Madiwale Taj, Liebelt Erica
Department of Pediatric Emergency Medicine, Children's Hospital of Alabama, University of Alabama School of Medicine, Birmingham, Alabama 35233, USA.
Curr Opin Pediatr. 2006 Apr;18(2):174-9. doi: 10.1097/01.mop.0000193275.62366.98.
This article reviews the pathophysiology and clinical presentation of iron poisoning. Recently proposed guidelines for triage of children with iron ingestion will be discussed as well as diagnostic and treatment modalities. Finally, the potential impact of unit-dose packaging as a primary preventative measure will be discussed.
Carbonyl iron has a greater safety margin than the iron salts. There have been no published reports of serious or fatal poisoning from the ingestion of carbonyl iron products. Evidence-based consensus guidelines have determined that the threshold for referral to a healthcare facility is 40 mg/kg of elemental iron in the form of adult iron formulations. Unit-dose packaging of iron preparations appeared to decrease the number of exposures to iron and deaths in the United States during the period they were instituted.
Iron poisoning remains primarily a clinical diagnosis, although certain laboratory and radiological testing may provide helpful evidence to guide evaluation and management. Primary prevention is the best modality for decreasing morbidity and mortality for all poisonings including iron.
本文回顾铁中毒的病理生理学和临床表现。将讨论最近提出的铁摄入儿童分诊指南以及诊断和治疗方法。最后，将讨论单位剂量包装作为主要预防措施的潜在影响。
羰基铁的安全系数高于铁盐。尚无因摄入羰基铁产品导致严重或致命中毒的报道。循证共识指南确定，以成人铁制剂形式摄入元素铁的转诊阈值为40mg/kg。在美国，铁制剂的单位剂量包装实施期间，铁暴露和死亡人数似乎有所减少。
铁中毒主要仍是临床诊断，尽管某些实验室和影像学检查可能提供有助于指导评估和管理的证据。一级预防是降低包括铁中毒在内的所有中毒发病率和死亡率的最佳方式。
