Life-threatening respiratory failure following accidental infusion of polyethylene glycol electrolyte solution into...

Area of Science:

• Pediatric Gastroenterology
• Pulmonology
• Critical Care Medicine

Background:

• Functional fecal retention is a common cause of encopresis in children, often requiring hospitalization for bowel clearance.
• Polyethylene glycol electrolyte solution is a safe and effective treatment for encopresis in children over six months old when managed appropriately.
• Patients with altered mental status or impaired airway reflexes require careful monitoring during bowel clearance therapy.

Observation:

• An 11-year-old female patient experienced accidental infusion of polyethylene glycol electrolyte solution into her lungs via a nasogastric tube.
• This complication led to the rapid development of life-threatening acute lung injury.
• The patient required emergent tracheal intubation, suctioning, and mechanical ventilation due to respiratory failure.

Findings:

• Accidental pulmonary administration of polyethylene glycol electrolyte solution can cause severe acute lung injury in pediatric patients.
• Nasogastric tube administration of this solution necessitates vigilant monitoring to prevent airway complications.
• Prompt respiratory support is critical for managing acute lung injury resulting from accidental pulmonary infusion.

Implications:

• Healthcare providers must exercise extreme caution when administering polyethylene glycol electrolyte solutions via nasogastric tubes, especially in vulnerable pediatric populations.
• Enhanced protocols and training are needed to minimize the risk of accidental pulmonary infusion during bowel clearance procedures.
• This case highlights the importance of careful patient selection and close monitoring to ensure the safe use of polyethylene glycol electrolyte solutions in pediatric encopresis management.