Ramirez-Romero Johanna, Cifuentes Zamalloa Claudia, Elorza Elena Amaia, Azkunaga Beatriz, Mintegi Santiago
Cruces University Hospital Paediatric Emergencies, Barakaldo, Spain.
Pediatric Emergency Department, Cruces University Hospital Paediatric Emergencies, Barakaldo, Spain
Arch Dis Child. 2025 Jun 19;110(7):510-513. doi: 10.1136/archdischild-2024-327478.
Although the administration of activated charcoal (AC) is considered safe, the associated risk of pulmonary aspiration explains certain reluctance of physicians to use this procedure. The objective of this study was to analyse the rate of pulmonary aspiration in children receiving AC after accidental ingestion of a toxic substance.
We carried out a substudy of a multicentre prospective registry-based cohort study including children presenting with acute poisoning to 58 paediatric emergency department (EDs) members of the Spanish Society of Pediatric Emergency Medicine between 2008 and 2022 on certain previously designated days.
During the study period, we registered 1983 episodes corresponding to accidental ingestion of a toxic substance in patients less than 7 years old. Of them, 517 (26.1%) received AC, 167 (32.3%) via a nasogastric tube. In most cases, the substance swallowed was a medication (paracetamol, psychotropics, and cough and cold medications accounting for 91.6% of episodes) and 419 children (81%) were asymptomatic on arrival to the ED. Gastric lavage was performed in 81 cases (15.7%). After receiving AC, 448 children (86.6%) were managed as outpatients (329 after a less than 24-hour stay in the ED observation unit).All patients did well, and no cases of pulmonary aspiration were reported, regardless of the route of AC administration.
The administration of AC to children after accidental ingestion of a toxic substance seems to be safe, regardless of the route of administration. Efforts are required to improve the ED management of these children.
尽管活性炭（AC）的应用被认为是安全的，但与之相关的肺误吸风险导致一些医生不太愿意采用这一治疗方法。本研究的目的是分析意外摄入有毒物质后接受AC治疗的儿童的肺误吸发生率。
我们对一项多中心前瞻性登记队列研究进行了子研究，该研究纳入了2008年至2022年期间在某些指定日期因急性中毒就诊于西班牙儿科急诊医学协会58个儿科急诊科（ED）的儿童。
在研究期间，我们记录了1983例7岁以下儿童意外摄入有毒物质的病例。其中，517例（26.1%）接受了AC治疗，167例（32.3%）通过鼻胃管给药。在大多数情况下，摄入的物质为药物（对乙酰氨基酚、精神药物以及止咳和感冒药占病例的91.6%），419名儿童（81%）到急诊科就诊时无症状。81例（15.7%）进行了洗胃。接受AC治疗后，448名儿童（86.6%）作为门诊患者处理（329例在急诊科观察病房停留不到24小时后出院）。所有患者情况良好，无论AC的给药途径如何，均未报告肺误吸病例。
意外摄入有毒物质后对儿童使用AC似乎是安全的，无论给药途径如何。需要努力改善对这些儿童的急诊科管理。
