{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:03:59Z","timestamp":1788552239676,"version":"build-2803163510"},"reference-count":31,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>The study characterizes cannabis toxicity in relation to tetrahydrocannabinol (THC) dose in pediatric edible cannabis ingestions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This is a retrospective review of children aged &amp;lt;6 years presenting with edible cannabis ingestions of known THC dose within a pediatric hospital network (January 1, 2015\u2013October 25, 2022). Cannabis toxicity was characterized as severe if patients exhibited severe cardiovascular (bradycardia, tachycardia\/hypotension requiring vasopressors or intravenous fluids, other dysrhythmias), respiratory (respiratory failure, apnea, requiring oxygen supplementation), or neurologic (seizure, myoclonus, unresponsiveness, responsiveness to painful stimulation only, requiring intubation or sedation) effects. Cannabis toxicity was characterized as prolonged if patients required &amp;gt;6 hours to reach baseline. The relationship between THC dose and severe and prolonged toxicity was explored using multivariable logistic regression and receiver operator characteristic curve analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Eighty patients met inclusion. The median age was 2.9 years. The median THC ingestion was 2.1 mg\/kg. Severe and prolonged toxicity was present in 46% and 74%, respectively. THC dose was a significant predictor of severe (adjusted odds ratio 2.9, 95% confidence interval: 1.8\u20134.7) and prolonged toxicity (adjusted odds ratio 3.2, 95% confidence interval: 1.6\u20136.5), whereas age and sex were not. Area under the curve was 92.9% for severe and 87.3% for prolonged toxicity. THC ingestions of \u22651.7 mg\/kg can predict severe (sensitivity 97.3%) and prolonged toxicity (sensitivity 75.4%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The THC dose of edible cannabis correlates to the degree of toxicity in children &amp;lt;6 years old. The threshold of 1.7 mg\/kg of THC may guide medical management and preventive regulations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2023-061374","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T08:17:44Z","timestamp":1693210664000},"source":"Crossref","is-referenced-by-count":33,"title":["Toxic Tetrahydrocannabinol (THC) Dose in Pediatric Cannabis Edible Ingestions"],"prefix":"10.1542","volume":"152","author":[{"given":"Lesley C.","family":"Pepin","sequence":"first","affiliation":[{"name":"aRocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Simon","sequence":"additional","affiliation":[{"name":"aRocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen","family":"Banerji","sequence":"additional","affiliation":[{"name":"aRocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Leonard","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics, Section of Emergency Medicine, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher O.","family":"Hoyte","sequence":"additional","affiliation":[{"name":"aRocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, Colorado"},{"name":"cDepartment of Emergency Medicine, University of Colorado Hospital, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Wang","sequence":"additional","affiliation":[{"name":"aRocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, Colorado"},{"name":"dUniversity of Colorado Anschutz Medical Campus, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"issue":"4","key":"2023111414382946900_B1","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.acap.2021.07.018","article-title":"Recent trends in marijuana-related hospital encounters in young children","volume":"22","author":"Bennett","year":"2022","journal-title":"Acad Pediatr"},{"issue":"12","key":"2023111414382946900_B2","doi-asserted-by":"crossref","first-page":"e969","DOI":"10.1097\/PEC.0000000000001841","article-title":"Prevalence and clinical characteristics of unintentional ingestion of marijuana in children younger than 6 years in states with and without legalized marijuana laws","volume":"37","author":"Leubitz","year":"2021","journal-title":"Pediatr Emerg Care"},{"issue":"8","key":"2023111414382946900_B3","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1056\/NEJMc2207661","article-title":"Edible cannabis legalization and unintentional poisonings in children","volume":"387","author":"Myran","year":"2022","journal-title":"N Engl J Med"},{"issue":"1","key":"2023111414382946900_B4","doi-asserted-by":"crossref","first-page":"e2142521","DOI":"10.1001\/jamanetworkopen.2021.42521","article-title":"Unintentional pediatric cannabis exposures after legalization of recreational cannabis in Canada","volume":"5","author":"Myran","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2023111414382946900_B5","unstructured":"Solutions\u2008DG\n          . 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