title: Safety of a 1-Day Polyethylene Glycol 3350 Bowel Preparation for Colonoscopy in Children.
abstract: Electrolyte-free polyethylene glycol powder (PEG-3350) has been widely used for colonoscopy preparation (prep); however, limited safety data on electrolyte changes exists with 1-day prep regimens. The primary aim of this study was to determine the proportion of patients with significant serum chemistry abnormalities before and at the time of colonoscopy. Secondary aims included evaluation of prep tolerance and bowel cleansing efficacy.
  
  
  
  We performed a prospective descriptive observational study of pediatric patients scheduled for outpatient colonoscopy who received our standard 1-day, weight-based 4 g/kg PEG-3350 prep with a single stimulant laxative dose and had serum chemistry testing within 60 days before and at the time of colonoscopy. A standardized bowel cleanliness tool (Aronchick scale) was completed by the endoscopist.
  
  
  
  One hundred fifty-five patients had serum electrolytes data pre- and postprep. Comparison of each patient's chemistries demonstrated statistical equivalence with the 1 exception of blood urea nitrogen levels (P = 0.56). Hypokalemia was detected postprep in 37 subjects (24%), but none had a serum level <3.3 mmol/L, which was deemed to be of no clinical significance. Five patients were hypoglycemic post prep; 3 were 7 years or younger (P = 0.02). The colon cleanliness rating was excellent or good in 77% and suboptimal in 23% of patients.
  
  
  
  A 1-day, weight-based PEG-3350 bowel prep in children appears safe. Changes in electrolyte levels and renal function were not clinically significant. Children of 7 years or younger seem to be at a higher risk of hypoglycemia compared with older children.
authors.affiliation: *Division of Gastroenterology & Nutrition, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park†Department of Nursing‡Biostatistics and Data Management Core§Division of Gastroenterology, Hepatology, & Nutrition, The Children's Hospital of Philadelphia, PA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sahn
authors.forename: Mei Lin
authors.initials: ML
authors.lastname: Chen-Lim
authors.forename: Denise
authors.initials: D
authors.lastname: Ciavardone
authors.forename: Lisa
authors.initials: L
authors.lastname: Farace
authors.forename: Frances
authors.initials: F
authors.lastname: Jannelli
authors.forename: Megan
authors.initials: M
authors.lastname: Nieberle
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ely
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhang
authors.forename: Judith
authors.initials: J
authors.lastname: Kelsen
authors.forename: Anita
authors.initials: A
authors.lastname: Puma
authors.forename: Petar
authors.initials: P
authors.lastname: Mamula
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003113:Colonoscopy; D004334:Drug Administration Schedule; D004573:Electrolytes / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D013501:Surface-Active Agents / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D004573:Electrolytes; D013501:Surface-Active Agents; D011092:Polyethylene Glycols