The Risks of Phosphate Enemas in Toddlers: A Life-Threatening Unawareness.

constipation pediatric gastroenterology phosphate-containing enemas side effects

Journal

Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936

Informations de publication

Date de publication:
15 Mar 2024
Historique:
received: 18 02 2024
revised: 09 03 2024
accepted: 13 03 2024
medline: 28 3 2024
pubmed: 28 3 2024
entrez: 28 3 2024
Statut: epublish

Résumé

While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs). Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians' awareness of PcE risks. We conducted an online survey by sending a multiple-choice questionnaire to the referents of 51 PEDs and 101 FPs. We collected and compared the answers with recommendations reported by the Italian Drug Agency (AIFA) and the available literature about PcE administration. Of the institutions and pediatricians receiving the questionnaire, 23 PEDs (45%) and 63 FP (62.3%) participated in the survey. Of PEDs, 95% and 33.0% of FPs treated fecal impaction with PcE. Moreover, 54% of PEDs and 86.0% of FPs did not provide treatment according to the AIFA recommendations for the daily dose. This study shows limited pediatricians' awareness of the potential risks related to PcE.

Sections du résumé

BACKGROUND BACKGROUND
While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs).
OBJECTIVES OBJECTIVE
Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians' awareness of PcE risks.
METHODS METHODS
We conducted an online survey by sending a multiple-choice questionnaire to the referents of 51 PEDs and 101 FPs. We collected and compared the answers with recommendations reported by the Italian Drug Agency (AIFA) and the available literature about PcE administration.
RESULTS RESULTS
Of the institutions and pediatricians receiving the questionnaire, 23 PEDs (45%) and 63 FP (62.3%) participated in the survey. Of PEDs, 95% and 33.0% of FPs treated fecal impaction with PcE. Moreover, 54% of PEDs and 86.0% of FPs did not provide treatment according to the AIFA recommendations for the daily dose.
CONCLUSIONS CONCLUSIONS
This study shows limited pediatricians' awareness of the potential risks related to PcE.

Identifiants

pubmed: 38539384
pii: children11030349
doi: 10.3390/children11030349
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : Ministero della Salute
ID : N/A

Auteurs

Alessandro Zago (A)

Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy.

Alessandro Agostino Occhipinti (AA)

Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy.

Matteo Bramuzzo (M)

Department of Pediatrics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy.

Viola Ceconi (V)

Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy.

Vincenzo Colacino (V)

Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy.

Egidio Barbi (E)

Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy.
Department of Pediatrics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy.

Federico Poropat (F)

Department of Pediatrics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy.

Classifications MeSH