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Whole bowel irrigation: experience in pediatric patients
Insights
Whole bowel irrigation (WBI) is a safe and effective method for pediatric colon cleansing. This study shows WBI in children leads to satisfactory colonic preparation and reduced postoperative complications.
Area of Science:
- Pediatric Gastroenterology
- Surgical Preparation
- Medical Procedures
Background:
- Whole bowel irrigation (WBI) is a method for cleansing the colon.
- Pediatric patients require effective bowel preparation for procedures like surgery and colonoscopy.
- Assessing the safety and efficacy of WBI in children is crucial.
Purpose of the Study:
- To evaluate the effectiveness and safety of whole bowel irrigation (WBI) in pediatric patients undergoing surgery or colonoscopy.
- To determine optimal WBI administration rates based on age and tolerance.
- To assess the impact of WBI on postoperative infectious complications.
Main Methods:
- Whole bowel irrigation (WBI) was administered to 50 children (16 months to 14 years) using a hydroelectrolytic solution.
- Patients were grouped by age (12-36 months, 3-6 years, 6-14 years).
- Antibiotics (neomycin and erythromycin) were given for colorectal surgery preparation. Vital signs and blood parameters were monitored.
Main Results:
- WBI was well-tolerated across all age groups, with specific administration rates determined for each group.
- Colonic preparation was satisfactory in 49 out of 50 pediatric patients.
- Postoperative infectious complications were significantly reduced to 3.3%.
Conclusions:
- Whole bowel irrigation (WBI) is a fast, simple, and well-tolerated method for pediatric colon cleansing.
- WBI ensures excellent colonic condition for surgery and colonoscopy in children.
- This method considerably decreases the incidence of postoperative complications in pediatric patients.
Abstract:
Whole bowel irrigation (WBI) was used in 50 children aged 16 months to 14 years in preparation for surgery (n = 30) and colonoscopy (n = 20). The patients were divided into three groups according to age: group A, 12 to 36 months; group B, 3 to 6 years; and group C, 6 to 14 years. A hydroelectrolytic solution (Na 150 mEq/L, K 30 mEq/L, Cl 130 mEq/L, HCO3 50 mEq/L) was administered to all the groups at a variable rate established according to tolerance, weight, and age. Neomycin (1 g) and erythromycin (50 mg/kg) were administered in the last liter of the solution of the patients being prepared for colorectal surgery. Vital signs (heartbeat, arterial tension, and central venous pressure) and blood parameters (Na, K, HCO3, pH, and Hct) were assessed before and after irrigation and remained stable in all the groups. The rate of administration of the solution was best tolerated in each group as follows: group A, 75 mL/kg/h; group B, 60 mL/kg/h; and group C, 45 mL/kg/h. Colonic preparation was satisfactory in 49 of the 50 cases. Postoperative infectious complications were reduced to 3.3%. WBI in pediatric patients is a fast, simple, and well-tolerated method that gets a colon in excellent condition for surgery and colonoscopy exploration and considerably decreases the number of postoperative complications.