Severe poisoning with cardiotropic drugs in children,  accompanied  by pronounced rhythm disorders  and low cardiac output syndrome,  is quite rare, but sometimes they can end fatally.The objective was to demonstrate the successful use of electrocardiostimulation in acute propafenone  poisoning in a child of three years old.Materials and Methods. A retrospective analysis of the features of the course of severe propafenone poisoning in a three-year-old child who required pacing was carried out. Special attention was paid to the analysis of rhythm disorders  that  led to cardiac arrest  by the type of electrical  activity without a pulse, high efficiency of timely electrocardiostimulation in order to relieve bradyarrhythmia. Against the background of the therapy,  a stable recovery of the correct  sinus rhythm was achieved six hours after the connection of a temporary electrocardiostimulator.Conclusion. The presence  of persistent bradyarrhythmia-type rhythm disorders  in acute  poisoning with antiarrhythmic drugs in children  is an indication for the emergency use of electrocardiostimulation.

Lidocaine poisoning with parenteral administration, accompanied by systemic toxic effects, is quite rare in pediatric practice, but even single cases may cause the development of critical conditions that require treatment in the intensive care unit. Objective. To demonstrate a clinical case of severe lidocaine poisoning in two children and the main measures to stabilize the condition of patients with overdoses of local anesthetics. The article presents the basic historical data on the creation of lidocaine, its pharmacokinetics and pharmacodynamics in children. The maximum single dose was indicated based on the patient's weight. The main principles of intensive therapy for lidocaine poisoning in children were considered, and the algorithm of actions in the development of a life-threatening state was provided. Special attention was paid to the use of the «lipid rescue protocol» in hemodynamic disorders and cardiac arrest. Conclusion. When prescribing local anesthetics in children, one should take into account the anatomical and physiological characteristics of the child, the age characteristics of the pharmacological effects of the drugs, and the maximum permissible single dose, which will prevent the occurrence of iatrogenic life-threatening complications. Key words: lidocaine, poisoning, systemic toxic effects, intensive care, pediatric

Hemophagocytic lymphohistocytosis is an extremely rare disease requiring early diagnosis and specific treatment.The objective: to demonstrate the clinical case of hemophagocytic lymphohistocytosis in an infant. The course of the disease in a 6-month-old child requiring treatment in the intensive care unit was retrospectively analyzed. The article presents the procedure of differential diagnosis of sepsis and hemophagocytic lymphohistocytosis in children, special attention is paid to the diagnostic criteria, and the clinical and laboratory differences of these diseases are described.Conclusion. The presence of leukopenia, neutropenia, thrombocytopenia, hypoalbuminemia and hypocoagulation in an infant with persistent fever is the basis for a thorough differential diagnosis in order to eliminate severe systemic diseases that manifest as childhood infections and sepsis.