Predictors of Myocardial Dysfunction in Children with Indian Red Scorpion (Mesobuthus tamulus) Sting Envenomation

Area of Science:

• Pediatric Cardiology
• Toxicology
• Emergency Medicine

Background:

• Scorpion sting envenomation is a significant cause of pediatric morbidity, with myocardial dysfunction being a serious complication.
• Identifying predictive risk factors and effective therapeutic interventions is crucial for managing these cases.

Purpose of the Study:

• To determine predictors of myocardial dysfunction in children following scorpion stings.
• To assess the efficacy of a combination therapy involving scorpion antivenom and prazosin in preventing myocardial dysfunction.

Main Methods:

• An observational study was conducted in a tertiary care hospital in Southern India.
• Eighty-five children under 13 years of age with scorpion sting envenomation were included.
• The study analyzed the frequency of myocardial dysfunction and its predictors.

Main Results:

• Myocardial dysfunction occurred in 28.2% of the children.
• Hypotension upon admission and a delay of over 4 hours in receiving appropriate therapy were identified as independent predictors of myocardial dysfunction.
• Combination therapy with scorpion antivenom and prazosin showed a positive trend in increasing the proportion of children who did not develop myocardial dysfunction.

Conclusions:

• Timely administration of scorpion antivenom combined with prazosin within 4 hours of the sting is associated with a higher cumulative percentage of children avoiding myocardial dysfunction.
• This combination therapy represents a promising strategy for mitigating cardiac complications in pediatric scorpion envenomation.