The 4.5-year-old patient, from Tay Ninh province, was admitted to the hospital in a state of drowsiness, sleepiness, jaundice, yellow eyes, respiratory failure and severe liver failure.
According to medical history, the child had a continuous fever for 3 days accompanied by abdominal pain and vomiting. The family bought medicine to treat at home, including 325mg of paracetamol. Due to concerns that the child would have a prolonged high fever, the family gave the medicine every 3 hours in many consecutive times, with a total dose of up to about 210mg/kg, far exceeding the safe threshold.
Tests showed that liver enzymes were very high, severe blood clotting disorders and increased ammonia in the blood, threatening life.
Doctors diagnosed the child with paracetamol poisoning causing acute liver failure and quickly deployed intensive treatment including respiratory support, circulatory support, anti-cerebral edema, and the use of N-Acetyl Cysteine (NAC) antidote. In particular, the patient underwent plasma replacement combined with continuous blood filtration in 3 phases.
After more than two weeks of treatment, the child's health condition improved significantly, liver function gradually recovered, jaundice subsided, alertness and ventilation was successfully removed.
BS.CKII Nguyen Minh Tien - Deputy Director of the City Children's Hospital - recommends that parents not arbitrarily use fever-reducing medicine for children in overdose. Paracetamol should only be used when the child has a fever from 38.5 degrees Celsius or higher, with a dose of 10-15mg/kg/time, the interval between two doses is 4-6 hours and the total maximum dose is no more than 60mg/kg/day.
Doctors also note that when a child has a fever lasting for more than 24-48 hours or abnormal signs appear, parents need to take the child to a medical facility for examination, avoiding self-treatment at home leading to dangerous complications.
