未经证实:药物测试通常遵循一刀切的方法,在某些临床情况下是不够的,比如虐待儿童,疏忽,和无意的药物暴露。基于免疫测定的测试结果,它们是非特定的,麻木不仁,远非全面,会给孩子和他们的家庭带来意想不到的后果。
UNASSIGNED:本回顾性病例系列研究的目的是评估实时(0-1天)综合药物测试在儿科急性护理环境中作为基于免疫测定的测试的替代方法的实用性。
UNASSIGNED:分析中包括通过质谱测试获得的综合药物测试结果以及2019年至2022年在一个机构中所有儿科病例(0-12年)的相关医疗数据。最终病例系列(n=7)包括来自<3年患者的所有病例,其具有与药物史和/或通过免疫测定的毒理学结果不一致的综合药物测试结果。
UNASSIGNED:从2019年至2022年,订购了174例尿液和血液样本的质谱综合药物测试,代表97名患者(0-12岁)。其中,76例患者均为<3岁;结果与用药史和免疫测定结果确认一致(n=34),与用药史一致(n=14),免疫测定结果的确认(n=10),负(n=9),或病史不完整(n=2)。其余7例纳入最终病例系列。
UNASSIGNED:这些病例突出了实时综合药物检测在急性儿科病例中的价值。当检测结果为阴性时,可以从诊断鉴别中排除毒性暴露,并在积极时导致适当的医疗和社会干预。
UNASSIGNED: Drug testing typically follows a one-size-fits-all approach that is inadequate in some clinical scenarios, such as child maltreatment, neglect, and unintentional drug exposure. Results from immunoassay-based testing, which are non-specific, insensitive, and far from comprehensive, can lead to unintended consequences for children and their families.
UNASSIGNED: The objective of this retrospective case series study is to evaluate the utility of real-time (0-1 day) comprehensive drug testing as an alternative to immunoassay-based testing in the pediatric acute care setting.
UNASSIGNED: Comprehensive drug testing results obtained by mass spectrometry testing and associated medical data for all pediatric cases (0-12 years) at one institution from 2019 to 2022 were included in the analysis. The final case series (n = 7) included all cases from patients <3 years with comprehensive drug testing results that were inconsistent with medication history and/or toxicology results by immunoassay.
UNASSIGNED: Comprehensive drug testing by mass spectrometry was ordered for 174 urine and blood samples representing 97 patients (0-12 years) from 2019 to 2022. Of these, 76 cases were from patients <3 years old; results were consistent with medication history and confirmatory for immunoassay results (n = 34), consistent with medication history (n = 14), confirmatory for immunoassay results (n = 10), negative (n = 9), or medical history was incomplete (n = 2). The remaining 7 cases were included in the final case series.
UNASSIGNED: The cases highlight the value of real-time comprehensive drug testing in acute pediatric cases. Testing results can rule out toxic exposure from the diagnostic differential when negative, and lead to appropriate medical and social interventions when positive.