Gastrointestinal dysmotility disorders in critically ill dogs and cats
| Autor: | KimMi Whitehead, Laura Eirmann, Yonaira Cortes |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Abdominal pain General Veterinary Gastric emptying Ileus 040301 veterinary sciences business.industry Sequela 04 agricultural and veterinary sciences medicine.disease Gastroenterology 0403 veterinary science Systemic inflammatory response syndrome 03 medical and health sciences 0302 clinical medicine Parenteral nutrition Cisapride Internal medicine Medicine 030211 gastroenterology & hepatology medicine.symptom business Gastrointestinal dysmotility medicine.drug |
| Zdroj: | Journal of Veterinary Emergency and Critical Care. 26:234-253 |
| ISSN: | 1479-3261 |
| DOI: | 10.1111/vec.12449 |
| Popis: | Objective To review the human and veterinary literature regarding gastrointestinal (GI) dysmotility disorders in respect to pathogenesis, patient risk factors, and treatment options in critically ill dogs and cats. Etiology GI dysmotility is a common sequela of critical illness in people and small animals. The most common GI motility disorders in critically ill people and small animals include esophageal dysmotility, delayed gastric emptying, functional intestinal obstruction (ie, ileus), and colonic motility abnormalities. Medical conditions associated with the highest risk of GI dysmotility include mechanical ventilation, sepsis, shock, trauma, systemic inflammatory response syndrome, and multiple organ failure. The incidence and pathophysiology of GI dysmotility in critically ill small animals is incompletely understood. Diagnosis A presumptive diagnosis of GI dysmotility is often made in high-risk patient populations following detection of persistent regurgitation, vomiting, lack of tolerance of enteral nutrition, abdominal pain, and constipation. Definitive diagnosis is established via radioscintigraphy; however, this diagnostic tool is not readily available and is difficult to perform on small animals. Other diagnostic modalities that have been evaluated include abdominal ultrasonography, radiographic contrast, and tracer studies. Therapy Therapy is centered at optimizing GI perfusion, enhancement of GI motility, and early enteral nutrition. Pharmacological interventions are instituted to promote gastric emptying and effective intestinal motility and prevention of complications. Promotility agents, including ranitidine/nizatidine, metoclopramide, erythromycin, and cisapride are the mainstays of therapy in small animals. Prognosis The development of complications related to GI dysmotility (eg, gastroesophageal reflux and aspiration) have been associated with increased mortality risk. Institution of prophylaxic therapy is recommended in high-risk patients, however, no consensus exists regarding optimal timing of initiating prophylaxic measures, preference of treatment, or duration of therapy. The prognosis for affected small animal patients remains unknown. |
| Databáze: | OpenAIRE |
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