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Tramadol overdose and apnea in hospitalized children, a review of 20 cases

We aimed to determine the clinical manifestations of tramadol intoxication in children and to find its potential poor prognostic factors. In a retrospective study, from 1363 cases of admitted pediatric poisoning, all tramadol-exposed hospitalized patients younger than 12 years were included in the s...

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Autores principales: Hassanian-Moghaddam, Hossein, Farnaghi, Fariba, Rahimi, Mitra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698865/
https://www.ncbi.nlm.nih.gov/pubmed/26779274
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author Hassanian-Moghaddam, Hossein
Farnaghi, Fariba
Rahimi, Mitra
author_facet Hassanian-Moghaddam, Hossein
Farnaghi, Fariba
Rahimi, Mitra
author_sort Hassanian-Moghaddam, Hossein
collection PubMed
description We aimed to determine the clinical manifestations of tramadol intoxication in children and to find its potential poor prognostic factors. In a retrospective study, from 1363 cases of admitted pediatric poisoning, all tramadol-exposed hospitalized patients younger than 12 years were included in the study. They were hospitalized between March 2010 and April 2012 to the only referral hospital for pediatric poisoned patients in Tehran, Iran. Data including age, weight, gender, ingested dose (determined by history), pupil size, seizure, apnea, treatment interventions, and laboratory results was collected using chart review of the hospitalized intoxicated children. Twenty children with a mean age of 3.7 ± 2.9 years were identified amongst children during this 26-month period of whom, 14 (70%) had a decreased level of consciousness, 3 (15%) experienced apnea, and four (20%) had nausea and vomiting. Witnessed seizure did not occur in any of these patients. All patients were referred to hospital within 10.5 h of the exposure. The mean ingested dose was 9.6 ± 5.5 mg/kg. There was no significant relation between apnea and the estimated toxic dose. Apnea was more common in children who had presented with respiratory acidosis (Relative risk = 3.8, 95% CI = 1.6, 8.7, P = 0.043). All patients survived. Patients with apnea were managed conservatively by naloxone and recovered without need for intubation. Respiratory depression might occur at doses just above the therapeutic dose. We recommend an observation time of 12 h for all asymptomatic children who have ingested any dose greater than the therapeutic one.
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spelling pubmed-46988652016-01-15 Tramadol overdose and apnea in hospitalized children, a review of 20 cases Hassanian-Moghaddam, Hossein Farnaghi, Fariba Rahimi, Mitra Res Pharm Sci Original Article We aimed to determine the clinical manifestations of tramadol intoxication in children and to find its potential poor prognostic factors. In a retrospective study, from 1363 cases of admitted pediatric poisoning, all tramadol-exposed hospitalized patients younger than 12 years were included in the study. They were hospitalized between March 2010 and April 2012 to the only referral hospital for pediatric poisoned patients in Tehran, Iran. Data including age, weight, gender, ingested dose (determined by history), pupil size, seizure, apnea, treatment interventions, and laboratory results was collected using chart review of the hospitalized intoxicated children. Twenty children with a mean age of 3.7 ± 2.9 years were identified amongst children during this 26-month period of whom, 14 (70%) had a decreased level of consciousness, 3 (15%) experienced apnea, and four (20%) had nausea and vomiting. Witnessed seizure did not occur in any of these patients. All patients were referred to hospital within 10.5 h of the exposure. The mean ingested dose was 9.6 ± 5.5 mg/kg. There was no significant relation between apnea and the estimated toxic dose. Apnea was more common in children who had presented with respiratory acidosis (Relative risk = 3.8, 95% CI = 1.6, 8.7, P = 0.043). All patients survived. Patients with apnea were managed conservatively by naloxone and recovered without need for intubation. Respiratory depression might occur at doses just above the therapeutic dose. We recommend an observation time of 12 h for all asymptomatic children who have ingested any dose greater than the therapeutic one. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4698865/ /pubmed/26779274 Text en Copyright: © Research in Pharmaceutical Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Hassanian-Moghaddam, Hossein
Farnaghi, Fariba
Rahimi, Mitra
Tramadol overdose and apnea in hospitalized children, a review of 20 cases
title Tramadol overdose and apnea in hospitalized children, a review of 20 cases
title_full Tramadol overdose and apnea in hospitalized children, a review of 20 cases
title_fullStr Tramadol overdose and apnea in hospitalized children, a review of 20 cases
title_full_unstemmed Tramadol overdose and apnea in hospitalized children, a review of 20 cases
title_short Tramadol overdose and apnea in hospitalized children, a review of 20 cases
title_sort tramadol overdose and apnea in hospitalized children, a review of 20 cases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698865/
https://www.ncbi.nlm.nih.gov/pubmed/26779274
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