Effectiveness of a Reliable Toxicological Analysis for a Correct Diagnosis of Acute Intoxication in Pediatrics: 2-Year Experience of an Analytical Toxicological Laboratory

摘要

This study aimed to assess the role of the laboratory of toxicology as a support for a correct diagnosis of intoxication through the application of a reliable analytical approach, critically designed to meet pediatric needs. Data collected from 360 cases of suspected intoxications in pediatric patients (aged 1 day to 17 years) during the period 2018 to 2019 are presented. Toxicological analyses were performed through different techniques (immunoassay and chromatography) with parameters (limit of detection and cut-off) adjusted according to pediatric needs to produce reliable toxicological data for a wide number of prescription drugs, drugs of abuse, and poisons. We present results about (1) agents involved in suspected poisonings and the methods adopted for a definite analytical diagnosis, (2) the assessment of the concordance of results for analyses proceeded by different techniques, and (3) the percentage of agreement between analytical result and clinical suspicion. An analytical approach critically designed to minimize misinterpretation of laboratory data and able to provide reliable results for a wide number of substances in a time compatible with the urgency represents a useful support for a correct diagnosis of intoxication in pediatrics.