Nutritional support in the mechanically ventilated small animal patient

Chan, Daniel L.

doi:10.1002/9781119052951.ch24

Cited by 1 publication

(4 citation statements)

References 35 publications

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“…Nutritional support is recommended for patients in caloric deficit for >72 h ( 106 ). Malnutrition in mechanically ventilated patients may contribute to weakness of the respiratory muscles and difficulty weaning ( 107 ). Additionally, in critically ill humans, malnutrition has been associated with immune-impairment, increased risk of infection and high mortality rates ( 108 ), with consensus guidelines recommending appropriate caloric intake be a prominent component of therapy ( 109 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…In mechanically ventilated patients, nutrition may be delivered enterally or parenterally ( 107 ). Provision of enteral nutrition (EN) is preferred as it allows for maintenance of gastrointestinal mucosal integrity, reduction of bacterial translocation and decreases the metabolic response to stress ( 111 ).…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…Reported complications of EN include vomiting or regurgitation with subsequent aspiration, dislodgement of the tube, delivery of nutrition outside of the gastrointestinal tract and infections at the stoma site ( 110 ). Critically ill animals receiving MV are at risk of gastrointestinal and esophageal dysmotility ( 107 ). Additionally, megaesophagus is prominent features of TP ( 15 ) and a clinician should be conscious of the significant aspiration risk these cases present when considering an EN feeding plan.…”

Section: Management Of the Ventilated Patientmentioning

confidence: 99%

“…EN via nasogastric (NG) tube is a minimally invasive and cost-effective ( 113 ) way to provide nutritional support to mechanically ventilated patients with TP. Due to the increased risk of regurgitation and aspiration in this population ( 30 ), patients with TP should only be considered for enteral nutrition if they are cardiovascularly stable, have no regurgitation and have gastric residual volume (GRV) <10 ml/kg ( 107 ). Animals meeting these criteria should be commenced on a low percentage of their daily recommended energy requirement (RER) and very gradually increased if tolerance is demonstrated by continually low GRV ( 114 ).…”

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%

Section: Management Of the Ventilated Patientmentioning

confidence: 99%