Abstract

*Dr. Muhammad Haris Shahzad, Dr. Hafiza Rubab Fatima and Dr. Muhammad Usman Khan

ABSTRACT

Objective: To evaluate the demographic and clinical features associated with acetaminophen overdose and to identify the clinical use of IV (intravenous) N- Acetylcysteine (NAC) treatment in children. Methods: This prospective study was conducted in Benazir Bhutto Hospital, Rawalpindi between June 2018 and June 2019. A total of 59 patients with overdose acetaminophen ingestion were included in this study. The toxic dose for acute acetaminophen intake was defined as greater than 150 mg/ kg. Rumack-Matthew nomogram was used to evaluate the risk of acute intoxication and to determine the decision of using antidote. Results: The mean age of the patients was 8.5±6.4 y and 34 of them (58%) were female. The mean time from ingestion to admission was 4.3±4.7 h. The mean ingested acetaminophen dose was 142.1±80 mg/kg. Twenty four patients (41%) received NAC and there were significant differences in terms of acetaminophen dose, creatinine and INR between antidote and decontamination therapy groups at admission time (p= 0.00, p= 0.03, p= 0.02, respectively). The complication due to antidote therapy was observed in only 1 patient. Conclusions: This study confirms that the side effects due to IV NAC therapy are uncommon and it is generally well tolerated in children.