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首页> 外文期刊>Human and Experimental Toxicology >Severe scorpion envenomation in children: Management in pediatric intensive care unit
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Severe scorpion envenomation in children: Management in pediatric intensive care unit

机译：儿童重度蝎毒：儿科重症监护室的处理

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Background: Scorpion envenomation is a common public health problem worldwide and children are at greater risk of developing severe cardiac, respiratory and neurological complications. The aim of this study was to evaluate the effects of antivenin and/or prazosin use on prognosis of scorpion-envenomed children admitted to pediatric intensive care unit (PICU). Methods: The standardized medical records of 45 children hospitalized with severe scorpion sting in PICU were retrospectively evaluated. General characteristics of the children, clinical and laboratory findings, treatment approaches and prognosis were evaluated. Results: The mean age of the patients were 6.1 4.1 years ranging between 4 month and 15 years. Male to female ratio was 1.8. Thirty-three (71.1%) cases of scorpion stings came from rural areas. Twenty-six (57.8%) of the patients were stung by Androctonus crassicauda. The most common sting localization was the foot-leg (55.6%). The mean duration from the scorpion sting to hospital admission was 4.5 2.6 hours. The most common findings at presentation were cold extremities (95.5%), excessive sweating (91.1%) and tachycardia (77.7%). The mean leukocyte count, and serum levels of glucose, lactate dehydrogenase, creatine phosphokinase and international normalized ratio were found above the normal ranges. Prazosin was used in all patients, dopamine in 11 (24.4%) and Na-nitroprusside in 4 (8.8%) patients. Two children died (4.4%) due to pulmonary oedema. These children, in poor clinical status at hospital admission, needed mechanical ventilation, and death occurred despite use of antivenin and prazosin in both of them. Conclusion: The current management of children with severe scorpion envenomation consists of administration of specific antivenom and close surveillance in a PICU, where vital signs and continuous monitoring enable early initiation of therapy for life-threatening complications. The aggressive medical management directed at the organ system specifically can be effective. Our data indicated that when admission to hospital is late, the beneficial effect of antivenom and/or prazosin is questionable in severe scorpion stings.
机译：背景：蝎子毒化是全世界常见的公共卫生问题，儿童患严重心脏，呼吸和神经系统并发症的风险更大。这项研究的目的是评估使用抗蛇毒蛋白和/或哌唑嗪对入院小儿重症监护病房（PICU）的蝎毒儿童的预后的影响。方法：回顾性分析45例重症监护病房（PICU）住院的重度蝎痛儿童的病历。对儿童的一般特征，临床和实验室检查结果，治疗方法和预后进行了评估。结果：患者的平均年龄为6.1 4.1岁，范围为4个月至15岁。男女比例为1.8。 33例（71.1％）蝎子ing病例来自农村地区。二十六（57.8％）名患者被Androctonus crassicauda st伤。最常见的刺定位是脚腿（55.6％）。从蝎刺到入院的平均时间为4.5 2.6小时。呈现时最常见的发现是四肢感冒（95.5％），出汗过多（91.1％）和心动过速（77.7％）。平均白细胞计数以及血清葡萄糖，乳酸脱氢酶，肌酸磷酸激酶和国际标准化比率均高于正常范围。所有患者均使用普拉唑嗪，11例（24.4％）使用多巴胺，4例（8.8％）使用钠-硝普钠。两名儿童因肺水肿而死亡（4.4％）。这些儿童入院时的临床状况较差，需要机械通气，尽管他们俩都使用了抗静脉蛋白和哌唑嗪，但仍发生了死亡。结论：目前对重度蝎子毒死儿童的治疗包括在PICU中给予特定的抗蛇毒和严密监视，其中生命体征和连续监视可及早开始治疗危及生命的并发症。针对器官系统的积极医疗管理特别有效。我们的数据表明，当住院较晚时，在严重的蝎子st中，抗蛇毒和/或哌唑嗪的有益作用值得怀疑。

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