DIGITALIS INTOXICATION IN INFANCY AND CHILDHOOD

[摘要] Ten infants and children with digitalis intoxication, overdosage without symptoms, multiple intoxication with cardio-active drugs and other confusing associated circumstances are reported, including three fatalities.Clinical and electrocardiographic manifestations were not related to the magnitude of the overdosage. Two examples of probable intoxication occurred in children who received digitalis not in excess of the maximum therapeutic doses commonly recommended.The frequent occurrence of congestive heart failure as a manifestation of digitalis intoxication in early life emphasizes the need to consider this cause in the differential diagnosis of cardiac decompensation.Dehydration is cited as a possible factor contributing to the occurrence of digitalis poisoning or if resulting from overdosage, aggravating the intoxication.A wide variety of electrocardiographic disturbances in rhythm and conduction was demonstrated. First degree A-V block occurred in half of the cases. Disturbances in A-V conduction and supraventricular arrhythmias were much more common than abnormalities in ventricular conduction or rhythm. Ventricular arrhythmia was limited to the fatal cases, with one exception.Digitalis therapy in infants and young children requires particular carefulness from all concerned. Whenever possible, the opportunity for error should be minimized by the use of standardized products, familiar to both physician and pharmacist.

[学科分类] 儿科学