Cardiac Arrest Following GoLytely Consumption: A Potential Trigger for Hypovolemic Shock.

This case report presents a rare but severe complication of polyethylene glycol (PEG) used for colonoscopic bowel preparation. A 71-year-old male developed cardiac arrest secondary to hypovolemic shock following consumption of GoLytely. Despite being hemodynamically stable prior to ingestion, the patient experienced extreme weakness, dizziness, and orthostatic hypotension post-consumption. Evaluation ruled out other causes of arrest. While serious complications from PEG are rare, this case underscores the importance of vigilance. Further investigation is warranted to elucidate the relationship between PEG use and cardiac events and to identify potential risk factors for adverse outcomes associated with bowel preparation regimens.

A Galvanizing Solution: Colonoscopy Bowel Preparation as a Trigger for Supraventricular Tachycardia.

BACKGROUND: Polyethylene glycol (PEG)-based solutions are among the most commonly used bowel preparation regimens for colonoscopy. Although these solutions are well tolerated, rare adverse cardiac events have been reported. OBJECTIVES: We sought to identify the characteristics that may predispose patients to develop supraventricular tachycardia (SVT) after ingestion of GoLYTELY (PEG 3350 and electrolytes oral solution) in anticipation for their colonoscopy. METHODS: We performed a retrospective observational cohort study of the electronic medical record of all patients who developed SVT after ingestion of GoLYTELY solution from April 2012 to March 2019 at the John D. Dingell VA Medical Center. Clinical data were obtained through review of medical records. RESULTS: We identified 16 patients with new-onset SVT after ingestion of bowel preparation solution before undergoing the colonoscopy procedure. In all, 12 (75%) patients developed atrial fibrillation, 3 (18.8%) patients developed atrial tachycardia, and 1 patient (6.3%) developed atrial flutter. Most patients were male (93.8%), and the mean age was 69 ± 8.2 years. The commonly associated comorbidities were hypertension (87.5%), hyperlipidemia (56.3%), and diabetes (37.5%). Laboratory testing demonstrated a normal electrolyte panel and thyroid stimulating hormone level. A significant percentage of patients had dilated atria and left-ventricular hypertrophy on echocardiogram. CONCLUSION: Our case series suggests that there may be certain individuals who are predisposed to development of atrial arrhythmias, more so than others, after ingestion of PEG based solution for colonoscopy. We hypothesize that the combination of atrial dilation, sympathovagal discharge, and transient electrolyte shifts at the cellular level led to the development of SVTs.

Management of polyethylene glycol solution aspiration using bronchoscopic lavage in a dog.

Polyethylene glycol lavage solutions are used for colonic preparation in dogs and are considered relatively safe. Aspiration is an uncommon but potentially devastating complication of polyethylene glycol administration. Full recovery is possible and often rapid in people treated with bronchoalveolar lavage. A healthy 2-year-old male Beagle used in an endoscopy teaching laboratory aspirated a small amount of polyethylene glycol lavage solution. Although initially appearing unaffected, the dog quickly became hypoxemic. Bronchoscopy was used to lavage the lungs and aspirate tracheal/pulmonary fluid 5 times over the course of 45 minutes. The dog completely recovered. This report presents the successful treatment of polyethylene glycol aspiration in a dog. Although the seriousness of aspiration might not be immediately evident, bronchoscopy and lavage should be pursued because of the rapidly progressive nature of polyethylene glycol-induced pulmonary edema.

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review.

PURPOSE: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). SUMMARY: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. CONCLUSION: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.