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A retrospective review of whole bowel irrigation in pediatric patients.

Abstract

BACKGROUND
Traditionally whole bowel irrigation (WBI) has been advocated for ingestions involving substances not bound with activated charcoal as well as extended release and enteric coated medications. Other than isolated case reports, little exists in the literature regarding the use of WBI in poisoned pediatric patients. The purpose of this study is to better understand the use of WBI in pediatric patients.
METHOD
A retrospective chart review of California Poison Control System electronic database for human poisoning cases between the years 2000 and 2010 was performed.
RESULTS
A total of 176 cases were identified. The most common age of poisoned patients that received WBI was 2 years. There were more pediatric patients who received WBI between 2000 and 2005 then between 2006 and 2010. The top three substances in which WBI was used were calcium channel blockers, iron, and antidepressants. There were 72 cases involving sustained release and delayed release substances. The top five sustained release/delayed release substances were nifedipine, bupropion, verapamil, diltiazem, and felodipine. Adverse drug reactions were noted in 17 patients, vomiting in 16 patients and abdominal pain in one patient. In 36 cases, abdominal radiographs were performed. Sixteen were positive, and in four cases, repeat abdominal radiographs demonstrated a decrease in opacities. Twelve patients had documented pills in their effluent.
CONCLUSION
Transient adverse drug reactions, vomiting and abdominal pain, were associated with WBI. Polyethylene glycol plus electrolyte lavage solution (PEG-ELS) was more frequently administered through the nasogastric tube. Patients who underwent WBI through nasogastric tube received higher doses of PEG-ELS.

Links

  • Publisher Full Text

    • Authors

    Lo JC, Ubaldo C, Cantrell FL

    Institution

    University of California-San Diego, Toxicology, San Diego, CA 92103, USA. jeanloem@hotmail.com

    Source

    Clinical toxicology (Philadelphia, Pa.) 50:5 2012 Jun pg 414-7

    MeSH

    Child
    Child, Preschool
    Delayed-Action Preparations
    Dose-Response Relationship, Drug
    Electrolytes
    Female
    Humans
    Infant
    Intestines
    Intubation, Gastrointestinal
    Male
    Pharmaceutical Preparations
    Poison Control Centers
    Poisoning
    Polyethylene Glycols
    Retrospective Studies
    Therapeutic Irrigation

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22578074