Unintentional intravenous infusion of Golytely in a 4-year-old girl.
OBJECTIVE
To report an accidental intravenous infusion of Golytely (polyethylene glycol and electrolyte solution; PEG-ELS) in a pediatric patient that did not result in systemic toxicity.


METHODS
A 4-year-old Hispanic girl presented to the emergency department after ingestion of approximately 24 tablets of 6-mercaptopurine (6-MP) 2 hours earlier. She vomited twice after receiving syrup of ipecac at home. Upon arrival, her vital signs were temperature 36.2 degrees C, heart rate 102 beats/min, respiratory rate 42 breaths/min, and blood pressure 115/67 mm Hg. Her physical examination was normal. The patient received activated charcoal 1 g/kg. Golytely administered through a nasogastric tube was ordered. Upon reevaluation, it was noted that the patient had received 391 mL of Golytely intravenously. The infusion was immediately stopped. There was no evidence of acidosis, renal failure, or ethylene glycol toxicity. She was admitted for observation and was discharged 36 hours later.


CONCLUSIONS
As of April 29, 2004, accidental intravenous infusion of PEG-ELS has not been previously reported. Potential toxicity from Golytely is mainly related to the molecular weight of PEG in the formulation. PEG can theoretically be degraded to ethylene glycol. It is thus important to monitor acid-base status, renal function, and pulmonary function in these patients.


CONCLUSIONS
When administered correctly, an infusion of PEG-ELS by nasogastric tube is a safe gastrointestinal decontamination technique used in toxicology; PEG-ELS is not indicated for intravenous administration. Protocols need to be implemented in the workplace to minimize errors in the delivery of treatment to patients. Fortunately, this patient did not have any toxicity from the intravenous infusion of Golytely.
Rivera
Wilfredo
W
University of Texas Southwestern (UTSW) Emergency Medicine/Section of Toxicology, Dallas, TX 75390-8579, USA. wilfredo.rivera@utsouthwestern.edu
Velez
Larissa I
LI
Guzman
Daniel D
DD
Shepherd
Greene
G
D002675:Child, Preschool; D004573:Electrolytes / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008508:Medication Errors; D011092:Polyethylene Glycols / Q000008:administration & dosage*
D004573:Electrolytes; C033608:Golytely; D011092:Polyethylene Glycols