Enteral Fluid Therapy Research Articles

Efeitos da nutrição parenteral total associada à glutamina, à fluidoterapia enteral, associada ou não à glutamina, e fluidoterapia sobre o lipidograma de equinos submetidos à inanição após laparotomia

ABSTRACT In order to evaluate the effect of total parenteral nutrition associated with glutamine and enteral fluid therapy, associated or not with glutamine, on the lipidogram of horses subjected to starvation (phase 1) and refeeding (phase 2), 16 adult healthy horses were used, mixed breed, aged between four and fourteen years and average weight of 248.40 ± 2.28kg, divided into four experimental groups, with four animals per group: Group ENTGL: enteral fluid therapy with electrolytes associated with glutamine; Group PARGL: total parenteral nutrition associated with glutamine; Group ENTFL: enteral fluid therapy with electrolytes; and Group PARFL: parenteral fluid therapy. This study was divided into two phases: phase 1 and phase 2. Phase 1 consisted of performing exploratory laparotomy and beginning of starvation, in addition to the administration of treatments, according to the group, while phase 2 consisted of re-feeding the animals. Total cholesterol values remained within the normal range for the species throughout the experimental period, but there was a slight increase during phase 1, followed by a decrease in values in phase 2. Hypertriglyceridemia in the ENFL, ENTGL and PARFL groups during phase 1 occurred because of the negative energy balance. The provision of enteral fluid therapy with electrolytes and an energy source, with or without glutamine, or parenteral fluid therapy were not effective in reversing the effects of negative energy balance. Thus, therapeutic protocols that combine enteral or parenteral fluid therapy for prolonged periods and food deprivation need additional nutritional support to avoid the deleterious effects of negative energy balance.

Biochemical, urinary, and acid-base profile in cattle treated with maintenance enteral electrolyte solutions containing calcium propionate, propylene glycol or glycerol.

Enteral fluid therapy administered in continuous flow through the naso-ruminal route for long periods with electrolyte solutions is safe and effective in cattle. The aim of this study was to carry out a comparative assessment between maintenance enteral electrolyte solutions containing calcium propionate, propylene glycol or glycerol administered in continuous flow in cattle. Six heifers were used and the study was carried out in a 6 × 3 crossover design, in which each animal received three different treatments: enteral electrolyte solution containing calcium propionate (ESCaP), enteral electrolyte solution containing glycerol (ESGly) and enteral electrolyte solution containing propylene glycol (ESPrG). Solutions were administered at a rate of 15 mL kg−1 h−1 for 12 h. Serum and urinary biochemical assessment; urinary volume, pH, and specific gravity; and blood gas analysis were measured at 0, 3, 6, 9, 12, and 24 h. All three enteral electrolyte solutions expanded blood volume and increased urine volume without causing electrolyte imbalances. ESCaP caused mild reversible metabolic alkalosis while the most significant glycemic potential was observed in electrolyte solutions containing propylene glycol (ESPrG) and calcium propionate (ESCaP).

How does parenteral compare with enteral fluid therapy for children hospitalized with bronchiolitis?

How does parenteral compare with enteral fluid therapy for children hospitalized with bronchiolitis?

Effects of total parenteral nutrition associated with glutamine, enteral fluid therapy with or without glutamine, and fluid therapy on the acid base and electrolyte balance of horses starved after exploratory laparotomy

