INTOXICATION IN CHILDREN TREATED AT THE PEDIATRIC INTENSIVE CARE UNIT AT THE UNIVERSITY HOSPITAL OF SPLIT IN THE PERIOD FROM 2008 TO 2017

Cilj: Glavni cilj ovog istraživanja bio je utvrditi broj intoksicirane djece liječene u Zavodu za intenzivnu pedijatriju s postintenzivnom skrbi Kliničkog bolničkog centra Split u razdoblju od siječnja 2008. do prosinca 2017. godine. Uz to, cilj je bio i utvrditi karakteristike kliničkog statusa djece pri prijemu u JILD te terapijske postupke koji su primjenjeni. Materijal i metode: U ovo retrospektivno istraživanje uključeno je 85 ispitanika u dobi od 0 do 18 godina. Za sve ispitanike prikupljeni su opći podatci, podatci o kliničkom statusu prilikom prijema te o primijenjenim terapijskim postupcima. Rezultati: U analiziranom razdoblju bilo je 85 intoksikacija, što predstavlja 2,77% svih prijema u JILD. Od toga su 44 (52%) ispitanice, a 41 (48%) ispitanik. Medijan duljine boravka iznosio je 1 dan (raspon 0-16 dana), a 87,06% ispitanika boravilo je kraće od 48 sati. Medijan dobi ispitanika iznosi 5808 dana (raspon 19-6565 dana), pri čemu je 64,71% starije od 15 godina. Najčešće korišteno sredstvo je alkohol (45,88%), zatim lijekovi (36,47%), među kojima se posebno ističu antipsihotici i antidepresivi. Slijedi ugljični monoksid (5,88%), pesticidi (4,71%), ilegalne droge (4,71%) te korozivna sredstva (2,35%). Slučajno nastalih intoksikacija je 22,35%, dok je 28,24% bilo sa suicidalnom namjerom i to značajno češće kod djevojčica u odnosu na dječake. U stanju somnolencije bilo je 27,06%, sopora 35,29%, a kome 15,29% djece. Tahikardno je bilo 23,53%, a hipotenzivno 15,29% djece. Tjelesnu temperaturu nižu od 36 ℃ imalo je 40% djece, a višu od 37℃ 8,24%. Prije hospitalizacije povraćalo je 27,06% djece, dok je lavaža želudca učinjena kod 17,65% djece. Aktivni ugljen primilo je 20%, a različite antidote 8,24% djece. Terapija kisikom bila je potrebna za 14,12% djece, mehanička ventilacija za 9,41%, a izmjena krvi za jedno dijete. Zabilježen je jedan smrtni ishod. Zaključak: U našem istraživanju najviše djece bilo je u dobi od 15 do 18 godina. Većina intoksikacija nastala je namjerno i najčešće korištena sredstva su alkohol i lijekovi. Iako su utvrđeni različiti poremećaji u kliničkom statusu djece, većina ih nije trebala nikakve posebne terapijske postupke već samo intenzivan nadzor i simptomatsku terapiju.Objectives: The main objective of this study was to determine the number of intoxicated children treated at the Pediatric Intensive and Post-intensive Care Unit at the University Hospital of Split in the period from January 2008 to December 2017. The objective was also to determine the characteristics of the children's clinical status upon admission to the Pediatric Intensive Care Unit and the therapeutic procedures applied to the cases of intoxication. Material and methods: This retrospective study included 85 subjects aged 0 to 18 years. General information, information on the clinical status upon admission, as well as information on the applied therapeutic procedures was collected from all subjects. Results: In the period analyzed there were 85 intoxication cases, representing 2.77% of all admissions to the Pediatric Intensive Care Unit. Out of those 85 cases, 44 (52%) were female and 41 (48%) were male subjects. The median length of hospital stay was 1 day (0-16 day range) while 87.06% of all subjects stayed in the hospital for less than 48 hours. The median age of subjects was 5808 days (19-6565 day range), with 64.71% of all subjects being over the age of 15. The most commonly used intoxicant was alcohol (45.88%), followed by prescription drugs (36.47%), particularly antipsychotics and antidepressants, and then by carbon monoxide (5.88%), pesticides (4.71%), illegal drugs (4.71%) and corrosive agents (2.35%). 22.35% of intoxication cases occurred by accident, while 28.24% were linked to suicide attempts, which were significantly more frequent in girls than in boys. 27.06% of children were in a state of somnolence, 35.29% in a state of sopor, and 1.29% in a state of coma. 23.53% of children were tachycardic, and 15.29% were hypotensive. The body temperature of 40% of children was below 36℃, while it was higher than 37℃ in 8.24% of children. Before the hospitalization, 27.06% of children were vomiting, while gastric lavage was performed in 17.65% of children. Activated charcoal was administered in 20% of children, and various antidotes in 8.24% of children. Oxygen therapy was necessary for 14.12% of children, mechanical ventilation for 9.41%, and blood exchange transfusion for only one child. One death was recorded. Conclusion: Most children in our research were between the ages of 15 and 18. Most of the intoxication cases have occurred intentionally, while the most commonly used intoxicants were alcohol and prescription drugs. Even though various disorders were identified in the children’s clinical status, most of them did not need any special therapeutic procedures, but only intensive monitoring and symptomatic therapy