Ingestion--associated adverse events necessitating pediatric ICU admissions

Abstract

Objective: To review the pattern of food-associated pediatric intensive care unit (PICU) admissions.

Methods: A retrospective chart review was conducted to analyse the pattern of food-associated PICU admissions at a teaching hospital between January 2004 and May 2007.

Results: Ten cases (7 boys and 3 girls, aged 9 month to 11.7 year) were identified. One girl developed progressive generalized urticarial rash and anaphylactic shock following consumption of bird nest drink. A boy presented with the classic triads of acute onset altered mental state, respiratory depression and small pupils following consumption of a bottle of presumed "green tea", which was subsequently found to contain methadone. In the remaining 8 cases, dried mango, peanut, peanut-shell, fishmeat ball, pork chop, bread and bone were the culprits, impacting in the airway or oesophagus. All but one patient had short ICU stay (<or=3 days). Ingestion-associated adverse events can be protean and may necessitate PICU admissions. All age groups can be affected. Solids are usually associated with symptoms from local obstruction or suffocation, while fluids may be associated with systemic manifestations.

Conclusion: Presentations were generally acute, dramatic and unmistaken. The majority of patients made prompt and uneventful recovery and had short PICU stay.