Dean B S, Krenzelok E P
Pittsburgh Poison Center, Children's Hospital of Pittsburgh, PA.
Vet Hum Toxicol. 1988 Feb;30(1):23-5.
To insure adequate nutrition, parents and pediatricians often advocate vitamin and mineral supplementation in young children. A retrospective review of 275 pediatric cases (6 mo-6 yr) involving multiple vitamins and vitamins with iron was conducted. Six cases with co-ingestants were excluded. The product ingested was the child's own dietary supplement in 93% of the cases. Fifty-six percent were children's multiple vitamins and 44% were children's multiple vitamins with iron. Adult vitamin preparations accounted for 7% of the ingestions. The average amount of vitamin A ingested by history was 43,300 IU (1,500-225,000) while the mean ingestion of iron was 16.8 mg/kg (0.9-77.5 mg/kg). Fifty ingestions (18.2%) involved more than one child. The mean time since ingestion was 15.8 min (0-150 min). Management data showed 246 (89.5%) being treated in the home setting with dilution (83%) or syrup of ipecac induced-emesis (10%). Medical intervention including emesis, serum iron/TIBC, and oral complexation was needed in 10.5% of the cases. The mean serum iron levels were 204.6 mcg/dl (81-414 mcg/dl). No patient needed admission. This review revealed 100% of patients showed no significant toxic effects. We conclude that early recognition and prompt treatment of pediatric overdoses involving multiple vitamins with and without iron significantly reduces morbidity.
为确保充足的营养，家长和儿科医生常主张给幼儿补充维生素和矿物质。对275例6个月至6岁儿童服用多种维生素及含铁维生素的病例进行了回顾性研究。排除了6例同时摄入其他物质的病例。93%的病例中摄入的产品为儿童自己的膳食补充剂。56%为儿童多种维生素，44%为儿童含铁多种维生素。成人维生素制剂占摄入量的7%。据病史记录，维生素A的平均摄入量为43,300国际单位（1,500 - 225,000），铁的平均摄入量为16.8毫克/千克（0.9 - 77.5毫克/千克）。50次摄入（18.2%）涉及不止一名儿童。摄入后平均时间为15.8分钟（0 - 150分钟）。处理数据显示，246例（89.5%）在家中接受处理，采用稀释（83%）或用吐根糖浆催吐（10%）。10.5%的病例需要包括催吐、血清铁/总铁结合力及口服络合剂在内的医学干预。血清铁平均水平为204.6微克/分升（81 - 414微克/分升）。无患者需要住院。该回顾显示100%的患者未出现明显毒性作用。我们得出结论，早期识别并及时治疗涉及含或不含铁的多种维生素的儿童过量摄入情况可显著降低发病率。
