Retrospective evaluation of the demographic and clinical characteristics of poisoning cases in our pediatric intensive care unit

Objective: This study aimed to retrospectively evaluate the demographic and clinical characteristics of pediatric patients admitted to the Pediatric Intensive Care Unit (PICU) of Çukurova University Faculty of Medicine, Balcalı Hospital due to poisoning between 2011 and 2024. The etiological agents, treatment approaches, and clinical outcomes of the poisonings were analyzed. Materials and Methods: A total of 450 patients admitted to the PICU with a diagnosis of poisoning between 01.01.2011 and 31.12.2024 were retrospectively reviewed. Demographic data, routes and causes of poisoning, clinical presentation, administered treatments, and severity scores were analyzed. Data were processed using IBM SPSS Statistics 27 software. Appropriate statistical tests were applied according to data distribution; chi-square test was used for categorical variables. Results: The mean age of the 450 patients included was 102.3±76.5 months, and 60.4% were female. Poisonings occurred predominantly at home (96.9%) and via the oral route (99.3%). 66.9% of the patients applied to the health institution within the first hour. Accidental exposure was the most common cause (57.1%), followed by suicide attempts (42.9%), which reached 95.8% among females older than 12 years (p<0.001). The most common presenting findings of poisoning were neurological findings (27.3%) and gastrointestinal system findings (22.2%), while 56.2% of patients were asymptomatic. The most frequently involved agents were paracetamol (16%) and central nervous system drugs such as selective serotonin reuptake inhibitors and tricyclic antidepressants. In the suicide attempt group, the mean age was higher, polypharmacy was more common (46.7%). ECG abnormalities were observed in 6.2% of patients, mostly associated with central nervous system drugs. Antidote therapy was administered in 16.3% of cases, with sodium bicarbonate (6.7%), N-acetylcysteine (5.1%) and atropine (3.3%) being the most commonly used. Organ failure occurred in 7.6% of patients, and the mortality rate was 0.9%. Three of the four deceased cases involved organophosphate poisoning; the remaining one was due to cardiovascular drug toxicity. Conclusion: Poisoning remains a significant cause of mortality and morbidity in the pediatric age group. Intentional drug ingestion for suicide is particularly prominent among adolescent females. Although the majority of cases had favorable outcomes, early identification and aggressive management of high-risk cases with appropriate intensive care support are crucial for improving prognosis. Keywords: Pediatric intensive care, poisoning, suicide attempt, accidental poisoning, antidote