Comparison between pediatric and adult acute natural cannabinoids toxicity: A 5-year retrospective study with special consideration of acute synthetic cannabinoids toxicity.

Natural cannabinoid poisoning is more common than synthetic cannabinoid poisoning. In a review of 106 cases from a poison control center, children (68 patients) more often had impaired consciousness and slow breathing, while adults (38 patients) more often had low oxygen, rapid heart rate, low potassium, and high white blood cell count. The time between exposure and medical help, along with potassium level, predicted complications in children. Delay to medical help and oxygen saturation predicted longer hospital stays in children. Only four patients had synthetic cannabinoid poisoning, mainly with seizures, rapid heart rate, high blood pressure, fast breathing, and low oxygen.

Study at a glance

Abstract

Acute cannabinoids toxicity is an alarming toxicological problem. The current study aimed to compare children and adults with acute natural cannabinoids toxicity and highlight cases with acute synthetic cannabinoids (SCs) toxicity. This retrospective cross-sectional study was conducted on patients with acute cannabinoids toxicity admitted to Tanta University Poison Control Center from January 2019 to December 2023. Socio-demographic, toxicological, clinical, and laboratory data were retrieved from patients' medical records. Patients were divided into a pediatric group (≤ 18 years) and an adult group (> 18 years). Out of 106 patients, 68 were children and 38 were adults. Impaired consciousness level and bradypnea were more significantly reported in children (P < 0.001, 0.007, respectively). Low oxygen saturation, tachycardia, hypokalemia, and leukocytosis were more significantly reported in adults (P < 0.001, for each). Delay time from exposure to medical intervention and potassium level were significantly valid to predict complications in children (Adjusted odds ratio: 1.393 and 4.139, respectively). Delay time to medical intervention and oxygen saturation were significant risk factors for prolonged hospital stay in children (Adjusted odds ratio: 1.255 and 0.677, respectively). Acute SCs toxicity was observed only in four cases presented mainly with seizures, tachycardia, hypertension, tachypnea, and hypoxemia. It could be concluded that natural cannabinoids toxicity is more prevalent than SCs. Presentation of acute natural cannabinoids toxicity exhibits variations between children and adults. Delay time to medical intervention, as well as potassium and oxygen saturation levels are significant risk factors for complications and prolonged hospitalization in children.