Complications arising from excess absorption and/or decreased excretion of phosphate:
(1) hyperphosphatemia
(2) hypocalcemia
(3) hypokalemia
(4) metabolic acidosis
(5) dehydration
(6) hypernatremia
(7) cardiac arrest
Patients at risk for metabolic complications:
(1) renal disease (renal dysplasia, chronic renal failure)
(2) congenital or acquired intestinal disorders (imperforate anus, Hirschsprung's disease)
(3) children under 5 years of age
Guidelines to minimize the risk of complications:
(1) do not use in children under the age of 2 years
(2) do not use in children from 2 to 5 years of age with intestinal or renal disorders
(3) if stool impaction is present, disimpaction should be performed prior to use of the enema
(4) if a child is 2 to 5 years of age and if other methods have been tried unsuccessfully, then only a single Fleet administration should be used
(5) an alternative to Fleet enema is a saline enema given at a dose of 20 mL per kg body weight
|
Patient
|
Dose of Fleet Enema
|
|
child weighing 14 kg
|
30 mL
|
|
child weighing 27 kg
|
60 mL
|
|
child weighing 40 kg
|
90 mL
|
|
adult
|
120 mL
|
If this data is analyzed in JMP, the following dose equation can be derived for patient up to 54 kilograms (with 120 mL supplied at higher weights):
volume of Fleet enema to use in mL =
= (2.2549 * (weight in kilograms)) - 1.102
