عنوان مقاله
مسمومیت حاد الکل در نوجوانان: تناوب نارسایی تنفسی
فهرست مطالب
مقدمه
روش ها
نتایج
بحث
نتیجه گیری
بخشی از مقاله
روش ها
بین ماه های سپتامبر سال 2007 و دسامبر 2010، یک نمونه ساده از افراد با مسمومیت حاد الکل در یک مطالعه آزمایشی مشاهده ای آینده نگر ثبت شد . افراد در صورتی که سنین بین 14 و 20 سال سن و مشکوک بودن به مستی شدید با اتانول بودند، واجد شرایط به ورود به مطالعه بودند.
معیارهای خروج از مطالعه شامل سطح الکل خون یا نفس کمتر از80 میلی گرم / دسی لیتر، لوله گذاری قبل و یا به محض ورود به بخش اورژانس ، آسیب تروماتیک قبل از ورود، و هر شرایط که در اندازه گیری ETCO2 تاثیر می گذارد ، از جمله شواهدی از تروما، کتواسیدوز دیابتی ، کم آبی شدید یا بیماری فعال راه هوایی با خطر کمتر.
کلمات کلیدی:
ACUTE ALCOHOL INTOXICATION IN ADOLESCENTS: FREQUENCY OF RESPIRATORY DEPRESSION Melissa L. Langhan, MD Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut Reprint Address: Melissa L. Langhan, MD, Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, CT 06511 , Abstract—Background: Adolescents and young adults are frequent users of alcohol. Younger patients may be more sensitive to the effects of alcohol than their adult counterparts, and toxicity has been known to occur at lower doses. Respiratory depression is a serious adverse effect of alcohol intoxication; however, current monitoring practices may not adequately detect respiratory depression. Objective: Our objective was to determine the frequency of hypoventilation as measured by capnography among adolescents with acute alcohol intoxication. Our secondary objective was to determine if an association exists between alcohol levels and incidence of hypoventilation. Methods: This was a prospective observational pilot study of patients 14–20 years of age with acute alcohol intoxication. Blood or breath alcohol measurements were obtained on arrival. Hourly measurements of vital signs including capnography were recorded. Results: Sixty-five subjects were analyzed. Mean alcohol level was 185 mg/dL. Twenty-eight percent of subjects had episodes of hypoventilation. Episodes occurred in similar proportions on arrival and during the first 5 h of measurements. There was no difference in alcohol levels between subjects who did and did not hypoventilate (185 mg/dL vs. 186 mg/dL; 95% confidence interval 29 to 25). Oxygen desaturations occurred in 14 subjects and were associated with hypoventilation (p = 0.015). Conclusions: Hypoventilation is common among adolescents who are acutely intoxicated with alcohol. It is independent of alcohol level and occurs at a steady rate during the first several hours of intoxication. Capnography should be considered as an additional monitoring device to detect these episodes and enhance patient safety. 2013 Elsevier Inc. , Keywords—hypoventilation; capnography; intoxication; alcohol; adolescents INTRODUCTION Alcohol is a common drug of abuse among adolescents and young adults. It is estimated that at least 50% of adolescents 12–20 years old have imbibed alcohol during any 30-d period (1). This population also accounts for nearly 20% of all the alcohol consumed in the United States (US) (1). In 2008, the rate of Emergency Department visits related to alcohol alone was 220.7 per 100,000 children age 12–17 years and 596.3 per 100,000 young adults aged 18–20 years (2). Alcohol is one of the most commonly abused drugs that can induce respiratory failure (3). Respiratory failure from central nervous system depression is a rare but serious consequence of alcohol intoxication. In adults, this has been known to occur in a dose-dependent fashion, Presented at Eastern Society of Pediatric Research, Philadelphia, PA, March 2009, Pediatric Academic Society, Baltimore, MD, May 2009. Financial Disclosure: Equipment on loan and donated from Nellcor Puritan Bennett LLC. Conflict of Interest: Melissa Langhan received an honorarium from Oridion for serving on an expert panel after the completion of this study and manuscript.