This study aimed to evaluate the effects of the total parenteral nutrition associated with glutamine, enteral fluid therapy with or without glutamine, and fluid therapy on the acid–base and electrolyte balance of horses starved after exploratory laparotomy. Sixteen healthy male and female adult horses of mixed breed, aged between 4 and 14 years, and having a mean body weight of 248.40 ± 2.28 kg and a body score index of 3–4 (scale of 1–5) were divided into four groups with four animals per group. After an adaptation period of 30 days, they were randomly divided into four experimental groups: enteral fluid therapy, enteral fluid therapy associated with glutamine, total parenteral nutrition associated with glutamine, and parenteral fluid therapy. The experiment was further divided into two phases: Phase 1 and Phase 2. In Phase 1, an exploratory laparotomy was performed, treatments were administered to the groups and the horses received no food or water other than those given to their respective groups. In Phase 2, the animals were re-fed. Each phase had a total duration of 144 h. Venous blood samples were collected every 24 h throughout the experimental period for blood gas and electrolyte analyses. The following parameters were evaluated: pH, partial pressure of carbon dioxide, total carbon dioxide, bicarbonate, base shift, anion gap, sodium, potassium, chloride, total calcium and magnesium. Completely randomized designs with a 4 × 7 factorial scheme (groups × harvest time) in Phase 1 and a 4 × 6 factorial scheme (groups × harvest time) in Phase 2 were used with four replications. All values were considered significant when p≤0.05 (95% probability). Blood pH, bicarbonate concentration, and base shift in the PARGL group decreased, indicating metabolic acidosis. Changes in the acid–base and electrolyte balance were more intense in the PARGL group than in the other groups. These results demonstrated the need to monitor blood gas and electrolyte balance in horses with food restriction under nutritional support or prolonged fluid therapy so that such changes are promptly corrected.

Parenteral versus enteral fluid therapy for children hospitalised with bronchiolitis.

Parenteral versus enteral fluid therapy for children hospitalised with bronchiolitis.

Comparative Trial of Continuous Flow Enteral and Intravenous Fluid Therapy in Horses.

Continuous flow enteral fluid therapy with isotonic and hypotonic enteral electrolyte solutions are as safe and effective as intravenous fluid therapy. The aim of this study was to carry out a comparative assessment between continuous flow enteral and intravenous (IV) fluid therapy in adult experimentally dehydrated horses. Six experimentally dehydrated adult mares were used in a study carried out in a 6 × 3 crossover design, which each animal received three different treatments (isotonic enteral fluid therapy—EsISO, hypotonic enteral fluid therapy—EsHYPO and intravenous fluid therapy with Lactate Ringer Solution—LR IV, all in continuous flow). Solutions were administered at a rate of 15 mL−1.kg−1.h−1 for 8 h, after 36 h of water and food deprivation. Serum and urinary biochemical assessment; urinary volume, pH and specific gravity; and blood gas analysis were measured at −36, 0, 2, 4, 6, and 8 h. The dehydration period (DP) caused discrete hydroelectrolytic and acid base imbalances. The EsISO, EsHYPO and LR IV increased blood volume. Enteral solutions restored the imbalances yielded by the DP and all treatments increased urine volume. Also, the EsHYPO and LR IV showed no effects in acid base balance, while EsISO showed slightly acidifying effect. The present study certifies the efficacy and safety of isotonic and hypotonic continuous flow enteral fluid therapy in comparison to IV fluid therapy in dehydrated horses.

Parenteral versus enteral fluid therapy for children hospitalised with bronchiolitis

Parenteral versus enteral fluid therapy for children hospitalised with bronchiolitis

Maintenance enteral electrolyte solutions for neonatal calves: sodium acetate and osmolarity effects

ABSTRACT The use of hypotonic electrolytic solutions in enteral fluid therapy is still understudied in calves. The objective of the present study was to evaluate the effects of maintenance enteral electrolytic solutions with different concentrations of sodium acetate and different osmolarities in calves. For this, 18 Holstein calves, six male and 12 female, 20 days old and weighing around 52kg, were used. The animals were randomly divided into three groups and each group received one of the treatments. The three electrolytic solutions contained the same components in different concentrations, resulting in a hyposmotic, an isosmotic and a hyperosmotic solution. Each animal was maintained in enteral fluid therapy for 12 hours with infusion rate of 15mL kg-1 h-1. Abdominal circumference, body weight, feces consistency, glucose and plasma lactate, pH, pCO2, HCO- 3 and BE were measured at the following times: T0h, T6h, T12h and T24h. The hyposmotic solution did not generate the onset of diarrhea, while the isosmotic and the hyperosmotic did. Regardless of the dose used, acetate did not cause metabolic alkalosis in the evaluated animals. The results suggest that the use of hyposmotic solution in diarrheic calves, dehydrated and without metabolic acidosis, may be clinically important.

