İlknur TOLUNAY, Orkun TOLUNAY, Yasin BAYRAM, Tamer ÇELİK, Ayla KILIÇ, Ümit ÇELİK

Çocuklarda akrep zehirlenmeleri ve yönetimi

Amaç: Akrep zehirlenmesi tanısı ile Çocuk Yoğun Bakım Ünitemize yatan hastaları geriye dönük olarak inceleyerek hastaların klinik ve laboratuvar bulgularını, tedavi yöntemlerini ve sonuçlarını değerlendirmek. Gereç ve yöntem: Ocak 2012-Ekim 2013 tarihleri arasında Çocuk Yoğun Bakım ve Yoğun Bakım Servislerinde akrep zehirlenmesi tanısı ile tedavi edilmiş olan 30 hasta çalışmaya dahil edildi. Bu hastaların klinik ve laboratuvar bulguları, tedavi yöntemleri incelendi. Bulgular: Hastaların yaşları ortalama 6,6±4 yıl olup, 12' si (%40) kız, 18' i (%60) erkek idi. Tüm hastalara antivenom tedavisi uygulandı. 9 hastaya prazosin, 8 hastaya dopamin, 3 hastaya dopamin ve dobutamin tedavisi uygulandı. Vakaların 5'ünde kalp yetmezliği ve 2'sinde akciğer ödemi gelişti. Laboratuvar sonuçları; hemoglobin 11,8±1 g/dl (9,6-13,1), lökosit 10,5±3,1 bin/mm3 (6,3-12,6), trombosit 284±42 bin/mm3 , kan şekeri 135±50 mg/dL , kreatin kinaz miyokard izoenzimi (CK-MB) 40±22 U/L (

Scorpion envenomation in children and management

Objectives: Retrospective examination of patients hospitalized to pediatric intensive care unit with scorpion envenomation and evaluation of clinical and laboratory findings of them, their treatment methods and results. Material and methods: Thirty patients treated with scorpion envenomation between January 2012 and October 2013 at pediatric intensive care and intensive care units were included in the study. Clinical and laboratory findings and treatments methods of these patients were examined. Results: Average age of patients was 6,6±4 years. Antivenom treatment was applied to all patients. Prazosin was applied to 9 patients, dopamine was applied to 8 patients and dopamine plus dobutamine treatment was applied to 3 patients. In 5 cases cardiac insufficiency and in 2 cases pulmonary oedema occurred. Laboratory results were as follows: haemoglobin 11,8±1 g/dl (9,6-13,1), leukocyte 10,5±3,1x109L (6,3- 12,6), thrombocyte 284±42x109L , glucose 135±50 mg/dL , creatine kinase-myocardial band 40±22 U/L (<25), troponine 1,76±2,3 ng/mL (<0,04), B-type natriuretic peptide 83±102 pg/ml . Echocardiography was made to 7 patients. Two (%6,6) were normal and 5 (left ventricles dysfunction, ejection fraction %40) were abnormal. Ejection fraction of 5 patients, whose echocardiography was abnormal and who were followed, turned to normal. Cardiac insufficiency and pulmonary oedema occurred in 2 patients with abnormal echocardiography. Conclusion: Scorpion envenomation is still a major problem in our country. With convenient and early treatment, prevention of mortality and morbidity is possible. Considering our patients and the treatment results, it is seen that with convenient treatment at scorpion envenomation, mortality rate in our region remains low

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