- Title
- Reality of clonidine poisoning in children and adolescents
- Creator
- Duong, Chi; Lovett, Caitlyn; Downes, Michael A.; Isbister, Geoffrey K.
- Relation
- NHMRC.GNT1154503 http://purl.org/au-research/grants/nhmrc/GNT1154503
- Relation
- Journal of Paediatrics and Child Health Vol. 59, Issue 6, p. 827-832
- Publisher Link
- http://dx.doi.org/10.1111/jpc.16399
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2023
- Description
- Aim: We aimed to describe the severity of clonidine poisonings in a paediatric population referred to a tertiary toxicology service. Methods: We undertook a retrospective review of all presentations of clonidine poisoning in children or adolescents reported to a tertiary toxicology service from March 2014 to February 2020. Cases were divided into young children (0–6 years), older children (7–11 years) and adolescents (12–17 years). We report clinical effects: bradycardia, hypotension and abnormal Glasgow coma score (GCS), based on standard paediatric observation charts, interventions, length of emergency department stay, proportion admitted to a medical ward or paediatric intensive care unit. Results: We identified 111 clonidine poisonings, 41 young children, 9 older children and 61 adolescents. There were more females in the adolescent group and slightly more males in the younger age groups. The median dose ingested was 13 mcg/kg (interquartile range: 7–38 mcg/kg), which varied across ages. Clonidine alone was ingested in 78 cases (70%) and co-ingestion was more common in adolescents (24/61; 39%). Thirty-seven patients (33%) were admitted and 23 (21%) were admitted to paediatric intensive care unit. Median length of emergency department stay was 16.4 h, longer for adolescents. At least one abnormal observation occurred in 101 of 111 (91%) cases: 76 of 106 (72%) bradycardia, 76 of 110 (69%) hypotension and 4 of 99 (4%) GCS < 9. Thirteen (12%) had severe bradycardia, more common in young children and 23 (21%) had severe hypotension, more common in adolescents. For 27 children (0–11 years) ingesting 5–10 mcg/kg, 3 (11%) had severe bradycardia or severe hypotension and 1 received naloxone (4%). No cases ingesting <5 mcg/kg developed moderate/severe bradycardia or hypotension. Four cases received naloxone with no significant change, two patients got atropine with a transient response. One patient was intubated to facilitate safe inter-hospital transfer. Conclusion: Paediatric clonidine poisoning commonly results in bradycardia, hypotension and decreased GCS, but rarely severe or requiring major interventions. Children ingesting <5 mcg/kg do not require admission.
- Subject
- adolescent; emergency medicine; pharmacology
- Identifier
- http://hdl.handle.net/1959.13/1482174
- Identifier
- uon:50874
- Identifier
- ISSN:1034-4810
- Rights
- © 2023 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. (http://creativecommons.org/licenses/by/4.0/).
- Language
- eng
- Full Text
- Reviewed
- Hits: 1475
- Visitors: 1529
- Downloads: 68
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 802 KB | Adobe Acrobat PDF | View Details Download |