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Protocol for treatment of constipation with polyethylene glycol 3350 plus electrolytes in critically ill children
Jorge López1, María G Barba2, Sarah N Fernández1
1Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network, Redes de Investigación Cooperativa Orientadas a Resultados en Salud [RICORS]) (RD21/0012/0011), Instituto de Salud Carlos III, Universidad Complutense de Madrid, Madrid, Spain.
Insights
Polyethylene glycol 3350 with electrolytes (PEG 3350 + E) effectively treated constipation in critically ill children, with a notable success rate in those under two years old. This treatment showed few adverse events, making it a safe option for pediatric intensive care units.
Area of Science:
- Pediatric Critical Care Medicine
- Gastroenterology
- Pharmacology
Background:
- Constipation is a common issue in critically ill children, yet treatment effectiveness remains understudied.
- Existing treatments may have limitations in this vulnerable population.
Purpose of the Study:
- To assess the implementation, efficacy, and safety of a polyethylene glycol 3350 with electrolytes (PEG 3350 + E) protocol for constipation in critically ill children.
- To compare PEG 3350 + E with traditional rectal enemas.
Main Methods:
- A single-centre prospective study included 56 critically ill children (minimum 72h ICU stay) who developed constipation.
- Patients received either oral PEG 3350 + E or rectal enemas, with physician discretion.
- Clinical outcomes, demographic variables, and adverse events were compared between treatment groups.
Main Results:
- Polyethylene glycol 3350 with electrolytes (PEG 3350 + E) was used in 78.6% of patients, with a 79.5% response rate compared to 58.3% for enemas (not statistically significant).
- Adverse events like diarrhea, abdominal distension, and electrolyte imbalances were similar between groups.
- PEG 3350 + E showed significantly higher efficacy in children under 2 years old (100% response) compared to older children (65.4% response; P < .01).
Conclusions:
- The polyethylene glycol 3350 with electrolytes (PEG 3350 + E) protocol is an effective and safe treatment for constipation in critically ill children.
- The protocol demonstrated particular effectiveness in younger children (under 2 years) with a low incidence of adverse events.
Introduction And Objectives:
No studies have analysed the effectiveness of treatment for constipation in critically ill children. The aim of this study was to assess the implementation, efficacy and safety of a treatment protocol using polyethylene glycol 3350 with electrolytes (PEG 3350 + E) for constipation in critically ill children.
Methods:
We conducted a single-centre prospective study in children admitted to the paediatric intensive care unit for a minimum of 72 h and who developed constipation. Children with previous gastrointestinal disorders or diseases were excluded. The patients were treated with rectal enemas or with the oral PEG 3350 + E protocol at the discretion of the treating physician. We compared clinical and demographic variables as well as adverse events (diarrhoea, abdominal distension and electrolyte imbalances).
Results:
The sample included 56 patients with a mean age of 48.2 ± 11.9 months, of who 55.4% were male. Forty-four patients (78.6%) were treated with PEG 3350 + E and 12 (21.4%) with rectal enemas. The proportion of patients that responded well to treatment was greater in the PEG 3350 + E group (79.5%) compared to the enema group (58.3%), but the difference was not statistically significant (P = .151). There were no significant differences between the groups in any of the adverse effects. Treatment with PEG 3350 + E was more effective in children aged less than 2 years (100%) compared to older children (100% vs 65.4%; P < .01), with no significant differences in the development of adverse events.
Conclusions:
The PEG 3350 + E treatment protocol for constipation in critically ill children was effective and associated with few adverse events, even in children aged less than 2 years.
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