Nursing Care of the Long‐Term Anesthetized Patient

Buriko, Yekaterina; Lyons, Bridget

doi:10.1002/9781118997246.ch46

Cited by 1 publication

(9 citation statements)

References 30 publications

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“…Continuous and exemplary nursing care is crucial for the successful management of patients undergoing MV ( 70 , 98 ). Careful thermoregulation, physiotherapy, and rigorous eye, oral, airway and bladder care are necessary to minimize complications of PPV, which include corneal, and oral ulceration, VAP, patient-ventilator asynchrony, and decubital ulcers ( 48 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…ICU hospitalization ( 99 ) and general anesthesia ( 100 ) have been associated with decreased tear production in dogs. In addition to decreased tear production, chemosis may develop in patients immobilized for long periods and can contribute to lagophthalmos and exposure keratopathy ( 98 ). Corneal ulceration has been reported in 5–36% of patients undergoing MV for all causes ( 41 , 42 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…Corneal ulceration has been reported in 5–36% of patients undergoing MV for all causes ( 41 , 42 ). Current recommendations are that ocular care be performed every 2 h and encompass gentle cleaning with saline-soaked swabs and administration of artificial tears ( 70 , 98 ). In a population of healthy anesthetized dogs, no difference in the incidence of corneal ulceration was found when the use of artificial tears alone was compared to administration of artificial tears and closure of the eyelids with tape ( 100 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…Fluorescein stain should be administered daily to evaluate both the presence and/or progression of corneal ulcers ( 70 ). If corneal ulceration is identified, broad spectrum topical antibiotics and atropine should be administered to prevent infection and the development of synechiae, respectively ( 98 ). Temporary tarsorrhaphy has been described in one patient with progressive bilateral corneal ulcers where protracted MV was anticipated ( 41 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…The most common lesions include erosions or ulceration of soft tissue structures subjected to continuous pressure from teeth, monitoring equipment, tube ties or mouth gags, as well as, swelling and ranulas of the tongue ( 41 , 101 ). The oral cavity should be inspected for lesions and care performed at least 4–6 hourly and may be required more frequently in patients with copious oral secretions ( 98 ). Mouth gags and monitoring equipment should be removed, and the tube cuff pressure checked for appropriate inflation prior to gentle suctioning of the oropharynx ( 98 , 101 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

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Mechanical ventilation in dogs and cats with tick paralysis

O'Keeffe¹,

Donaldson²

2023

Front. Vet. Sci.

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Respiratory failure from tick paralysis (TP) is an important cause of mortality in cats and dogs in Australia, occurring from a combination of respiratory muscle paralysis, upper respiratory tract obstruction and pulmonary disease. Patients may require positive-pressure ventilation in management of any combination of hypoxemia, hypoventilation or respiratory fatigue, but may also require airway management due to laryngeal paralysis. No single ventilation strategy is recommended due to the heterogenous disease presentations. Lung protective ventilation should be used in patients with pulmonary disease. Due to local and systemic effects of TP, patients are at higher risk of complications such as aspiration pneumonia and corneal ulceration and may have additional intravenous fluid and nutritional considerations. Treatment with hyperimmune serum is associated with improved outcomes. Prognosis is considered good with documented survival to discharge (STD) of 52.6–77% for animals with TP ventilated with lung disease and 90.5% for animals without lung disease. Median reported duration of ventilation for TP ranges from 23 to 48 h (range 3 h−10 days). The severity of individual neuromuscular signs and the presence of associated conditions such as aspiration pneumonia and laryngeal paralysis may necessitate longer periods of mechanical ventilation. This review aims to summarize the current recommendations regarding indications, management and prognosis of cats and dogs undergoing MV for TP and to identify areas for future research.

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Section: Management Of the Ventilated Patientmentioning

confidence: 99%