Nitroglycerine in scorpion sting with decompensated shock.
This study was designed to examine the effect of nitroglycerine infusion in children hospitalized for scorpion sting with severe myocardial dysfunction and decompensated shock. Children satisfying the inclusion criteria were started on nitroglycerine infusion under hemodynamic monitoring and other supportive measures. The effects of nitroglycerine, including improvement in oxygenation and decrease in pulmonary congestion and liver size were recorded. Seven out of 11 children responded well to nitroglycerine therapy and the clinical response was evident within 30 to 60 minutes. The first parameter to improve was oxygen saturation, followed by an improvement in the blood pressure and respiratory rate. Heart rate was the last parameter to improve after nitroglycerine infusion. The average duration of nitroglycerine infusion was 25 hours (12 - 36 hours). It was seen that the non-survivors had significant tachycardia at admission, and a greater need for assisted ventilation compared to the survivors. We conclude that nitroglycerine therapy could bring about significant improvement in myocardial function and hemodynamic parameters with a potential for improved survival.
Narayanan
P
P
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),Pondicherry 605 006, India.
Mahadevan
S
S
Serane
V Tiroumourougane
VT
D000818:Animals; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D005996:Nitroglycerin / Q000627:therapeutic use*; D011446:Prospective Studies; D065008:Scorpion Stings; D012605:Scorpions; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000209:etiology; D001098:Spider Bites / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D013111:Spider Venoms / Q000506:poisoning*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D002316:Cardiotonic Agents; D013111:Spider Venoms; D014665:Vasodilator Agents; D005996:Nitroglycerin