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Pulmonary aspiration after activated charcoal in unintentional acute poisonings in childhood

Johanna Ramirez-Romero1, Claudia Cifuentes Zamalloa1, Amaia Elorza Elena1

  • 1Cruces University Hospital Paediatric Emergencies, Barakaldo, Spain.

Archives of Disease in Childhood
|January 11, 2025
PubMed

Insights

Activated charcoal (AC) administration is safe for children with accidental toxic ingestions. This study found no pulmonary aspiration cases, even with nasogastric tube use, supporting its safety in pediatric emergency care.

Area of Science:

  • Pediatric Emergency Medicine
  • Toxicology
  • Clinical Research

Background:

  • Physician reluctance to administer activated charcoal (AC) in children stems from the risk of pulmonary aspiration.
  • This study addresses the safety concerns surrounding AC administration in pediatric poisoning cases.

Purpose of the Study:

  • To analyze the rate of pulmonary aspiration in children receiving AC after accidental toxic ingestion.
  • To evaluate the safety of AC administration via different routes in pediatric patients.

Main Methods:

  • A multicenter prospective registry-based cohort study was conducted.
  • Data were collected from 58 pediatric emergency departments between 2008 and 2022.
  • Included children under 7 years old with acute poisoning.

Main Results:

  • 1983 poisoning episodes were registered; 517 children received AC (26.1%), with 167 (32.3%) via nasogastric tube.
  • Most ingestions involved medications; 81% of children were asymptomatic upon arrival.
  • No cases of pulmonary aspiration were reported, regardless of AC administration route.

Conclusions:

  • Activated charcoal administration appears safe for children with accidental toxic ingestions, irrespective of the administration route.
  • Further efforts are needed to optimize emergency department management for these pediatric cases.
Abstract

Keywords:
Paediatric Emergency MedicineToxicology

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