Diagnosis, management and prognosis of large colon impactions

SummaryThe majority of large colon feed impactions occur in the left ventral colon at the pelvic flexure. Sand and enterolith impactions most commonly occur in the left ventral colon at the pelvic flexure or in the right dorsal colon; however, sand can accumulate anywhere along the gastrointestinal tract. Enteral fluid therapy can, in most cases, supplement or even replace i.v. administration of fluids and it appears effective and safe to soften large colon contents and resolve simple large colon impactions. Surgical intervention is indicated when a concurrent displacement is suspected, as lengthy medical treatment of large colon impaction secondary to large colon displacements would not be indicated and may increase the risk of colonic rupture. Other indications for surgical intervention include uncontrollable pain, when cardiovascular parameters deteriorate, or when there is evidence of intestinal devitalisation. The prognosis for horses undergoing large colon enterotomy is dependent on the extent and type of impaction, but is generally excellent.

Enteral fluid therapy administered in continuous flow by naso-ruminal route using three maintenance electrolyte solutions: effects on physiological biomarkers and the hemogram of bovines

ABSTRACT: The aim of this study was to evaluate the effects of three enteral electrolyte solutions, each with different energy sources, administrated as continuous flow on the physiological parameters and blood count of healthy Holstein heifers. Six Holstein heifers were used in a crossover design. All animals received all three treatments: solution with calcium propionate, 4g of NaCl, 0.5g of KCl, 0.3g of MgCl2, and 10g of calcium propionate diluted in 1000mL of water (measured osmolarity: 299mOsm/L); solution with glycerol, 4g of NaCl, 0.5g of KCl, 0.3g of MgCl2, 1g of calcium acetate, and 10mL of glycerol in 1000mL of water (measured osmolarity: 287mOsm/L); solution with propylene glycol, 4g of NaCl, 0.5g of KCl, 0.3g of MgCl2, 1g of calcium acetate, and 15mL of propylene glycol in 1000mL of water (measured osmolarity: 378mOsm/L). Physical evaluations and blood samples were collected immediately before the initiation of fluid therapy, at 3-hour intervals over the 12-hour period of fluid therapy, and 12 hours after the end of fluid therapy. Animals presented no signs of stress or discomfort. All solutions resulted in a significant decrease in erythrocyte concentration, hemoglobin concentration, and hematocrit, without affecting the leukogram. Enteral fluid therapy administered as continuous flow via the naso-ruminal route was well-tolerated by animals with minimal effects on animal welfare, even when administered for 12 hours. This technique is indicated as an alternative route for parenteral maintenance fluid therapy. Electrolyte solutions proposed here were able to significantly expand blood volume.

Enteral fluid therapy in neonatal calves and features of commercially available electrolyte solutions in Brazil

ABSTRACT: According to the World Health Organization, the development of orally replacement fluids and electrolytes was one of the most significant advances of the twentieth century, markedly reducing mortality from diarrheal children. In veterinary medicine, oral electrolyte solutions (OES) are routinely used to treat diarrheic neonatal calves in order to correct water, electrolyte and acid base imbalances. In North America, the use of OES is routine and there are at least 20 commercial alternatives. Use of OES has increased in recent years in Brazil, but just five commercial products are currently available. The OES should contain, in suitable concentrations, electrolytes, glucose and an alkalizing agent to ensure its therapeutic efficacy. This review aimed to address the therapeutic importance of OES for neonatal calves and to evaluate the compositions and characteristics of those commercially available in Brazil.

