In general , the most of import criterion is to move out the source of the toxic condition . Chelation treatment is use in someone with elevated blood pencil lead level , chelating agents bind to lead in the descent , facilitate their elimination by gall and urine , which reduces the entire amount of lead in the body and its toxic effects .
The treatment for lead toxic condition must be acquit by a multidisciplinary team . This is based on three column , which in order of grandness are : elimination or reduction of the rootage of exposure , nutritional support and if necessary treatment with lead chelators .
Elimination of Source of Exposure:
The elimination of the source of exposure is the most crucial footstep in the lead story poisoning treatment of intoxication . When the rootage of exposure is indecipherable , a thoroughgoing probe of possible sources should be impart out . To reduce the dust that contains booster cable from place which is deposited on floors , windowpane frames and doors , it must be remove with a material or sponge moistened with common or special detergent hold in phosphates .
Other recommendations include : frequent hand washing of children especially before corrode or sleeping , always keep the play field clear , bottle , pacifier , toys and curb the habit of pica ( persistent and determined craving to take in non - comestible center ) .
One study show that paternal counselling of the aforementioned bill proved to be in effect in decreasing lead levels which were reduced by approximately 20 % .
Providing a Balanced Diet:
Deficiencies of iron and Ca should be treat . fit that diet is balanced as this contract the absorption of Pb .
Treatment with Lead Chelators:
guide poisoning intervention with chelators has decreased mortality . The used chelators are disodium calcium edetate ( EDTA ) ; dimercaprol ( BAL ) and the succimer ( DMSA ) .
Symptomatic children and / or with lead levels of 70 μg / dl or more:
In this group , everyone should be considered a medical emergency and should be hospitalized for contiguous lead poisoning treatment .
The lead poisoning intervention is start with BAL reaching a total daily Elvis of 450 mg / m2 divided into six venereal disease . Three or four hours after get going lead toxic condition treatment , continuous infusion of intravenous extract is continued with EDTA 1,500 mg / m2 / 24 hours . The duration of the treatment is five day . The BAL is set aside when the blood lead omit to 60 μg / dl .
In some cases , treatment cycles must be carried out until the lineage lead layer fall to 20 μg / dl .
Asymptomatic children with lead levels of 45-69 μg / dl:
Everyone in this group must take in lead story poison discussion . EDTA 100 mg / m2 / 24 hours is dispense intravenously for five straight days .
Another lead poisoning intervention is DMSA , which is administered by word of mouth with few contrary effects . It is administered for five twenty-four hour period at a rate of 350 mg / m2 every 8 hour , abide by by an extra 14 days at a rate of 350 mg / m2 every 12 hours . If necessary , other discourse cycles can be deal out at a two - calendar week separation until the blood spark advance floor are less than 20 μg / dL.
Asymptomatic Children with Lead Levels between 20-45 μg / dl:
In this mathematical group , it is preferred to perform the EDTA challenge test for lead poisoning intervention , which assesses the usefulness of initiating chelation discussion .
The test consists of the government activity of 500 magnesium / m2 of EDTA in an intravenous extract for 30 minutes . Then roll up the diuresis for the next 8 hours . The excreted lead is correlate with the EDTA administered according to the following convention : lead in weewee ( μg ) / EDTA administered ( mg ) . If the ratio is greater than 0.7 , it is regard a positive ( abnormal ) result . This abnormal or plus result intimate that the discourse is indicated and that it will be effective . Results of the trial with figures humiliated than 0.7 indicate that environmental control should be emphasized and subsequent controls carried out . The chelator to be used is EDTA at a rate of 1000 mg / m2 / 24 hours .
Asymptomatic Children with Lead Levels of 10-19 μg / dl:
The chelation treatment for atomic number 82 intoxication treatment is not necessary : general Department of Education on prevention will be carried out and the sources of picture will be controlled .
