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Digoxin toxicity: pediatric survival after asystolic arrest
Dalit Eyal1, Kenneth A Molczan, Leslie S Carroll
1Department of Pediatrics, Division of Pediatric Emergency Medicine, Temple University Children's Medical Center, Philadelphia, Pennsylvania, USA. eyald@tuhs.temple.edu
Clinical Toxicology (Philadelphia, Pa.)
|March 1, 2005
Summary
A child with heart disease survived cardiac arrest from digoxin poisoning. Treatment with Digibind (Fab) antibodies successfully reversed toxicity, leading to full recovery and discharge.
Area of Science:
- Pediatric Cardiology
- Clinical Toxicology
Background:
- Congenital heart anomalies require complex management, including post-surgical care.
- Digoxin is a cardiac glycoside used to treat heart failure, but carries a risk of toxicity.
Observation:
- A 12-week-old infant with a history of congenital heart anomaly repair presented in asystolic cardiac arrest.
- The infant had a confirmed toxic level of digoxin in her system.
Findings:
- Successful resuscitation was achieved using standard Advanced Pediatric Life Support protocols.
- Administration of Digoxin-specific antibody fragments (Digibind, Fab) effectively neutralized digoxin toxicity.
- All toxic effects resolved, and the infant experienced full neurological recovery.
Implications:
- This case highlights the critical importance of recognizing and managing digoxin toxicity in pediatric patients with cardiac conditions.
- Digoxin-specific antibody fragments are a life-saving intervention for severe digoxin poisoning in infants.
- Prompt diagnosis and treatment can lead to favorable outcomes even in critical poisoning events.