Electrolyte disorder, metabolic acidosis, and hyponatremia encephalopathy caused by polyethylene glycol electrolytes powder (Ⅳ)
10.3760/cma.j.cn114015-20181216-01249
- VernacularTitle:复方聚乙二醇电解质散（Ⅳ）引起电解质紊乱、代谢性酸中毒和低钠血症性脑病
- Author:
Man XING
1
;
Shiqiang SHI
;
Jing GAO
;
Na WANG
Author Information
1. 西安交通大学第二附属医院（西北医院）药学部 710004；山东省青岛市第三人民医院药学部 266041
- Publication Type:Journal Article
- Keywords:
Polyethylene glycols;
Powders;
Hyponatremia;
Water-electrolyte imbalance;
Epilepsy
- From:
Adverse Drug Reactions Journal
2020;22(4):270-271
- CountryChina
- Language:Chinese
-
Abstract:
A 61-year-old female patient underwent intestinal preparation before electronic colonoscopy. She took polyethylene glycol electrolytes powder (Ⅳ) in 6 times (dissolved content A 24 bags and B 24 bags in warm water 3 000 ml and then took 500 ml orally per 30 minutes). During the intestinal preparation, the patient′s urine output was about 4 500 ml, diarrhea occurred 8 times, and she vomited 2 times within 5.5 hours. The patient fell into a coma at 14:00 on the day, accompanied by limb convulsion and trismus. Laboratory tests showed that the serum sodium and potassium decreased from 140 mmol/L and 4.0 mmol/L to 120 mmol/L and 2.7 mmol/L before and after treatment, respectively. In addition, his chloride was 87.2 mmol/L and bicarbonate was 11.5 mmol/L. Blood gas analysis showed pH 7.29 mmHg, partial pressure of carbon dioxide 31 mmHg, partial pressure of oxygen 105 mmHg, and base excess -10.4 mmol/L. Metabolic acidosis was diagnosed. Head CT and MRI showed no abnormalities. Electrolyte disorder, metabolic acidosis, and hyponatremia encephalopathy due to hyponatremia caused by polyethylene glycol electrolytes powder (Ⅳ) was considered. Oxygen inhalation, continuous ECG monitoring, correction of electrolyte disorders, correction of acidosis, rehydration, and other symptomatic and supportive treatments were given immediately. After 4 hours of treatments, the vital signs of the patient were gradually stable but she was still in a coma. On the third day of treatments, the patient was conscious, her serum electrolytes returned to normal, and no seizures occurred.
