Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes.

Abstract

INTRODUCTION\nPediatric exposures to cannabis edibles have been associated with serious adverse\xa0effects, such as respiratory depression. Yet, their incidence and relationship to\xa0exposure characteristics are not well defined. We attempt to describe the temporal,\xa0demographic, and clinical characteristics of pediatric patients with edible cannabis\xa0exposures and examine the relationship between these characteristics and two clinical\xa0outcomes: need for respiratory support and hospital admission.\n\n\nMETHODS\nA retrospective chart review was conducted at a single, tertiary care academic medical\xa0center covering a 28-month period. Inclusion criteria were: evaluation in the ED, age\xa0<18 years at the time of presentation, and physician documented exposure to edible\xa0cannabis. Exclusion criteria were: known or suspected co-ingestion of other\xa0substances.\n\n\nRESULTS\nThirty-two cases of edible cannabis ingestions were identified. Age <10 years was\xa0associated with bradypnea, hypertension, hospital admission, and respiratory support.\xa0Use of respiratory support was significantly associated with the presence of lethargy,\xa0bradypnea, hypercarbia, seizure, and hypertension. There was a five-fold increase in\xa0the number of pediatric edible cannabis exposures after recreational cannabis\xa0dispensaries opened in Massachusetts. Five patients (16%) required respiratory\xa0support and eleven (34%) required hospital admission.\n\n\nCONCLUSIONS\nThere was a low incidence of need for respiratory support in our population, but\xa0hospital admission was more common. Severe symptoms (including lethargy and\xa0respiratory depression), need for respiratory support and hospital admission were more\xa0frequent in younger children. Exposures occurred with increasing frequency over time.\xa0Larger studies are needed to explore the relationship between THC dosage, age, and\xa0incidence of adverse outcomes.