Effects of Enteral Fluid Therapy in Continuous Flow Administered by Nasogastric Tube in Buffalo Calves

To investigate the employment of enteral fluid therapy in continuous flow administered by a nasogastric tube in buffalo calves; toassesstheeffectsof a hypotonic and an isotonic electrolyte solutionon: vital functions, blood count and serum andurinary biochemistry profile of buffalo calves. Seven buffalo calves, clinically healthy, were submitted to two treatments. The solutions were administered in continuous flow through a nasogastric tube at a dose of 15 mL/kg/hr for 12 hours. The serum biochemistry profile showed an increase in chloride concentration, decrease in serumurea and osmolarity. In urine, anincrease in sodium and chloride concentrations and a decrease in calcium, creatinine and urea were observed. Enteral fluid therapy in continuous flow proved to beeasy to use and effective in maintaining volemia and concentration of electrolytes in buffalo calves

Enteral Fluid Therapy in Horses: Effects of Maintenance Hypotonic Electrolyte Solutions Containing Maltodextrin, Sucrose, or Dextrose Administered in Continuous Flow

To evaluate the effects of maintenance hypotonic electrolyte solutions containing carbohydrates administered by nasoesophageal tube in continuous flow in horses during 12 hours on body weight, waist circumference, water intake, aspect and moisture content of the stool, frequency of defecation, urine density and urinary glucose, sodium, potassium, chloride, urea and creatinine, and urinary volume in horses. We used six mares randomly divided into three treatments in two Latin squares 6 × 3, concurrent, in mixed model. All solutions had the same composition (5 g of NaCl, 0.5 g of KCl, 200 mg of magnesium pidolate, and 1 g of calcium gluconate, diluted in 1,000 mL of water), only differing in power source and osmolarity, ESMaltodextrin—electrolyte solution plus 15 g of maltodextrin (measured osmolarity of 203 mmol L−1); ESSucrose—electrolyte solution plus 15 g of sucrose (measured osmolarity of 234 mmol L−1); and ESDextrose—electrolyte solution plus 15 g of dextrose (measured osmolarity of 264 mmol L−1). The electrolyte solutions were administered at a dose of 15 mL kg−1 h−1 for 12 hours in continuous flow. Maintenance hypotonic electrolyte solutions containing maltodextrin, dextrose, and sucrose were effective in promoting diuresis and decreasing urinary density, without presenting adverse effects. ESSucr was more effective in softening the stool.

Enteral Fluid Therapy: Biochemical Profile of Horses Treated with Hypotonic Enteral Electrolyte Solutions Associated with Energy Sources

The present study evaluated the biochemical profile of horses that received hypotonic electrolyte solutions associated with energy sources by enteral route in continuous flow using a small caliber tube for naso-esophageal administration. Experimental design was a latin square 3 × 3 with two replicates and three periods. The assays were carried out with “six adult females horses”, divided into three groups submitted to the following treatments each: electrolyte solution containing dextrose (ESDext)—“5 g sodium chloride, 0.5 g potassium chloride”, 1 g of calcium gluconate, 200 mg of magnesium pidolate, and 15 g of dextrose diluted in 1,000 mL of water with measured osmolarity of 264 mOsmol/L; electrolyte solution containing maltodextrine (ESMalt)—5 g of sodium chloride, 0.5 g of potassium chloride, 1 g of calcium gluconate, 200 mg of magnesium pidolate, and 15 g of maltodextrin diluted in 1,000 mL of water with measured osmolarity of 203 mOsmol/L; and electrolyte solution containing sucrose (ESSucr)—“5 g sodium chloride, 0.5 g potassium chloride”, 1 g of calcium gluconate, 200 mg of magnesium pidolate, and 15 g of sugar diluted in 1,000 mL of water with measured osmolarity of 234 mOsmol/L. The electrolyte solutions were administered at the dosage 15 mL/kg/h during 12 hours. Hypotonic enteral electrolyte solutions that contain maltodextrin (ESMalt) and dextrose (ESDext) were effective to increase glycemia in horses without causing any adverse effects, whereas ESSucr presented slight effect on blood glucose, but without causing electrolyte imbalances.

