Predictors of myocardial dysfunction in children with indian red scorpion (Mesobuthus tamulus) sting envenomation

详细信息    查看全文

• 作者：P.M. Ananda Kumar ; Sriram Krishnamurthy ; Rangan Srinivasaraghavan&#8230
• 关键词：Children ; Myocardial dysfunction ; Scorpion sting envenomation ; Scorpion antivenom
• 刊名：Indian Pediatrics
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：52
• 期：4
• 页码：297-301
• 全文大小：498 KB
• 参考文献：1.Bawaskar HS, Bawaskar PH. Prazosin in management of cardiovascular manifestations of scorpion sting. Lancet. 1986;1:510鈥?.View Article PubMed
  2.Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: Randomised open label clinical trial. BMJ. 2011;342:c7136.
  3.Pandi K, Krishnamurthy S, Srinivasaraghavan R, Mahadevan S. Efficacy of scorpion antivenom plus prazosin versus prazosin alone for Mesobuthus tamulus scorpion sting envenomation in children: a randomised controlled trial. Arch Dis Child. 2014;99:575鈥?0.View Article PubMed
  4.Bawaskar HS, Bawaskar PH. Indian red scorpion envenoming. Indian J Pediatr. 1998;65:383鈥?1.View Article PubMed
  5.Kumar M, Krishnamurthy S, Delhikumar CG, Narayanan P, Biswal N, Srinivasan S. Scrub typhus in children at a tertiary hospital in southern India: clinical profile and complications. J Infect Public Health. 2012;5:82鈥?.View Article PubMed
  6.Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE. Nelson Textbook of Pediatrics. 18th edition. Philadelphia: Saunders Elsevier; 2007. p. 389鈥?1.
  7.Boyer LV, Theodorou AA, Berg RA, Mallie J, Arizona Envenomation Investigators, Ch谩vez-M茅ndez A, et al. Antivenom for critically ill children with neurotoxicity from scorpion stings. N Engl J Med. 2009;360:2090鈥?.View Article PubMed
  8.Cupo P, Hering SE. Cardiac troponin I release after severe scorpion envenoming by Tityusserrulatus. Toxicon. 2002;40:823鈥?0.View Article PubMed
  9.Ghalim N, El-Hafny B, Sebti F, Heikel J, Lazar N, Moustanir R, et al. Scorpion envenomation and serotherapy in Morocco. Am J Trop Med Hyg. 2000;62:277鈥?3.PubMed
  10.Hammoudi-Triki D, Ferquel E, Robbe-Vincent A, Bon C, Choumet V, Laraba-Djebari F. Epidemiological data, clinical admission gradation and biological quantification by ELISA of scorpion envenomations in Algeria: effect of immunotherapy. Trans R Soc Trop Med Hyg. 2004;98:240鈥?0.View Article PubMed
  11.Sevcik C, D鈥橲uze G, D铆az P, Salazar V, Hidalgo C, Azp煤rua H, et al. Modelling Tityus scorpion venom and antivenom pharmacokinetics. Evidence of active immunoglobulin G鈥檚 F(ab鈥?2 extrusion mechanism from blood to tissues. Toxicon. 2004;44:731鈥?1.
  12.Prasad R, Mishra OP, Pandey N, Singh TB. Scorpion sting envenomation in children: Factors affecting the outcome. Indian J Pediatr. 2011;78:544鈥?.View Article PubMed
  13.Bouaziz M, Bahloul M, Kallel H, Samet M, Ksibi H, Dammak H, et al. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: Multivariate analysis of 951 cases. Toxicon. 2008;52:918鈥?6.View Article PubMed
  14.Bahloul M, Chabchoub I, Chaari A, Chtara K, Kallel H, Dammak H, et al. Scorpion envenomation among children: Clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg. 2010;83:1084鈥?2.View Article PubMed Central PubMed
  15.Bouaziz M, Bahloul M, Hergafi L, Kallel H, Chaari L, Hamida CB, et al. Factors associated with pulmonary edema in severe scorpion sting patients鈥揂 multivariate analysis of 428 cases. ClinToxicol. 2006;44:293鈥?00.
  
• 作者单位：P.M. Ananda Kumar (1)
  Sriram Krishnamurthy (1)
  Rangan Srinivasaraghavan (1)
  Subramanian Mahadevan (1)
  K.T. Harichandrakumar (2)
  
  1. Departments of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
  2. Departments of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
  
• 刊物主题：Pediatrics; Pediatric Surgery; Maternal and Child Health;
• 出版者：Springer India
• ISSN：0974-7559

文摘

Objectives To identify predictive risk factors for myocardial dysfunction in children with scorpion sting envenomation and to evaluate the effects of Scorpion antivenom and prazosin combination therapy on occurrence of myocardial dysfunction. Design Observational. Setting Tertiary care hospital in Southern India. Participants 85 children aged < 13 years with scorpion sting envenomation. Outcome measures Frequency of myocardial dysfunction; predictors of myocardial dysfunction. Results 24 children (28.2%) developed myocardial dysfunction. Hypotension at admission (P=0.003) and increased time (>4h) between sting and administration of appropriate therapy (P=0.001) were independent predictors of myocardial dysfunction on logistic regression. Scorpion antivenom plus prazosin combination therapy led to an increase in cumulative proportion of children without myocardial dysfunction. Conclusion Early (<4 hours) administration of Scorpion antivenom along with prazosin increases the cumulative percentage of children not developing myocardial dysfunction.