Universidade Estadual de Campinas, Campinas, SP, Brazil.
Rev Paul Pediatr. 2021;39:e2019262. doi: 10.1590/1984-0462/2021/39/2019262. Epub 2020 Jul 3.
To describe a case series of severe acute toxic exposures (SATE) in individuals <20 years old followed-up by a regional Poison Control Center (PCC).
Descriptive cross-sectional study. All patients who were <20yo and classified as score 3 (severe) and 4 (fatal) following Poisoning Severity Score were included for analysis. According to the outcome, patients were classified as PSS 3 when they developed intense clinical manifestations with risk of death or important sequelae; and as PSS 4 when death had resulted from direct cause or complication of the initial exposure. The data of patients were obtained from the Brazilian electronic database system (DATATOX).
During the biennium 2014-2015, Campinas PCC followed up 5,095 patients <20yo, with 30 being classified as SATE (PSS=3, n=24; PSS=4, n=6). The exposures circumstances were unintentional (15); intentional (14; suicide attempt = 11; street drugs consumption = 3); and not explained (1). The exposures were significantly more frequent in adolescents >14yo (n=17; p<0.01). The involved agents were venomous animals (8; scorpions=5); medicines (8; miscellaneous=6); chemicals (6); illegal rodenticides containing acetylcholinesterase inhibitors (chumbinho, 4); drugs of abuse (3); button battery (1). Three patients evolved with sequels (esophageal stricture post-corrosive ingestion). The median length of hospital stay was 6 days (IQR: 5-12 days); 26 patients were treated in intensive care units, and 22 of them needed mechanical ventilation; 12, inotropic/vasopressors; and 3, renal replacement therapy.
Scorpion stings and poisonings caused by medicines and chemicals were the main causes of SATE. The SATE were significantly more frequent in adolescents, due to deliberate self-poisoning.
描述由区域中毒控制中心（PCC）随访的 20 岁以下严重急性中毒暴露（SATE）病例系列。
描述性的横断面研究。所有被分类为中毒严重程度评分（PSS）3 分（严重）和 4 分（致命）的 20 岁以下患者均纳入分析。根据结果，出现强烈临床表现、有死亡风险或重要后遗症的患者被归类为 PSS 3；因初始暴露的直接原因或并发症而导致死亡的患者归类为 PSS 4。患者数据从巴西电子数据库系统（DATATOX）中获得。
在 2014-2015 年的两年期间，坎皮纳斯 PCC 共随访了 5095 名 20 岁以下的患者，其中 30 例被归类为 SATE（PSS=3，n=24；PSS=4，n=6）。暴露情况为非故意（15 例）；故意（14 例；自杀企图=11 例；街头毒品吸食=3 例）；以及无法解释的情况（1 例）。暴露在 14 岁以上青少年中的情况更为常见（n=17；p<0.01）。涉及的药物有有毒动物（8 例；蝎子=5 例）；药物（8 例；杂项=6 例）；化学品（6 例）；含有乙酰胆碱酯酶抑制剂的非法杀鼠剂（chumbinho，4 例）；药物滥用（3 例）；纽扣电池（1 例）。3 例患者出现后遗症（腐蚀性摄入后食管狭窄）。住院中位数为 6 天（IQR：5-12 天）；26 例患者在重症监护病房治疗，其中 22 例需要机械通气；12 例需要使用正性肌力药/血管加压药；3 例需要肾脏替代治疗。
蝎子蜇伤和由药物及化学品引起的中毒是 SATE 的主要原因。由于蓄意自杀，SATE 在青少年中更为常见。
