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Respiratory failure requiring extracorporeal membrane oxygenation after sodium phosphate enema intoxication
David B Everman1, Mara E Nitu2,3, Brian R Jacobs2
1Greenwood Genetic Center, Greenwood, South Carolina, USA, USA.
Insights
Hypertonic sodium phosphate enemas can cause severe adverse effects in children, including cardiopulmonary failure. This case highlights the critical risks associated with these laxatives.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Critical Care Medicine
Background:
- Hypertonic sodium phosphate enemas are commonly used as laxatives in pediatric patients.
- Potential adverse effects, including electrolyte disturbances and renal injury, are known.
- Severe toxicity is rare but can be life-threatening.
Observation:
- A case of a child experiencing severe toxicity after receiving a hypertonic sodium phosphate enema is presented.
- The child developed cardiopulmonary failure requiring advanced life support.
- Extracorporeal membrane oxygenation (ECMO) was necessary to manage the critical condition.
Findings:
- Hypertonic sodium phosphate enemas can lead to severe systemic toxicity in children.
- Cardiopulmonary failure is a potential, albeit unusual, complication.
- Prompt recognition and aggressive management are crucial for patient survival.
Implications:
- Clinicians should exercise caution when prescribing hypertonic sodium phosphate enemas for pediatric use.
- Awareness of potential severe adverse events, including cardiopulmonary failure, is essential.
- Alternative, safer laxative options should be considered for pediatric patients.
Unlabelled:
A variety of adverse effects are associated with the use of hypertonic sodium phosphate enemas and laxatives in children. We describe an unusual case of phosphate enema toxicity in a child that resulted in cardiopulmonary failure necessitating the use of extracorporeal membrane oxygenation. The toxicity associated with hypertonic sodium phosphate enemas is reviewed.
Conclusion:
Hypertonic sodium phosphate enemas can cause cardiopulmonary failure.