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Acute pediatric digoxin ingestion.

M A Gittelman¹, M Stephan, H Perry

¹Department of Pediatric Emergency Medicine, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.

Pediatric Emergency Care

|October 26, 1999

Summary

This summary is machine-generated.

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Most pediatric digoxin ingestions are mild, but some children develop toxicity. Prompt recognition and treatment, including supportive care or digoxin-specific antibody fragments, are crucial for managing acute cardiac glycoside poisoning in children.

Area of Science:

Pediatric Toxicology
Cardiology
Emergency Medicine

Background:

Acute ingestions of cardiac glycosides, such as digoxin, are common in children.
While often asymptomatic, significant toxicity can occur, necessitating prompt medical intervention.

Observation:

Gastrointestinal upset and first-degree atrioventricular block are the most frequent initial symptoms in symptomatic pediatric patients.
A history of ingestion may not always be readily available, requiring a high index of clinical suspicion.

Findings:

Most pediatric patients with acute digoxin ingestion can be managed with activated charcoal and observation.
A subset of patients will exhibit toxicity, requiring intensive monitoring, medical management, and potentially digoxin-specific antibody fragments.

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Implications:

Clinicians must maintain a high index of suspicion for acute digoxin poisoning in children, even without a clear ingestion history.
Appropriate diagnostic tests, including digoxin levels, potassium levels, and electrocardiograms (ECGs), are essential for confirming toxicity.
Timely recognition of clinical manifestations and initiation of appropriate therapy, ranging from supportive care to digoxin-specific antibody fragments, are critical for favorable outcomes.