A clinical case of acute methadone poisoning in an infant child

Abstract

Introduction. The article considers a case of a favorable outcome of severe acute oral methadone poisoning complicated by the development of acute respiratory failure and toxic hypoxic encephalopathy. Clinical observation. A clinical case of acute oral (through breast milk) methadone poisoning of severe degree in a child of 9 months and 6 days with the development of toxicohypoxic encephalopathy is presented. The narcotic substance entered the body once, after breastfeeding from mother to child. Acute poisoning in the child was manifested by respiratory insufficiency with impaired consciousness (did not respond to pain stimuli, short-term apnea was noted, saturation of arterial blood with oxygen (SpO2) was 62%). Intensive therapy included infusion, antidote, detoxification therapy, correction of acid-base state disorders, water-electrolyte balance, hypoxic disorders. Conclusion. Methadone-induced respiratory failure is characterized by dose dependence and the possibility of relief after administration of naloxone. In our clinical case, a specific antidote was used at the prehospital and hospital stages and an activator of metabolic cellular processes – riboxin in combination with B vitamins: thiamine chloride (vitamin B1) and pyridoxine hydrochloride (vitamin B6). In conclusion, it should be noted that the relevance of acute methadone poisoning in childhood remains high. Taking into account the mechanisms of the toxic effect of methadone, it is possible to formulate the directions of intensive therapy: maintenance of life support systems, rational antidote therapy, the fight against hypoxia and its consequences.