Enteral Fluid Therapy Research Articles

From the editors

From the editors

Enteral fluid therapy in large animals

Enteral fluids administered alone, or in conjunction with intravenous fluids, are reported to be useful for the treatment of dehydration and electrolyte loss associated with diarrhoea in a number of species, following exercise in horses and for feed impaction of the large intestine of horses. Enteral fluids are suitable for treatment of mild to moderately dehydrated patients with some intact intestinal epithelium and motile small intestine. In patients that will drink voluntarily or tolerate nasal intubation the use of enteral fluids may avoid the complications associated with intravenous fluid administration. However the labour costs associated with repeated nasal intubation in intensively managed patients requiring large volumes of fluids may make the use of enteral fluids less economical than intravenous fluid administration. Enteral fluid use alone is contraindicated in patients that are severely dehydrated and/or in hypovolaemic shock, however, if used in conjunction with intravenous fluids, the effects of villous atrophy and malnutrition may be ameliorated and the duration of hospitalisation shortened. There is a variety of commercially available enteral fluids available to veterinary practitioners. While the key components of these fluids are sodium, chloride and carbohydrates, the amounts of ions and other ingredients such as potassium, alkalising agents, amino acids and shortchain fatty acids may vary. The species of the animal, the underlying condition, and the constituents of the fluid, should influence the choice of an enteral fluid.

Dehydration versus volume depletion

To the Editor: In his recent Nephrology Forum, Dr. Friedman1 makes a number of interesting and cogent observations regarding enteral and parenteral fluid and electrolyte therapy in infants and children. However, I believe discussions of fluid and electrolyte disorders, and their treatments, become much clearer and more easily understood when terms such as "hydration," "dehydration," "volume depletion," and "volume expansion" are used in a more exacting and restricted fashion. As Menge et al2 describe in their article, "hydration" is best used to define the ratio between total body solute and total body water, and is usually reflected by the sodium concentration. In the absence of internal water translocations such as those produced by hyperglycemia, hyponatremia indicates that body water is increased in relation to solute and overhydration exists, while hypernatremia indicates a relative deficit of water, or excess of sodium, and indicates dehydration. In contradistinction, volume depletion defines contraction of the ECF and vascular spaces as may result from blood loss or the loss of salt and volume due to diarrhea, and is appropriately treated by the infusion of volume expanding solutions such as saline or blood.

Administration of enteral fluid therapy: methods, composition of fluids and complications

Administration of enteral fluid therapy: methods, composition of fluids and complications

Physiological aspects, indications and contraindications of enteral fluid therapy

Physiological aspects, indications and contraindications of enteral fluid therapy

Tratamento de compactação do cólon maior em eqüídeos com fluidoterapia enteral

A eficiência da fluidoterapia por via enteral foi avaliada em 14 eqüídeos (12 eqüinos e dois muares) que apresentavam compactação do cólon maior. Os animais tinham entre um ano e meio e 20 anos de idade e todos eram alimentados com capim elefante (Pennisetum purpureum Schumach) triturado. O início dos sinais de cólica foi observado no dia do internamento em seis casos, um dia antes em cinco casos, três dias antes em um caso, quatro dias antes em um caso e seis dias antes em um caso. Um cavalo havia sido banhado com amitraz dois dias antes dos primeiros sinais de cólica. Quando foram internados, todos os animais apresentavam desidratação, dor leve a moderada e intermitente, fezes ressecadas e digesta compactada no cólon maior. Onze animais foram medicados com analgésico. Através de sonda nasogástrica foi administrada água a todos os animais. O volume administrado, de cada vez, foi de no máximo 10 litros e o intervalo entre as administrações foi de no mínimo 30 minutos. O volume total administrado a cada animal variou de 60 a 223 litros (média 119,14 litros). Durante o tratamento, o único ali mento fornecido foi ração à base de grãos e suplemento mineral. Diariamente eram feitos dois exames clínicos e todos os animais apresentaram poliúria, redução gradativa do volume abdominal, amolecimento das fezes e remissão dos sinais de desidratação. O tratamento teve a duração de um a cinco dias (média 2,57 dias). Quando a fluidoterapia foi interrompida, nenhum animal apresentava dor abdominal ou compactação do intestino grosso. Concluiu-se que a fluidoterapia enteral foi eficiente no tratamento de compactação do cólon maior em eqüídeos.