Abstract P-155: COMPREHENSIVE TREATMENT OF CHILDREN WITH ACUTE WASP STING COMPLICATED BY MULTIPLE ORGAN FAILURE.

Abstract

Aims & Objectives: We report the clinical features and comprehensive treatment of 5 children with severe wasp sting combined with multiple organ failure Methods A retrospective analysis of 5 severe wasp sting children from PICU of Kunming children’s hospital between January 2015 and April 2017 were done include the patient’s general information clinical features diagnosis and treatment process and outcome. Results 3 of these 5 patients between 2–8 years old are male and 2 are female. They were stung by wild wasps and from rural mountain areas. The shortest time to our hospital after sting was 36 h, and the longest was 46 h. All of them had respiratory failure and renal failure; 3 of them had rhabdomyolysis syndrome and liver failure, 2 of them with pulmonary hemorrhage, 2 cases with brain disorders; All patients accepted mechanical ventilation (pressure control ventilation, with expiration tidal volume 6–8 ml/Kg). Blood perfusion and plasma exchange were administrated after admission, Continuous veno-venous hemodiafiltration (CVVHDF) were done between the treatment of plasma exchange and blood perfusion, the shortest CVVHDF time was 11 hours, the longest was up to 131 hours for organ function recovery. Wound clean anti-inflammation glutathione and correction of electrolyte disorder were done at the same time. The five children were discharged from our hospital with no complications. Conclusions Children with severe wasp stings need blood perfusion as soon as possible, those who has respiratory failure need respiratory support in time, early plasma exchange and hemodialysis filtration are effective rescue methods for those who have liver and kidney injury rhabdomyolysis syndrome.