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Acute pediatric digoxin ingestion. A ten-year experience
American Journal of Diseases of Children (1960)
|August 1, 1986
Summary
Acute pediatric digoxin ingestion is uncommon and typically not severe. Symptoms at presentation predict higher digoxin levels, but early signs don't always indicate later complications.
Area of Science:
- Pediatric Toxicology
- Cardiovascular Pharmacology
Background:
- Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
- Acute digoxin ingestion in children can lead to toxicity, but data on its severity and presentation is limited.
Purpose of the Study:
- To evaluate the clinical presentation, serum concentrations, and outcomes of acute pediatric digoxin ingestions.
- To identify predictors of digoxin toxicity in pediatric patients.
Main Methods:
- Retrospective chart review of 41 pediatric patients with acute digoxin ingestion and documented serum levels.
- Analysis of clinical signs, symptoms, electrocardiographic (ECG) findings, serum potassium, and digoxin concentrations.
Main Results:
- Most ingestions were not severe; 27% of patients were symptomatic, with digoxin levels > 2 ng/mL.
- ECG abnormalities (bradycardia, AV block) occurred in 11 patients, often delayed (>5 hours), and were not life-threatening.
- No clear correlation between serum potassium and digoxin levels was observed; rapid initial and slower second-phase serum half-lives were noted.
Conclusions:
- Acute pediatric digoxin ingestions are rare and generally not severe.
- Symptomatic presentation predicts digoxin levels > 2 ng/mL.
- Absence of early signs does not rule out later ECG abnormalities, necessitating careful monitoring.