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Labadie M, Vaucel JA, Courtois A, Nisse P, Legeay M, Medernach C, Patat AM, Von Fabeck K, Gallart JC, Tournoud C, Puskarczyk E. Button Battery Ingestion in Children (PilBouTox®): A Prospective Study Describing the Clinical Course and Identifying Factors Related to Esophageal Impaction or Severe Cases. Dysphagia 2023; 38:446-456. [PMID: 35841456 DOI: 10.1007/s00455-022-10485-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/13/2022] [Indexed: 01/27/2023]
Abstract
In this study, we aimed to identify the factors related to esophageal impaction following button battery (BB) ingestion in children. PilBouTox, a prospective multicentric observational cohort study, was conducted from French Poison Control Centers between June 1, 2016 and May 31, 2018. Children (0-12 years old) with BB ingestion were included. After ingestion, patients were monitored for 21 days or more if they remained symptomatic (maximum 1 year). Causes of ingestion, clinical manifestations, medical management, and the outcomes were recorded. In total, 415 patients were included; among them, 35 had esophageal impaction and 14 had severe complications or died. Seven symptoms were closely related (relative risk (RR) > 30) to esophageal impaction: anorexia, drooling, dyspnea, fever, hemodynamic instability, pallor, and pain. Furthermore, BBs > 15 mm were related to esophageal impaction (RR = 19, CI95% [4.1; 88]). The absence of initial symptoms was a protective factor for esophageal impaction (RR = 0.013, CI95% [0.002; 0.1]). Nine symptoms were closely related (RR > 30) to major effects and death: dyspnea, cough, dysphagia, drooling, fever, hemodynamic instability, pain, pallor, and vomiting. Seven symptoms were related to esophageal impaction and their rapid recognition could help to ensure that the patient is taken to a health care facility. Nine factors were related to the major effects of BB ingestion. We recommended an X-ray as soon as possible to determine the position of the BB.Trial Registry: Clinical Trial ID: NCT03708250, https://clinicaltrials.gov/ct2/show/NCT03708250.
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Affiliation(s)
- Magali Labadie
- Centre Hospitalier et Universitaire de Bordeaux, Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], 1 Place Amélie Rabat Léon, 33000, Bordeaux, Aquitaine, France.
| | - Jules-Antoine Vaucel
- Centre Hospitalier et Universitaire de Bordeaux, Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], 1 Place Amélie Rabat Léon, 33000, Bordeaux, Aquitaine, France
| | - Arnaud Courtois
- Centre Hospitalier et Universitaire de Bordeaux, Centre Antipoison Nouvelle Aquitaine [Nouvelle Aquitaine Poison Control Center], 1 Place Amélie Rabat Léon, 33000, Bordeaux, Aquitaine, France
| | - Patrick Nisse
- Centre Antipoison [Lille Poison Control Center], Centre Hospitalier et Universitaire de Lille, 59000, Lille, France
| | - Marion Legeay
- Centre Antipoison [Angers Poison Control Center], Centre Hospitalier et Universitaire de Angers, 49000, Angers, Pays de la Loire, France
| | - Chantal Medernach
- Centre Antipoison de Paris [Paris Poison Control Center]-Fédération de Toxicologie, Groupe Hospitalier Lariboisière Fernand-Widal, 75000, Paris, Île-de-France, France
| | - Anne-Marie Patat
- Centre Antipoison [Lyon Poison Control Center], Centre Hospitalier et Universitaire de Lyon, 69000, Lyon, Auvergne-Rhône-Alpes, France
| | - Katharina Von Fabeck
- Centre Antipoison [Marseille Poison Control Center], Centre Hospitalier et Universitaire de Marseille, 13000, Marseille, France
| | - Jean-Christophe Gallart
- Centre Antipoison-SAMU 31 [Toulouse Poison Control Center], Centre Hospitalier et Universitaire de Toulouse, 31000, Toulouse, Midi-Pyrénées, France
| | | | - Christine Tournoud
- Centre Antipoison [East Poison Control Center], Centre Hospitalier et Universitaire de Nancy, 54000, Nancy, Lorraine, France
| | - Emmanuel Puskarczyk
- Centre Antipoison [East Poison Control Center], Centre Hospitalier et Universitaire de Nancy, 54000, Nancy, Lorraine, France
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Langrand J, Bassi C, Dufayet L, Vodovar D, Laborde-Casterot H, Caré W, Medernach C, Etchevers A, Garnier R. Incendie de Notre Dame et plomb : impact chez les enfants. Toxicologie Analytique et Clinique 2021. [DOI: 10.1016/j.toxac.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Caré W, Medernach C, Langrand J, Larabi A, Alvarez J, Villa A. Toxicité systémique de la lidocaïne et de la prilocaïne appliquées sous forme de crème eutectique avant épilation au laser : à propos de 3 cas. Toxicologie Analytique et Clinique 2018. [DOI: 10.1016/j.toxac.2018.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Caré W, Larabi IA, Langrand J, Medernach C, Alvarez JC, Villa A. Poisoning associated with inappropriate use of a eutectic mixture of lidocaine and prilocaine before laser-assisted hair removal: about 3 cases. Int J Legal Med 2018; 133:843-846. [PMID: 29785585 DOI: 10.1007/s00414-018-1858-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/11/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Eutectic mixtures of lidocaine and prilocaine are used during painful dermatological procedures. Poisoning is rarely reported in adults. MATERIAL AND METHOD We report three cases of women who experienced lidocaine and prilocaine poisoning after laser-assisted hair removal. Plasma levels of local anesthetics were assayed by a fully validated liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method. CASE REPORTS The rules of application of the anesthetic cream were observed apart from the maximum dose and/or maximum surface area. One patient applied a higher dose than the maximum recommended dose (140 instead of 60 g) and all patients failed to comply with the maximum recommended surface area (600 cm2). The patients presented an unusual clinical pattern as compared with other local anesthetics overdose: signs of cardiac toxicity with no ECG changes or arrhythmia, neurological toxicity without seizures or coma, and methemoglobinemia. DISCUSSION Health authorities should publish explicit recommendations targeting users and prescribers with particular emphasis on the maximal surface area of application.
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Affiliation(s)
- Weniko Caré
- Centre antipoison et de toxicovigilance de Paris, hôpital Fernand-Widal, Paris, France. .,Service de médecine interne, hôpital d'instruction des armées Percy, Clamart, France.
| | - Islam-Amine Larabi
- Laboratoire de toxicologie, hôpital Raymond Poincaré, hôpitaux universitaires Paris Ile-de- France Ouest, Garches, France
| | - Jérôme Langrand
- Centre antipoison et de toxicovigilance de Paris, hôpital Fernand-Widal, Paris, France
| | - Chantal Medernach
- Centre antipoison et de toxicovigilance de Paris, hôpital Fernand-Widal, Paris, France
| | - Jean-Claude Alvarez
- Laboratoire de toxicologie, hôpital Raymond Poincaré, hôpitaux universitaires Paris Ile-de- France Ouest, Garches, France
| | - Antoine Villa
- Centre antipoison et de toxicovigilance de Paris, hôpital Fernand-Widal, Paris, France
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Bavoux F, Lanfranchi C, Olive G, Asensi D, Dulac O, Francoual C, Huault G, Olivier C, Seilaniantz M, Castot A, Medernach C, Benzaken C, Efthymiou ML. [Adverse effects on newborns from intra uterine exposure to benzodiazepines and other psychotropic agents (author's transl)]. Therapie 1981; 36:305-12. [PMID: 6117137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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