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幼儿使用磷酸盐灌肠剂的风险:危及生命的未被重视情况。

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

作者信息

Zago Alessandro, Occhipinti Alessandro Agostino, Bramuzzo Matteo, Ceconi Viola, Colacino Vincenzo, Barbi Egidio, Poropat Federico

机构信息

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.

出版信息

Children (Basel). 2024 Mar 15;11(3):349. doi: 10.3390/children11030349.

DOI:10.3390/children11030349
PMID:38539384
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10968950/
Abstract

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

Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians' awareness of PcE risks.

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

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

This study shows limited pediatricians' awareness of the potential risks related to PcE.

摘要

背景

虽然口服泻药是粪便嵌塞的一线治疗方法,但灌肠剂在儿科急诊科(PEDs)和家庭儿科医生(FPs)的临床实践中经常使用。

目的

含磷酸盐灌肠剂(PcEs)被普遍使用,甚至会导致罕见但致命的毒性风险。我们调查了儿科医生对PcE风险的认知情况。

方法

我们通过向51个儿科急诊科和101位家庭儿科医生的负责人发送多项选择题问卷进行了一项在线调查。我们收集了答案并与意大利药品管理局(AIFA)报告的建议以及有关PcE给药的现有文献进行了比较。

结果

在收到问卷的机构和儿科医生中,23个儿科急诊科(45%)和63位家庭儿科医生(62.3%)参与了调查。在儿科急诊科中, 95%的医生和33.0%的家庭儿科医生使用PcE治疗粪便嵌塞。此外,54%的儿科急诊科和86.0%的家庭儿科医生未按照AIFA的每日剂量建议进行治疗。

结论

这项研究表明儿科医生对与PcE相关的潜在风险的认知有限。

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2
The science of Hirschsprung disease: What we know and where we are headed.先天性巨结肠症的科学研究:我们的所知与未来方向。
Semin Pediatr Surg. 2022 Apr;31(2):151157. doi: 10.1016/j.sempedsurg.2022.151157. Epub 2022 Apr 18.
3
Toxicity of phosphate enemas - an updated review.磷酸盐灌肠剂的毒性——最新综述。
Clin Toxicol (Phila). 2022 Jun;60(6):672-680. doi: 10.1080/15563650.2022.2054424. Epub 2022 May 5.
4
Self-Efficacy in Children with Functional Constipation Is Associated with Treatment Success.儿童功能性便秘的自我效能感与治疗效果相关。
J Pediatr. 2020 Jan;216:19-24. doi: 10.1016/j.jpeds.2019.08.062. Epub 2019 Oct 31.
5
A Comparison of the Efficacy of Enema Solutions in Pediatric Emergency Department Patients.儿科急诊科患者灌肠溶液疗效比较
J Emerg Med. 2019 Oct;57(4):461-468. doi: 10.1016/j.jemermed.2019.07.009. Epub 2019 Oct 5.
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Quality of Life in Children with Functional Constipation: A Systematic Review and Meta-Analysis.儿童功能性便秘生活质量的系统评价和Meta 分析。
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7
Awareness and Implementation of the 2014 ESPGHAN/NASPGHAN Guideline for Childhood Functional Constipation.2014年ESPGHAN/NASPGHAN儿童功能性便秘指南的认知与实施
J Pediatr Gastroenterol Nutr. 2018 May;66(5):732-737. doi: 10.1097/MPG.0000000000001786.
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Psychological maladjustment and quality of life in adolescents with constipation.便秘青少年的心理适应不良与生活质量
Arch Dis Child. 2017 Mar;102(3):268-273. doi: 10.1136/archdischild-2016-310694. Epub 2016 Jul 11.
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