Τίτλος:
Respiratory complications following hydrocarbon aspiration in children
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Accidental hydrocarbon ingestion may lead to aspiration and chemical pneumonitis in children. In this review article, the clinical course of hydrocarbon pneumonitis, chest radiographic abnormalities, complications, and treatment interventions are summarized. Most children remain asymptomatic and without complications following ingestion of a hydrocarbon. In approximately 15% of ingestions, aspiration pneumonitis occurs and evolves over the first 6-8 hr presenting with fever, tachypnea, hypoxemia, and tachycardia. A symptom zenith is reached within 48 hr followed by progressive improvement. Up to 5% of pneumonitis cases progress rapidly to acute respiratory failure. Chest radiographic abnormalities develop by 4-8 hr after ingestion, but they are not always predictive of clinical pneumonitis. Patients with history of hydrocarbon ingestion should be monitored for 6-8 hr in the emergency department and a chest radiogram should be obtained at the end of the observation period. Spontaneous or induced emesis and gastric lavage have been related to aspiration pneumonitis. Children who are symptomatic are admitted to the hospital for cardiorespiratory status monitoring and supportive care. Approximately 90% of hospitalized patients have a benign clinical course. Increased work of breathing with or without altered sensorium and seizures are indications for admission to the intensive care unit. Hypoxemia unresponsive to supplemental oxygen and/or severe central nervous system involvement require mechanical ventilation. Corticosteroids do not seem to offer any benefit and antibiotics are administered in cases of bacterial superinfection. Pneumatoceles may become evident after the first 6-10 days of symptoms on follow-up chest radiograms and they resolve up to 6 months later. Pediatr Pulmonol. © 2016 Wiley Periodicals, Inc.
Συγγραφείς:
Makrygianni, E.A.
Palamidou, F.
Kaditis, A.G.
Περιοδικό:
Pediatric Pulmonology
Εκδότης:
John Wiley and Sons Inc
Λέξεις-κλειδιά:
amoxicillin; antibiotic agent; hydrocarbon; methylprednisolone; placebo; antiinfective agent; hydrocarbon; petroleum, acute respiratory failure; Article; artificial ventilation; aspiration pneumonia; bacterial infection; child; drug efficacy; emergency ward; fever; hospital patient; human; hypoxemia; intensive care unit; lobectomy; lung toxicity; nonhuman; patient monitoring; pneumatocele; priority journal; prognosis; seizure; stomach lavage; symptom; tachycardia; tachypnea; thorax drainage; thorax radiography; vomiting; case report; chemically induced; drug dependence; hospitalization; infant; lung function test; male; pathophysiology; Pneumonia, Aspiration; practice guideline; procedures, Anti-Bacterial Agents; Hospitalization; Humans; Hydrocarbons; Infant; Intensive Care Units; Male; Petroleum; Pneumonia, Aspiration; Practice Guidelines as Topic; Radiography, Thoracic; Respiration, Artificial; Respiratory Function Tests; Substance-Related Disorders
