Urtikarija kao rijetka nuspojava polietilen glikola-3350 kod djeteta: prikaz slučaja

Polyethylene glycol electrolyte (PEG-3350) solution is usually used for bowel emptying before co-lonoscopy in adults. It has also been reported to be safe in children. It is thought that bowel irrigation with this solution can be a useful treatment alternative for poisoning with slow releasing drugs, swallowed packaged substances, enteric coated drugs, drugs not binding to charcoal, and heavy metals in children. Due to high molecular weight of PEG-3350, its absorption from the intestinal mucosa is very low (0.2%). Therefore, it is less likely to have side effects. A three-year-old girl bit and ate one-third of an alkali battery and was brought to our pediatric emergency unit. Vital signs and results of physical examination and laboratory investigations were normal. Irrigation of the bowels with PEG-3350 solution given orally at a rate of 20 mL/kg/h was initiated. Upon excretion of feces of normal appearance in the sixth hour, irrigation was continued. Since rashes and itching started throughout her body in the thirtieth hour after administration of 9 L PEG-3350, the irrigation was discontinued and the patient was administered antihistamines. Rashes and itching regressed within one hour of its discontinuation. This suggested that they were due to the irrigation solution. There are five adult cases of allergic reactions to PEG-3350 reported in the literature. The case presented is the first pediatric patient developing allergic reaction to PEG-3350.Otopina polietilen glikola (PEG-3350) najčešće se primjenjuje za pražnjenje crijeva prije kolonoskopije u odraslih osoba, a opisuje se kao sigurno sredstvo i u djece. Smatra se da ispiranje crijeva ovom otopinom može biti korisna alternativa za liječenje otrovanja lijekovima sa sporim otpuštanjem, progutanim pakovanjima nekih tvari, lijekovima sa zaštitnom ovojnicom za probavni sustav, lijekovima koji se ne vežu na ugljen te teškim metalima u djece. Zbog velike molekularne težine vrlo mali dio PEG-3350 (0,2%) se apsorbira iz crijevne sluznice pa su stoga nuspojave manje vjerojatne. Djevojčica u dobi od tri godine zagrizla je i progutala jednu trećinu alkalne baterije pa je dovedena u našu hitnu pedijatrijsku službu. Vitalni znaci kao i rezultati fizikalnog pregleda i laboratorijskih pretraga bili su normalni. Započeto je ispiranje crijeva otopinom PEG-3350 peroralno, 20 mL/kg/h. Nakon što je dijete imalo stolicu normalnog izgleda u šestom satu, ispiranje je nastavljeno. Međutim, nakon što je djevojčica primila 9 L PEG-3350, u tridesetom satu davanja otopine nastupio je osip i svrbež po čitavom tijelu pa je ispiranje crijeva prekinuto i djetetu su dani antihistaminici. Osip i svrbež su se povukli unutar jednog sata od prestanka ispiranja otopinom PEG-3350. U literaturi je opisano pet slučajeva alergijskih reakcija na PEG-3350 u odraslih osoba. Ovaj prikaz opisuje prvi slučaj alergijske reakcije na PEG-3350 u djeteta

A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)

Background/aim: To characterize the clinical course of noninvasive positive pressure ventilation (NIPPV) and high flow humidified nasal cannula ventilation (HFNC) procedures; perform risk analysis for ventilation failure

A Multicentered Study on Efficiency of Noninvasive Ventilation Procedures (SAFE-NIV).

Background/aim: To characterize the clinical course of noninvasive positive pressure ventilation (NIPPV) and high flow humidified nasal cannula ventilation (HFNC) procedures; perform risk analysis for ventilation failure