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入住重症监护病房的急性药物中毒患者的临床和流行病学特征。

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU.

作者信息

Orsini Jose, Din Nanda, Elahi Ershad, Gomez Anthony, Rajayer Salil, Malik Ryan, Jean Elie

机构信息

Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, Brooklyn, New York, USA.

Department of Emergency Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, Brooklyn, New York, USA.

出版信息

J Community Hosp Intern Med Perspect. 2017 Sep 19;7(4):202-207. doi: 10.1080/20009666.2017.1356189. eCollection 2017 Oct.

Abstract

: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). : A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March). : Sixty-five patients were admitted. Their median age was 49 years (mean 48.2, range 20-72), and the majority were male (48, 74%). Median Sequential Organ Failure Assessment (SOFA) score on admission to ICU was 6 (mean 6, range 0-13). Fifty-five patients (85%) had a positive urine and/or serum toxicology screen. Most commonly detected substances were: opiates (18, 33%), cocaine (13, 24%), methadone (12, 22%), benzodiazepines (10, 18%), and marijuana (9, 16%). In 16 patients (29%), >1 substance was isolated. Twenty-three patients (35%) had negative urine toxicology screen. Ethyl alcohol was detected in the serum of 23 patients (35%). Five patients (8%) expired in ICU. : Classic recreational drugs remain the most common substances involved in acute drug poisoning. More sensitive detection methods are warranted to identify new designer drugs of abuse such as synthetic cannabinoids.

摘要

药物过量仍然是全球急性中毒最常见的原因。在过去十年中,药物过量的发病率和患病率大幅上升,这可能是新型合成设计药物出现的结果。本研究的目的是描述入住重症监护病房(ICU)的急性药物中毒患者的临床和流行病学特征。

在6个月期间(9月至3月),对所有从急诊科(ED)收治入ICU且有急性药物中毒临床体征的成年患者进行了一项单中心、前瞻性、观察性研究。

共收治65例患者。他们的中位年龄为49岁(平均48.2岁,范围20 - 72岁),大多数为男性(48例,74%)。入住ICU时的中位序贯器官衰竭评估(SOFA)评分为6分(平均6分,范围0 - 13分)。55例患者(85%)的尿液和/或血清毒理学筛查呈阳性。最常检测到的物质有:阿片类药物(18例,33%)、可卡因(13例,24%)、美沙酮(12例,22%)、苯二氮䓬类药物(10例,18%)和大麻(9例,16%)。16例患者(29%)检测出>1种物质。23例患者(35%)的尿液毒理学筛查呈阴性。23例患者(35%)的血清中检测到乙醇。5例患者(8%)在ICU死亡。

经典的消遣性药物仍然是急性药物中毒最常见的相关物质。需要更灵敏的检测方法来识别新型滥用设计药物,如合成大麻素。

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