Talay Mehmet N, Güngör Emre, Orhan Özhan
Department of Pediatrics, Mardin Artuklu University, Mardin, Turkey.
Department of Pediatric Emergency, Mardin Training and Research Hospital, Mardin, Turkey.
Arch Argent Pediatr. 2025 Feb 1;123(1):e202410390. doi: 10.5546/aap.2024-10390.eng. Epub 2024 Sep 5.
Introduction: Cyanide poisoning, whether it be accidental or intentional, remains a significant danger to adults and children, especially in societies where agriculture is a primary source of income. We examined the clinical follow-up, complications, and results of cyanide poisoning cases that occurred after eating the pits and seeds of plants containing cyanide glycosides, such as apricot kernels and almonds. Methods: Between 01/01/2017 and 01/08/2022, 14 children aged 1-18 years who were followed up with a prediagnosis of cyanide poisoning in our Paediatric Intensive Care Unit (PICU) were retrospectively analysed. Results: Eight of the patients followed with a preliminary diagnosis of cyanide poisoning were female and six were male. The most common admission month was July (42.8%) coinciding with the agricultural season. The most common symptoms at presentation were weakness and fatigue (n = 7). In the PICU, 4 patients presented lip cyanosis; 3, altered level of consciousness. Vomiting, seizure, headache, dizziness and palpitatons were less frequent. Four patients were treated with hydroxocobalamin (Cyanokit®) as an antidote due to acidosis in their blood gases. All patients treated for cyanide poisoning were discharged. Conclusions: Cyanide poisoning should be considered in paediatric patients with suspicious findings, sudden loss of consciousness, increased anion gap acidosis and lactic acidosis. The history of eating the seeds of plants such as apricot and almonds should be investigated.
氰化物中毒,无论是意外还是故意,对成人和儿童仍然构成重大危险,尤其是在农业是主要收入来源的社会。我们研究了食用含有氰苷的植物种子(如杏仁)后发生的氰化物中毒病例的临床随访、并发症及结果。方法:回顾性分析2017年1月1日至2022年8月1日期间在我们儿科重症监护病房(PICU)接受随访且预诊断为氰化物中毒的14名1至18岁儿童。结果:初步诊断为氰化物中毒并接受随访的患者中,8名女性,6名男性。最常见的入院月份是7月(42.8%),与农业季节相符。就诊时最常见的症状是虚弱和疲劳(n = 7)。在PICU,4例患者出现嘴唇发绀;3例意识水平改变。呕吐、癫痫发作、头痛、头晕和心悸较少见。4例患者因血气分析显示酸中毒而接受羟钴胺(Cyanokit®)作为解毒剂治疗。所有接受氰化物中毒治疗的患者均已出院。结论:对于有可疑表现、突然意识丧失、阴离子间隙酸中毒和乳酸性酸中毒增加的儿科患者,应考虑氰化物中毒。应调查食用杏仁等植物种子的病史。