The American journal of gastroenterology
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Am. J. Gastroenterol. · Jun 1993
Review Case ReportsFatal hyperphosphatemia following Fleet Phospo-Soda in a patient with colonic ileus.
A fatal case of hyperphosphatemia secondary to enteral administration of Fleet Phospo-Soda is presented. A 64-yr-old male admitted for theophylline toxicity was treated with activated charcoal and sorbitol, but subsequently developed colonic ileus. Two sequential doses of Phospo-Soda were administered to facilitate clearance of the charcoal; however, this resulted in marked hyperphosphatemia, hypocalcemia, acidemia, and other electrolyte abnormalities, followed by the patient's demise. This case is added to several other reports about the risks of injudicious use of sodium phosphate cathartics.
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Large volume paracentesis (LVP) is a safe, rapid, and effective treatment of ascites in cirrhotic patients. We investigated the effects of a 5-L aspiration of ascites on pulmonary function parameters in eight hemodynamically stable patients with cirrhosis and tense ascites. None had known lung disease or abnormal chest roentgenograms. ⋯ Post-LVP, lung volumes increased significantly; the mean expiratory reserve volume showed the greatest percent increase (105%) and correlated with the increases in the vital capacity, functional residual capacity, and total lung capacity. Airflow, the mean diffusing capacity, and arterial oxygenation were not significantly changed after LVP. We conclude that LVP significantly increases indices of lung volume but does not significantly alter parameters of airflow or gas exchange.