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Extracorporeal treatment in children with acute severe poisoning

Xiaomei Sun1,2, Xiuying Chen1,2, Jing Lu1,2

  • 1Department of Pediatrics.

Medicine
|November 26, 2019
PubMed

Insights

Extracorporeal treatment (ECTR) effectively manages severe acute poisoning in children, particularly from pesticides like Paraquat. This method showed high cure rates with manageable adverse events, proving beneficial in pediatric toxicology.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Toxicology
  • Critical Care Nephrology

Background:

  • Acute poisoning in children represents a critical medical emergency requiring rapid intervention.
  • Extracorporeal treatment (ECTR) offers a viable method for augmenting poison elimination.
  • Severe poisoning necessitates advanced therapeutic strategies to improve patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of Extracorporeal treatment (ECTR) in pediatric patients with severe acute poisoning.
  • To identify the primary causes of poisoning and the specific ECTR modalities employed.
  • To document the adverse events and overall outcomes associated with ECTR in this population.

Main Methods:

  • Retrospective observational study of 338 children hospitalized with severe acute poisoning from January 2010 to December 2017.
  • Data collection included types of poisonous substances, ECTR utilization, adverse reactions, and patient outcomes.
  • Analysis of common poisoning categories (pesticides, biotoxins, pharmaceuticals) and ECTR techniques (hemoperfusion, plasma exchange, CRRT, hemodialysis).

Main Results:

  • Pesticides were the leading cause of poisoning (57.99%), with Paraquat being the most frequent agent (35.21%).
  • Hemoperfusion (50.59%) and therapeutic plasma exchange (42.60%) were the predominant ECTR modalities.
  • A high cure rate of 87.28% was observed, with manageable mild to moderate adverse events.

Conclusions:

  • Extracorporeal treatment (ECTR) modalities are clinically effective and well-tolerated for treating severe acute poisoning in children.
  • ECTR plays a significant role in pediatric toxicology, particularly for poisonings involving pesticides, biotoxins, and pharmaceuticals.
  • The study supports the continued use of ECTR as a critical intervention for life-threatening poisonings in pediatric patients.

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