Zucker A R, Lacina S J, DasGupta D S, Fozzard H A, Mehlman D, Butler V P, Haber E, Smith T W
Pediatrics. 1982 Sep;70(3):468-71.
Digitalis poisoning is a rare problem in children, but it may be life threatening. A case of massive overdose of digoxin in a 2 1/2-year-old boy that produced prolonged ventricular fibrillation refractory to conventional therapy is reported. After two hours the boy was given digoxin-specific Fab fragments of antibody in sufficient quantity to bind his estimated dose of 10 mg. By completion of the treatment minutes later, normal rhythm and circulation were restored. The serum free digoxin level before antibody administration was greater than 100 ng/ml, and it rapidly fell to undetectable levels after antibody was given. Digoxin bound to the antibody had a clearance half-life of approximately 48 hours. The child had no apparent neurologic damage and his intellectual function was normal on discharge. He had a transient hematuria and a residual incomplete right bundle branch block. Administration of purified Fab fragments of digoxin-specific antibodies can be life saving in children with digitalis poisoning, and prolonged cardiopulmonary resuscitation in children is justified when the cause of cardiac arrest is potentially reversible.
洋地黄中毒在儿童中是一个罕见问题，但可能危及生命。本文报告了一例2岁半男孩服用大量地高辛过量，导致持续性室颤，常规治疗无效。两小时后，给该男孩足量的地高辛特异性Fab抗体片段，以结合其估计服用的10毫克剂量。几分钟后治疗结束时，恢复了正常心律和循环。给予抗体前血清游离地高辛水平大于100纳克/毫升，给予抗体后迅速降至无法检测的水平。与抗体结合的地高辛清除半衰期约为48小时。该儿童无明显神经损伤，出院时智力功能正常。他有短暂性血尿和残余不完全性右束支传导阻滞。给予纯化的地高辛特异性抗体Fab片段对洋地黄中毒儿童可挽救生命，当心脏骤停原因可能可逆时，对儿童进行长时间心肺复苏是合理的。
