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Neostigmine in the Treatment of Refractory Constipation in Critically Ill Children

González, Rafael; López-Herce, Jesús; García, Ana; Botrán, Marta; Solana, Maria Jose; Urbano, Javier

Journal of Pediatric Gastroenterology & Nutrition: August 2011 - Volume 53 - Issue 2 - p 224–226
doi: 10.1097/MPG.0b013e3182187bab
Short Communication

ABSTRACT: Constipation is a common complication in critically ill children and it is occasionally resistant to the drugs typically used in treatment. Neostigmine has been used in some cases of refractory constipation in critically ill adults. There is no reference to its use in critically ill children. We describe 3 cases of refractory constipation in critically ill children treated with intravenous neostigmine by continuous infusion. Two patients responded well. There were no adverse effects. We conclude that continuous intravenous neostigmine can be effective in critically ill children with refractory constipation. Further studies are necessary to determine the dose and safety of the treatment.

Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Address correspondence and reprint requests to Dr J. López-Herce Cid, Pediatric Critical Care Department, Hospital General Universitario Gregorio Marañón, Dr Castelo, 47, 28009 Madrid, Spain (e-mail: pielvi@hotmail.com).

Received 17 November, 2010

Accepted 3 March, 2011

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN