Whole bowel irrigation with lactated Ringer's solution in children: A prospective study

Abstract

Purpose: A prospective study was carried out to evaluate the effects of whole bowel irrigation with lactated Ringer's solution on the vital signs, serum biochemistry and quality of bowel cleansing. Methods: 234 whole bowel irrigation were performed in pediatric patients ages 1 month to 15 years. Lactated Ringer's solution warmed to body temperature was infused into the stomach via a nasogastric tube or a gastrostomy tube at a rate of 40 ml/kg/h until 60 minutes after the rectal or stomal effluent was clear. Vital signs (blood pressure, pulse and respiratory rate) were monitored during the procedure and body weight, serum biochemistry (Na, K, Cl, Urea), hematocrit concentrations were assessed before and after lavage. The adequacy of bowel preparation was categorized as satisfactory if no fecal material was encountered, adequate if small amounts of fecal material were present in scattered locations, and poor if there was considerable fecal material. Results: Vital signs remained stable during the procedure. There was a mean weight gain of 1.3 percent but no gross electrolyte, urea and hematocrit disturbances. Whole bowel irrigation was well tolerated by the patients. Subjective complaints were mild and included distending discomfort (10%) and nausea / vomiting (7%). Results of bowel preparation were satisfactory in 91.8%, adequate in 7.8 % and poor in 0.4%. Conclusion: The results show that whole bowel irrigation with lactated Ringer's solution is a cheep, safe and satisfactory method of bowel preparation for pediatric patients.