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Related Experiment Videos

Using saline solutions for ACE washouts.

S-J Hyde1, M G Coulthard, B Jaffray

  • 1Medical School, Newcastle University, Newcastle, UK.

Archives of Disease in Childhood
|September 21, 2007
PubMed
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Normal saline (NS) enemas are recommended for children undergoing antegrade continence enema (ACE) lavages. While twice-normal saline (2NS) is effective, it causes adverse symptoms, unlike carefully prepared NS.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Bowel Management

Background:

  • Antidegrade continence enema (ACE) lavages are used for bowel management in children.
  • Twice-normal saline (2NS) lavages have shown efficacy but are associated with adverse symptoms.
  • The optimal fluid for ACE lavages requires further investigation.

Purpose of the Study:

  • To compare the safety and efficacy of water, normal saline (NS), and twice-normal saline (2NS) for ACE lavages in children.
  • To evaluate the physiological effects of different lavage solutions.
  • To provide recommendations for home-based ACE lavage protocols.

Main Methods:

  • A double-blind crossover study was conducted in four children comparing water, NS, and 2NS.
  • Physiological parameters including plasma osmolality and sodium were monitored.

Related Experiment Videos

  • Home testing was performed by five additional children to assess practical application and efficacy.

    • Main Results:

    • Water lavage caused a transient fall in plasma osmolality and reduced urine sodium/osmolality.
    • 2NS lavage led to increased plasma sodium and proteins, with fluid shifts into the colon, causing thirst in some subjects.
    • Home-prepared saline varied in concentration; 30 ml/kg NS achieved similar results to 20 ml/kg 2NS.

    Conclusions:

    • Carefully prepared normal saline (NS) is the recommended fluid for ACE lavages.
    • Adjusting the volume of NS may be necessary to achieve adequate results.
    • Avoiding 2NS and ensuring accurate saline preparation are crucial for safe and effective home ACE protocols.