Aspiration: A Possible Severe Complication in Colonoscopy Preparation of Elderly People by Orthograde Intestine Lavage

Gabel, Andreas; Müller, Stefan A.

doi:10.1159/000007672

Cited by 23 publications

(16 citation statements)

References 3 publications

(2 reference statements)

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“…87 Rare adverse events in patients receiving PEG have been reported and include nausea with and without vomiting, abdominal pain, pulmonary aspiration, Mallory-Weiss tear, PEG-induced pancreatitis and colitis, lavage-induced pill malabsorption, cardiac dysrhythmia, and the syndrome of inappropriate antidiuretic hormone. 2,[88][89][90] An increase in plasma volume has been shown to occur in some individuals with concomitant disease states that predispose them to fluid retention. 91,92 Adverse effects may occur less frequently in association with preparation regimens that use a reduced volume of PEG.…”

Section: Safetymentioning

confidence: 99%

A Consensus Document on Bowel Preparation Before Colonoscopy: Prepared by a Task Force From The American Society of Colon and Rectal Surgeons (ASCRS), The American Society for Gastrointestinal Endoscopy (ASGE), and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

Wexner

Beck

Baron

et al. 2006

Diseases of the Colon &Amp; Rectum

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Section: Safetymentioning

confidence: 99%

A Consensus Document on Bowel Preparation Before Colonoscopy: Prepared by a Task Force From The American Society of Colon and Rectal Surgeons (ASCRS), The American Society for Gastrointestinal Endoscopy (ASGE), and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

Wexner

Beck

Baron

et al. 2006

Diseases of the Colon &Amp; Rectum

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“…The remaining 8 patients (cases 5-12; age 5-86 years) did not have radiographic evidence of the location of the nasogastric tube at any time. [8][9][10][11][12][13][14][15] Pulmonary complications from the PEG-ES infusions contributed to the death of 5 of these patients (cases 6-10).…”

Section: Resultsmentioning

confidence: 99%

“…Fluid withdrawn from the nasogastric tube in case 7 was described as "acidic." 10 Although an aspirate with a low pH most likely rules out respiratory placement, it cannot rule out esophageal placement, given that fluid withdrawn from the esophagus could be refluxed acidic gastric contents. 18,19 Signs of gastrointestinal intolerance were observed in multiple cases; for example, vomiting occurred in 6 patients (cases 2, 3, 6, 10, 11, and 12) before development of respiratory symptoms.…”

Section: Commentsmentioning

confidence: 99%

Administering Polyethylene Glycol Electrolyte Solution Via a Nasogastric Tube: Pulmonary Complications

Metheny

Meert

2017

American Journal of Critical Care

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Background Patients sometimes require insertion of a nasogastric tube for the administration of a large volume of a polyethylene glycol electrolyte solution. If the tube is malpositioned, the risk for direct instillation of the solution into the lung increases. The risk for aspiration also increases if the infusion rate exceeds gastrointestinal tolerance. Purpose To review published cases of patients’ experiencing adverse pulmonary events after administration of polyethylene glycol electrolyte solution via a nasogastric tube and to offer suggestions to prevent these outcomes. Methods A search of the literature from 1993 through 2014 was performed by using the PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Scopus databases. Results In the 12 case reports located, none of the patients had radiographs to verify tube location before infusion of polyethylene glycol electrolyte solution. After symptoms developed in 3 children (ages 8–11 years), radiographs showed their tubes incorrectly positioned in the bronchus, lung, or esophagus; ports of a fourth child’s tube were in the oropharynx. The remaining 8 patients (ages 5–86 years) never had radiographs to determine tube placement. Pulmonary complications from the infusions of polyethylene glycol electrolyte solution contributed to the death of 5 of the patients. Conclusion Relatively simple maneuvers to reduce the likelihood of adverse pulmonary events following the administration of large volumes of polyethylene glycol electrolyte solution via a nasogastric tube are well worth the cost and effort to protect patients from potential serious injury.

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“…In elderly patients or patients whose medical conditions prevent oral administration, nasogastric administration may be required. Caution and vigilance must be taken to ensure that the tube is properly positioned and that the patient is closely monitored, because aspiration may result in fatal complications [34].…”

Section: Cleansing Regimensmentioning

confidence: 99%

Update on Preparation for Colonoscopy

Landreneau¹,

Palma²

2010

Curr Gastroenterol Rep

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Colonoscopy requires adequate bowel cleansing to be safe and effective. Current options for preparation include dietary restrictions plus cathartics and purgatives, large-volume gut lavage solutions, and sodium phosphate preparations. Gut lavage with or without a stimulant laxative is safe and effective, and traditionally is taken the evening before the procedure. Sodium phosphate formulations also provide effective cleansing, but fluid and electrolyte disturbances can occur. Recent advances include split administration of gut lavage solutions-ingesting only half of the solution the evening prior to, and the rest the morning of, the procedure. Split administration can yield adequate preparations in inpatients, traditionally a difficult group for proper cleansing. A new oral sulfate solution, when commercially available, should provide safe, effective cleaning with a lower ingested volume. This review discusses the current clinical experience of available preparation options and the efforts to make preparation for colonoscopy more tolerable.

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Aspiration: A Possible Severe Complication in Colonoscopy Preparation of Elderly People by Orthograde Intestine Lavage

Cited by 23 publications

References 3 publications

A Consensus Document on Bowel Preparation Before Colonoscopy: Prepared by a Task Force From The American Society of Colon and Rectal Surgeons (ASCRS), The American Society for Gastrointestinal Endoscopy (ASGE), and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

A Consensus Document on Bowel Preparation Before Colonoscopy: Prepared by a Task Force From The American Society of Colon and Rectal Surgeons (ASCRS), The American Society for Gastrointestinal Endoscopy (ASGE), and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

Administering Polyethylene Glycol Electrolyte Solution Via a Nasogastric Tube: Pulmonary Complications

Update on Preparation for Colonoscopy

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