Projects

Project Description

Acute poisoning is a common pediatric emergency and a persistent cause of childhood morbidity and mortality worldwide. The World Health Organisation estimates that approximately 45,000 deaths occur each year in the under-20-year population as a result of poisoning. (1) The pattern of poisoning agents and their outcomes varies by geography and socioeconomic setting. In India, household products, prescription drugs, kerosene, and other hydrocarbons predominate in urban children, whereas insecticide and organophosphate exposures are more frequent in rural areas. Exploratory ingestions dominate in children younger than about 7 years, while intentional ingestions become more common in older children and adolescents.
For most poisoned children, the cornerstone of management is supportive care, prevention of further absorption, and administration of an antidote when one exists. In a small but critically important subset, however, the toxin is severely dangerous and amenable to enhanced elimination, and extracorporeal therapy can be lifesaving.
Extracorporeal therapy removes the toxin independently of the patient’s own renal and hepatic clearance and encompasses intermittent haemodialysis (HD), continuous renal replacement therapy (CRRT), peritoneal dialysis (PD), hemoperfusion (HP), and therapeutic plasma exchange (TPE).