S84 Posters / Resuscitation 175S1 (2022) S29–S94

P127
Cardiac complications in children with multisystem inflammatory
syndrome
Wiem Barbaria1,2, Nouha Kharbech1, Amani Soua1, Amal Bougdar1,
Olfa Hammami1, Imen Chelly1, Ichrak Khamassi1
1
Universitary hospital Habib Bougatfa, Bizerta, Tunisia;
2
Tunis El manar University, Fasulty of medecine of Tunis, Tunisia
Introduction: Multisystem inflammatory syndrome in children
(MIS-C) is a new and rare hyper inflammatory disorder. It has a
temporal link with Coronavirus disease. It is a multisystem disorder of
which the cardiac impairment is the most serious and conditions the
prognosis. We report 2 cases of MIS-C which progressed favorably
under medical treatment.
Observation 1: MK, 15 years old with no past medical history. He
was hospitalized in December 2020 for prolonged fever, abdominal
pain, skin rash and arthralgia. Physical examination revealed a
generalized rash, a mild general condition. Biology showed significant
inflammatory syndrome, elevation of Troponins and D-Dimers, leuko-
lymphopenia and hepatic cytolysis. Cardiac ultrasound revealed
pericardial detachment. The COVID-19 RT-PCR test was negative as
well as the serology. The child received methylprednisolone and
polyvalent immunoglobulins. The outcome was favorable.
Observation 2: ZBA aged 14 years 8 months with diabetes since the
age of 4 under insulin was infected with SARS cov2 in December 2020.
She was hospitalized in May for retro sternal chest pain without fever or
deterioration of the general condition. Clinical examination reveals good
neurological and hemodynamic status. She had no signs of heart failure.
Troponins were 16,947 pg/ml, D-dimers 3458 IU/L. Echocardiography
revealed mild hypokinesis of the midline and basal segment of the lower
wall and a retained left ventricular ejection fraction. There was
circumferential pericardial effusion with no hemodynamic impact. The
SARS Cov2 serology was positive. The outcome was favorable with
immunoglobulins and systemic corticosteroid therapy.
Conclusion: Multisystem inflammatory syndrome is a new and
serious pathology in the context of the Covid19 pandemic. The
prognosis depends on the early diagnosis and treatment. The risk of
long-term myocardial sequelae is currently unknown.
References
Alsaied T, Tremoulet AH, Burns JC, et al. Review of Cardiac Involvement
in Multisystem Inflammatory Syndrome in Children. Circulation.
2021;143(1):78–88.
P128
Carbon monoxide intoxication in children in a Tunisian pediatric
unit
Wiem Barbaria1,2, Hager Maalaoui1, Bourcheda Manel1,
Salma Mechlia1, Olfa Hamami1, Imen Chelly1, Ichrak Khamassi1
1
Universitary hospital Habib Bougatfa, Bizerta, Tunisia;
2
Tunis El Manar University, Faculty of Medecine of Tunis, Tunisia
Objective: To evaluate the epidemiologic, clinical, and evolutionary
profile of carbon monoxide (CO) poisoning in a general pediatric ward.
Methods: Retrospective descriptive study including patients
admitted to the department of pediatrics and neonatology of Habib
Bougatfa Hospital in Bizerta (Tunisia) over a period of 3 years from 01/
01/2019 to 31/12/2021.
Results: Our study included 21 patients. The incidence of CO
poisoning was 0.5%. The sex ratio was 0.96 (M/F). Mean age was 3.5
years. The intoxication occurred during spring in the majority of cases.
The highest incidence rate was in May. Main cause of CO poisoning was
poorly functioning heating system. The majority of the cases occurred
in the afternoon. All cases of intoxication occurred in the patient’s
home. The time delay between the intoxication and the consultation
was 3 hours. Principle symptoms presented were drowsiness and
confusion. Respiratory distress was noted in 2 patients. Liver damage
was noticed in one child. Mean Carboxyhemoglobin level was 12.8%.
Six patients were discharged against medical advice. Referral to an
intensive care unit was needed for two children. All patients
performed oxygenothrapy with facial mask. Hyper bare oxygen
therapy was performed in four cases. Mean length of stay in hospital
was 39 hours. The evolution was favorable in the majority of cases.
Death was noticed in one case.
Conclusion: CO intoxication remains the main cause of death by
intoxication in developing country. Although the evolution was
favorable in the majority of cases in our study, education is obligatory
to minimize morbidity and mortality.
Reference
Unsal Sac R, Taşar MA, Bostancı İ, Ş imşek Y, Bilge Dallar Y.
Characteristics of Children with Acute Carbon Monoxide Poisoning
in Ankara: A Single Centre Experience. J Korean Med Sci. 2015;30
(12):1836–40.
P129
Heart Safe Finland web service as a tool for monitoring and
developing heart safety
Mari Blek-Vehkaluoto, Esa Takala, Pirjo Valjanen, Antti Haverinen
Finnish Heart Association, Helsinki, Finland
Heart safety in Finland: The incidence of out-of-hospital cardiac
arrest is 51/100 000 inhabitants/year. Since Finland is, compared to the
rest of Europe, a very sparsely populated country, there is regional
change and inequality in the emergency response time. There are only
some 5 700 AEDs in the registry (1,0/1 000 inhabitants vs. Denmark
3,6/1 000). There is not a citizen responder program and the education
of school children in CPR is not mandatory. Therefore, it is important to
develop the heart safety, which consists of people’s willingness and
readiness to do CPR and a closely located AED.
Heart Safe Finland: In March 2022 the Finnish Heart Association
launches a new web service called Heart Safe Finland to develop the
level of heart safety. The service concretizes the concept of heart safety
and is functioning as a tool for monitoring and developing heart safety
in all of Finland’s municipalities (309), wellbeing services counties (21)
and in the whole state. The web service is designed to provide a fun and
interactive way for users (county council members, municipal decision
makers and inhabitants) to be able to view the statistics of their own
areas and also to compare it with others. Through the service we offer
concrete practical suggestions for how to improve the heart safety of
the chosen area. These can include, for example, a suggestion to
increase AEDs in the area or a suggestion for better placement for
AEDs.
Indicators behind the heart safety level: The level of heart safety
is measured with four indicators:
number of AEDs,
placement of AEDs - rural areas,
placement of AEDs - areas with ≥75 over 65-year-olds/km2 and
incidence of CVD.
The indicators will be supplemented, for example, by the number
of first aid courses.