Enteral fluid therapy through nasogastric tube in rumen cannulated goats

This paper reports the effects of fluid therapy in goats through nasogastric route with an electrolyte solution composed by concentrations of sodium, potassium and chloride similar to goat plasma (140mmol/L of Na+, 4.5mmol/L of K+, 110mmol/L of Cl-). Four Alpine Chamoisee goats, two of them with evident leakage of the rumen cannulas, were used in a crossover experimental design of two periods and two groups. In one group the two goats were submitted to a treatment protocol to induce dehydration before the fluid therapy, whereas the other group was not. Fluid therapy consisted supplying 10mL/kg/h of the electrolyte solution during 8 hours. No signs of discomfort or stress were observed. The dehydration model employed caused a mild dehydration indicated by decrease in feces humidity, body weight and abdominal circumference, and increase in plasma total solids concentration. During fluid therapy globular volume and plasma total solids decreased, whereas % body weight and abdominal circumference increased. No signs of hyperhydration were observed and serum electrolytes (Na+, Cl-, K+) presented no significant alterations in both groups. Fluid therapy proposed in this study was efficient to treat dehydration, even for rumen cannulated animals with evident leakage, and can be administrated safely with no electrolyte imbalance.

Tratamentos da compactação experimental do cólon maior de equinos com hidratação enteral, intravenosa e sene (Cassia augustifolia Vahl)

O objetivo deste estudo foi investigar a ação da hidratação enteral (HET), da hidratação intravenosa (IV) e da sene, associada à hidratação intravenosa (SEN), no tratamento da compactação do cólon maior, em equinos. Foram utilizados 15 animais, divididos em três grupos de cinco, cada. Os animais eram portadores de compactação do cólon maior, induzida experimentalmente. O grupo HET recebeu solução isotônica poliônica enteral (8 mL kg-1 h-1,durante 48 horas); o grupo SEN foi tratado com sene (20 mg kg-1, duas doses de 24/24 h), mais Ringer lactato i.v. (10 mL kg-1 h-1 12h-1, durante dois dias) e ao grupo IV foi administrado Ringer lactato i.v. (16 mL kg-1 h-1 12h-1, durante dois dias). O tratamento HET ocasionou maior amolecimento das fezes e desfez a compactação em menor tempo. Entretanto, foi observada hipomotilidade intestinal mais prolongada. O tratamento SEN normalizou mais rapidamente a motilidade intestinal, porém o tempo necessário para desfazer a compactação foi maior. Além disso, ocasionou o maior aumento na distensão abdominal e no grau da dor, assim como a menor capacidade para reverter a desidratação. O tratamento do grupo IV debelou a compactação, igualmente ao HET, e a hipomotilidade intestinal, em menor tempo, mas foi o que menos amoleceu as fezes. Concluiu-se que os tratamentos IV e HET foram os mais eficientes na terapia da compactação, induzida no cólon maior, em equinos. O grupo SEN foi eficiente, porém, foi o que apresentou os efeitos adversos mais importantes.

