| Title | Chloral hydrate intoxication in a three month old child: avoidance of hemodialysis by an immediate determination of trichloroethanol. | | Author(s) | Dogan-Duyar S, Willemse JL, Van Hee P, Duval EL, Neels H | | Institution | Paediatric Intensive Care Unit ZNA Queen Paola Children's Hospital Antwerp, Belgium. | | Source | Clin Biochem 2009 Sep 9. | | Abstract | Background: Chloral hydrate is used worldwide as a first-line agent for procedural sedation in paediatric patients undergoing painless diagnostic investigations. Chloral hydrate overdoses in children and adults have been reported to cause various toxicities, including central nervous system, respiratory and cardiac depression with sometimes fatal outcome. Patient and methods: A 3-month old girl was admitted after an unintentional administration of a 10-fold dose of chloralhydrate (667 mg/kg). She showed respiratory insufficiency in need of intubation and ventilation. Gastric endoscopy revealed esophagitis and gastric ulcerations. To assess the need for haemodialysis, serum trichloroethanol (TCE) was determined using a mass spectrometric quantification after a methyl tertiary butyl ether extraction using an external standard method. The serum TCE level 6 hours after administration was 89 mg/L and declined to 20 mg/L within 24 hours. The child could be extubated the next day, her further course was uneventful.
Conclusion: The repeated determination of serum TCE levels prevented a technically difficult and risky haemodialysis in this very young patient. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19747907 |
|
