Clinical features in toxic coma in children

Stanca,Simona; Ulmeanu,Coriolan   Emil; Stanca,Horia   Tudor; Iovanescu,Gheorghe

doi:10.3892/etm.2019.7857

December-2019 Volume 18 Issue 6

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

December-2019 Volume 18 Issue 6

Full Size Image

Article Open Access

Clinical features in toxic coma in children

Authors:
- Simona Stanca
- Coriolan Emil Ulmeanu
- Horia Tudor Stanca
- Gheorghe Iovanescu
View Affiliations / Copyright

Affiliations: Department of Pediatrics, ‘Carol Davila’ University of Medicine and Pharmacy, ‘Grigore Alexandrescu’ Clinical Emergency Hospital for Children, 050474 Bucharest, Romania, Department of Pediatrics, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Ophthalmology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of ENT, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania

Copyright: © Stanca et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 5082-5087
|
Published online on: August 6, 2019

https://doi.org/10.3892/etm.2019.7857
Expand metrics +

Abstract

The purpose was to identify rapidly the etiology of toxic coma in children, to appreciate the severity of the coma, to detect elements of gravity based on associated clinical signs and symptoms and to evaluate the initial treatment. Toxic coma is a medical emergency, especially in a Pediatric Emergency Department, requiring rapid and precise evaluation. The key objectives in the evaluation and management of coma in children are: detecting severity characteristics, depth of coma, specific clinical signs and symptoms, etiological and differential diagnostic and also initializing supportive therapy and specific treatment. This is a retrospective study, where we analyzed all patients diagnosed with coma admitted to the ‘Grigore Alexandrescu’ Clinical Emergency Hospital for Children over a nine‑year period from 2003 to 2011. We focused on toxic coma. A prospective component related to tracking certain signs and symptoms associated with toxic coma to diagnose and initiate appropriate therapy as early as possible was also included. In this nine‑year study, 750 comatose patients were included. We found that toxicants represent the main cause of coma in children. There were 445 patients diagnosed with toxic coma, representing 59.3% and 305 cases of non‑toxic coma, 40.7% of all coma cases presented in ER. The etiology of toxic coma in children is dominated by alcohol and abuse substances, followed by neurologic medication. Clinical manifestations were more frequent and more severe as the coma degree increases. Associating clinical manifestations in patients with altered neurologic status of toxic cause and toxicants has an important role in practice, because it helps us recognize the frequency of association of coma complications such as: aspiration syndrome, arrhythmias and seizures.

View Figures

View References

1	Nichols DG and Cantwell GP: Roger's Textbook of Pediatric Intensive Care. (31st). 441–464. 2008.
2	Daly FF, Little M and Murray L: A risk assessment based approach to the management of acute poisoning. Emerg Med J. 23:396–399. 2006. View Article : Google Scholar : PubMed/NCBI
3	Abend NS, Kessler SK, Helfaer MA and Licht DJ: Evaluation of the comatose childRogers' Textbook of Pediatric Intensive Care. 4th. Abend NS: Lippincot Williams & Wilkins; Philadelphia: pp. 846–847. 2008
4	Stanca S, Petran M, Ulmeanu C and Nitescu V: Toxic coma in children - etiology and clinical diagnosis. Therapeutics. Pharmacol Clin Toxicol. 15:51–55. 2011.
5	World Health Organisation, . International Statistical classification of Diseases and Related Health Problems10th revision, ICD-10. WHO; Geneva: 1992
6	Stack C and Dobbs P: Trauma. Essentials of Paediatric Intensive Care Cambridge University Press; pp. 156–157. 2008
7	Behrman RE, Kliegman R and Jenson HB: Nelson Textbook of Pediatrics16th. WB Saunders Co.; Philadelphia: 2000
8	Caruntu C, Boda D, Dumitrascu G, Constantin C and Neagu M: Proteomics focusing on immune markers in psoriatic arthritis. Biomarkers Med. 9:513–528. 2015. View Article : Google Scholar
9	Solomon I, Voiculescu VM, Caruntu C, Lupu M, Popa A, Ilie MA, Albulescu R, Caruntu A, Tanase C, Constantin C, et al: Neuroendocrine factors and head and neck squamous cell carcinoma: An affair to remember. Dis Markers. 2018:97878312018. View Article : Google Scholar : PubMed/NCBI
10	Ion A, Popa IM, Papagheorghe LML, Lisievici C, Lupu M, Voiculescu V, Caruntu C and Boda D: Proteomic approaches to biomarker discovery in cutaneous T-cell lymphoma. Dis Markers. 2016:96024722016. View Article : Google Scholar : PubMed/NCBI
11	Lupu M, Caruntu A, Caruntu C, Papagheorghe LM, Ilie MA, Voiculescu V, Boda D, Constantin C, Tanase C, Sifaki M, et al: Neuroendocrine factors: The missing link in non-melanoma skin cancer (Review). Oncol Rep. 38:1327–1340. 2017. View Article : Google Scholar : PubMed/NCBI
12	Batani A, Brănișteanu DE, Ilie MA, Boda D, Ianosi S, Ianosi G and Caruntu C: Assessment of dermal papillary and microvascular parameters in psoriasis vulgaris using in vivo reflectance confocal microscopy. Exp Ther Med. 15:1241–1246. 2018.PubMed/NCBI
13	Balica NC, Poenaru M, Doroş CI, Baderca F, Preda MA, Iovan VC, Stanca HT, Busuioc CJ, Oprişcan IC and Boruga O: The management of the oropharyngeal anterior wall cancer. Rom J Morphol Embryol. 59:113–119. 2018.PubMed/NCBI
14	Frasinariu O and Streanga V: Toxic coma in a medical intensive care unitProceedings of the 7th Congress of the European Academy of Paediatric Societies. EAP, ESPNIC and ESPR; Paris: 2018, https://eaps.kenes.com/2018

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Clinical features in toxic coma in children

This article is mentioned in:

Abstract

Related Articles