Hidratação enteral em bovinos: avaliação de soluções eletrolíticas isotônicas administradas por sonda nasogástrica em fluxo contínuo

Foram avaliados os efeitos de soluções eletrolíticas isotônicas administradas via sonda nasogástrica de pequeno calibre e fluxo contínuo sobre o hematócrito, proteína total, albumina, sódio, potássio, cloreto, magnésio total, uréia, creatinina, glicose e lactato de bovinos desidratados experimentalmente. Seis bovinos adultos, mestiços, dois machos e quatro fêmeas foram avaliados. A hidratação enteral foi administrada na dose de 15mL kg-1 h-1 durante 12 horas. Os animais foram separados em dois tratamentos num delineamento experimental crossover e submetidos a cada um dos seguintes tratamentos: SEGlic: NaCl 4g, KCl 1g, NaHCO3 4g, dextrose 5g em 1.000mL de água; SEProp: NaCl 8g, KCl 0,5g, CaCl2 0,5g, propilenoglicol 15mL em 1.000mL de água. Após a administração das soluções eletrolíticas, ocorreu expansão da volemia, em ambos os tratamentos, ocasionando diminuição do hematócrito e proteína total. A SEGli ocasionou o aparecimento de hipernatremia e aumento do lactato plasmático. Por sua vez, a SEProp aumentou a taxa de glicose plasmática, enquanto os demais parâmetros avaliados permaneceram na faixa de referência.

Primary gastric impaction in horses: A retrospective study of 20 cases (2005-2008)

Primary gastric impaction is an uncommon condition. Furthermore, the factors associated with gastric impaction and the optimal method of treatment are not clear. The aim of this article is to describe the clinical findings, treatment and outcome of horses with a primary gastric impaction. Medical records of horses that presented with a primary gastric impaction between 2005 and 2008 were reviewed and 20 horses with a primary gastric impaction identified. Diagnosis of a primary gastric impaction was made if the horse had been fasted for a minimum of 16 h, a concretion of ingesta precluded visualisation of the margo plicatus and there was no evidence of concurrent intestinal pathology. Thirteen of 20 (65%) horses were presented on an emergency basis. The most common complaint was inappetence (50%) followed by acute colic (35%) and recurrent colic (35%). On initial examination for colic, all horses had a normal heart rate and 7 of 20 (35%) had decreased gastrointestinal borborygmi. All horses were treated with enteral fluid therapy. The median dose of fluids administered per day was 5 doses (range 1–8 doses) of 2–10 l of isotonic electrolyte solution. The median length of treatment until resolution was 2 days (range 1–5 days). Eighteen of 20 (90%) horses survived to discharge. Primary gastric impaction appears to be a condition with clinical signs of inappetence and mild abdominal discomfort. This is the largest group of horses reported that were treated with enteral fluid therapy for a gastric impaction and it was concluded that enteral fluid therapy was of value in this study.

Enteral fluid therapy in 108 horses with large colon impactions and dorsal displacements

To assess the effect of enteral fluid therapy (EFT) in horses with colic, 78 adult horses with colon impactions and 30 with left dorsal colon displacements received an isotonic electrolyte...

HIDRATAÇÃO ENTERAL EM BOVINOS VIA SONDA NASOGÁSTRICA POR FLUXO CONTÍNUO

ENTERAL FLUID THERAPY IN CATTLE BY CONTINUOUS NASOGASTRIC INFUSION Nasogastric infusion via small-bore tubes is an alternative form of fluid administration in cattle. It allows the animals to be kept in free stall barns and does not affect food ingestion. This study evaluates 72 cows between 2 days and 12 years of age attended to at the Veterinary Hospital of Universidade Federal de Vicosa. The nasogastric small-bore tube was 4mm in diameter and 1,5 to 2 m in length. Two types of electrolytic solutions were used: Solution 1 (8g of NaCl, 0,5g of KCl, 0,5g of CaCl2 and 15mL of propylenoglycol diluted in 1L of water); Solution 2 (5g of NaCl, 1g of KCl, 4g of NaHCO3 and 5g of dextrose diluted in 1L of water). Continuous infusions of 10-20mL/kg per hour for 12 hours/day were performed. During this process, there was a gradual reduction of hematocrit, total plasma proteins, dehydration level, and urinary density. We conclude that this method causes minimum stress on the animal due to the fact that the same tube is used during fluid therapy. Furthermore, it is practical and economic.