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Using saline solutions for ACE washouts

Lookup NU author(s): Dr Malcolm Coulthard, Bruce Jaffray

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Abstract

We had found that twice-normal saline (2NS) antegrade continence enema (ACE) lavages were better than with normal saline (NS) but caused unpleasant symptoms. We therefore undertook a double-blind crossover study comparing water, NS and 2NS in four children. NS produced no disturbances, but water caused a transient fall in plasma osmolality of 7.3 mosmol/kg at 20 min, and falls in urine sodium and osmolality. With 2NS, the plasma sodium rose by 2.5 mmol/l, the plasma proteins rose by 2.3 g/l and the lavage fluid sodium fell, suggesting that about 10 ml/kg of plasma water had moved into the colonic lumen, and two subjects became thirsty. Five other children did home testing. Their home-produced saline was too concentrated and varied widely, and they found that 30 ml/kg of NS produced the same washout result as 20 ml/kg of 2NS. Carefully made-up NS should be used for lavage, increasing volumes if necessary.

Publication metadata

Author(s): Hyde S-J, Coulthard MG, Jaffray B, Vallely ME, Harding SM

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood

Year: 2008

Volume: 93

Issue: 2

Pages: 149-150

Date deposited: 08/06/2010

ISSN (print): 0003-9888

ISSN (electronic): 1468-2044

Publisher: BMJ Group

URL: http://dx.doi.org/10.1136/adc.2007.123489

DOI: 10.1136/adc.2007.123489

PubMed id: 17881423

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