courses related to their poisoning. Methods. All poisonings over a 5-year period (2008-2012) at an academic medical center in New England were retrospectively reviewed using electronic medical records in an observational case series. Poisonings were identified using key search terms within an admissions database. Results. There were 273 admissions for poisonings, which represent 8% of total PICU admissions over this time period. The poisonings were unintentional in 148 (54%) cases and intentional in 125 (46%). The vast majority of poisonings occurred in patients either 3 years or below (N = 121, 44%) or 13 years or above (N = 124, 45%). Most (96%) admissions were for less than 48 h and 41% were for less than 24 h. Mean PICU length of stay was 1.2 + 0.7 days. A total of 468 substances were ingested in 54 different drug classes, with analgesics and antidepressants being the most common. Eighty-five (31%) poisonings were polypharmaceutical. The most commonly used therapies were naloxone, activated charcoal, and benzodiazepines. Twenty-seven patients (10%) received mechanical ventilation. There was one fatality, an adolescent with a polypharmacy overdose in a suicide attempt. Conclusion. Pediatric poisonings are a significant percentage of admissions to the PICU. The majority of poisonings are non-fatal, require supportive care, close monitoring, and some specific treatment. Drug classes causing poisonings have changed to a higher percentage of opioids in younger patients and atypical antidepressants in adolescents.

AB - Background. Poisonings represent a significant number of preventable admissions to the pediatric intensive care unit (PICU), but data about poisonings requiring PICU-level care are limited. Objectives. To identify the demographics of patients admitted with poisonings and characterize their clinical courses related to their poisoning. Methods. All poisonings over a 5-year period (2008-2012) at an academic medical center in New England were retrospectively reviewed using electronic medical records in an observational case series. Poisonings were identified using key search terms within an admissions database. Results. There were 273 admissions for poisonings, which represent 8% of total PICU admissions over this time period. The poisonings were unintentional in 148 (54%) cases and intentional in 125 (46%). The vast majority of poisonings occurred in patients either 3 years or below (N = 121, 44%) or 13 years or above (N = 124, 45%). Most (96%) admissions were for less than 48 h and 41% were for less than 24 h. Mean PICU length of stay was 1.2 + 0.7 days. A total of 468 substances were ingested in 54 different drug classes, with analgesics and antidepressants being the most common. Eighty-five (31%) poisonings were polypharmaceutical. The most commonly used therapies were naloxone, activated charcoal, and benzodiazepines. Twenty-seven patients (10%) received mechanical ventilation. There was one fatality, an adolescent with a polypharmacy overdose in a suicide attempt. Conclusion. Pediatric poisonings are a significant percentage of admissions to the PICU. The majority of poisonings are non-fatal, require supportive care, close monitoring, and some specific treatment. Drug classes causing poisonings have changed to a higher percentage of opioids in younger patients and atypical antidepressants in adolescents.

UR - http://www.scopus.com/inward/record.url?scp=84902250732&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902250732&partnerID=8YFLogxK

U2 - 10.3109/15563650.2014.909601

DO - 10.3109/15563650.2014.909601

M3 - Review article

C2 - 24738737

AN - SCOPUS:84902250732

VL - 52

SP - 519

EP - 524

JO - Clinical Toxicology

JF - Clinical Toxicology

SN - 1556-3650

IS - 5

ER -