Abstract
Introduction
Pediatric exposures to cannabis edibles have been associated with serious adverse effects, such as respiratory depression. Yet, their incidence and relationship to exposure characteristics are not well defined. We attempt to describe the temporal, demographic, and clinical characteristics of pediatric patients with edible cannabis exposures and examine the relationship between these characteristics and two clinical outcomes: need for respiratory support and hospital admission.
Methods
A retrospective chart review was conducted at a single, tertiary care academic medical center covering a 28-month period. Inclusion criteria were: evaluation in the ED, age <18 years at the time of presentation, and physician documented exposure to edible cannabis. Exclusion criteria were: known or suspected co-ingestion of other substances.
Results
Thirty-two cases of edible cannabis ingestions were identified. Age <10 years was associated with bradypnea, hypertension, hospital admission, and respiratory support. Use of respiratory support was significantly associated with the presence of lethargy, bradypnea, hypercarbia, seizure, and hypertension. There was a five-fold increase in the number of pediatric edible cannabis exposures after recreational cannabis dispensaries opened in Massachusetts. Five patients (16%) required respiratory support and eleven (34%) required hospital admission.
Conclusions
There was a low incidence of need for respiratory support in our population, but hospital admission was more common. Severe symptoms (including lethargy and respiratory depression), need for respiratory support and hospital admission were more frequent in younger children. Exposures occurred with increasing frequency over time. Larger studies are needed to explore the relationship between THC dosage, age, and incidence of adverse outcomes.
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Acknowledgements
The authors would like to acknowledge Catherine W. Carr, MLIS, AHIP, for her contribution as education clinical services librarian.
Funding
Dr. Carreiro is funded by NIH/NIDA (K23DA045242).
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Dr. Kaczor conceptualized and designed the study, designed the data collection instruments, collected and organized the data, interpreted the results, and reviewed and revised the manuscript.
Dr. Mathews participated in study design, drafted the initial manuscript, interpreted the results, and reviewed and revised the manuscript.
Dr. LaBarge participated in study design, performed data extraction, interpreted the results, and reviewed and revised the manuscript.
Ms. Chapman participated in study design, designed the data collection instruments, interpreted the results, and reviewed and revised the manuscript.
Dr. Carreiro participated in study conceptualization and design, carried out statistical analysis of the data, interpreted the results, and reviewed and revised the manuscript.
All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Previous Presentations: Abstract accepted to the 2021 American College of Medical Toxicology Annual Scientific Meeting
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Kaczor, E.E., Mathews, B., LaBarge, K. et al. Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes. J. Med. Toxicol. 17, 386–396 (2021). https://doi.org/10.1007/s13181-021-00849-0
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DOI: https://doi.org/10.1007/s13181-021-00849-0