A French study of cocaine intoxication/exposure in children (2010-2020).

Autor: Claudet I; Service d'accueil des Urgences Pédiatriques, Hôpital des Enfants, CHU Toulouse, France.; UMR 1295, Inserm, Paul Sabatier University, UPS, Toulouse, France., Caula C; Urgences pédiatriques, Hôpital Robert-Debré, AP-HP, Paris, France., Gallart JC; Centre Antipoison et Toxicovigilance (CAPTV), CHU Toulouse, France., Tourniaire G; Urgences pédiatriques, CHU Montpellier, France., Lerouge-Bailhache M; Urgences pédiatriques, CHU Bordeaux, France., Michard-Lenoir AP; Urgences Pédiatriques, CHU Grenoble Alpes, France., Tran A; Urgences pédiatriques, CHU Nice, France., Maleterre A; Urgences pédiatriques, CHI Créteil, France., Huet F; Urgences pédiatriques, CHU Dijon Bourgogne, France., Dufour D; Urgences pédiatriques, CH Le Havre, France., Billaud N; Urgences pédiatriques, CHR Metz-Thionville, France., David A; Urgences pédiatriques, CH Pau, France., Di Patrizio M; Urgences pédiatriques, CHRU Nancy, France., Granjon M; Urgences pédiatriques, CHRU Brest, France., Benoist G; Urgences pédiatriques, Hôpital Ambroise-Paré, AP-HP, France., Laguille C; Urgences pédiatriques, CHU Limoges, France., Guitteny MA; Urgences pédiatriques, Pédiatrie-Médecine légale, CHU Rennes, France., Balençon M; Urgences pédiatriques, Pédiatrie-Médecine légale, CHU Rennes, France., Vrignaud B; Urgences pédiatriques, CHU Nantes, France., Basmaci R; Urgences pédiatriques, Hôpital Louis Mourier, AP-HP, France., Dampfhoffer M; Service de pédiatrie, Centre hospitalier Métropole Savoie, France., Dubos F; Urgences pédiatriques, CHRU Lille, France., Chappuy H; Urgences pédiatriques, Hôpital Necker, AP-HP, France., Minodier P; Urgences Enfants, AP-HM, Marseille, France., Médiamolle N; Urgences pédiatriques, Hôpital Trousseau, AP-HP, Paris, France., Bréhin C; Service d'accueil des Urgences Pédiatriques, Hôpital des Enfants, CHU Toulouse, France.
Jazyk: angličtina
Zdroj: Clinical toxicology (Philadelphia, Pa.) [Clin Toxicol (Phila)] 2023 May; Vol. 61 (5), pp. 370-378. Date of Electronic Publication: 2023 May 15.
DOI: 10.1080/15563650.2023.2188143
Abstrakt: Background and Objective: In the European Union, the record of cocaine-related seizures indicates an expanding supply. The purity has also been increasing. The health impact of these trends remains poorly documented, in particular, the changes and clinical manifestations of intoxication in young children. We attempted to evaluate the trend in French pediatric admissions for cocaine intoxication/exposure over an 11-year period (2010-2020).
Methods: A retrospective, national, multicenter, study of a pediatric cohort. All children less than 15 years of age admitted to a tertiary-level pediatric emergency unit for proven cocaine intoxication (compatible symptoms and positive toxicological screening) during the reference period were included.
Results: Seventy-four children were included. Forty-six percent were less than 6 years old. Annual admissions increased by a factor of 8 over 11 years (+700%) and 57% of all cases were admitted in the last two years. The main clinical signs were neurologic (59%) followed by cardiovascular symptoms (34%). Twelve patients were transferred to the pediatric intensive care unit. Factors significantly associated with the risk of being transferred to the pediatric intensive care unit were initial admission to the pediatric resuscitation area ( P  < 0.001), respiratory impairment ( P  < 0.01), mydriasis ( P  < 0.01), cardiovascular symptoms ( P  = 0.014), age of less than 2 years ( P  = 0.014). Blood and/or urine toxicological screening isolated eighteen other substances besides cocaine in 46 children (66%).
Conclusion: Children are collateral victims of the changing trends in cocaine availability, use and purity. Admissions of intoxicated children to pediatric emergency departments are more frequent and there is an increase in severe presentations. Therefore, this is a growing public health concern.
Databáze: MEDLINE
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