Sunday, April 7, 2013

Experiência clínica com nutrição parenteral pronta para uso livre de lipideos em cães: 70 casos / Clinical experience with a lipid-free, ready-made parenteral nutrition solution in dogs: 70 cases


Clinical experience with a lipid-free, ready-made parenteral nutrition solution in dogs: 70 cases (2006–2012)

  1. Isuru Gajanayake BVSc, DACVIM, MRCVS1,*
  2. Claire E. Wylie BVM&S, MSc, PhD, MRCVS2
  3. Daniel L. Chan DVM, DACVECC, DACVN, MRCVS1
Article first published online: 5 MAR 2013
DOI: 10.1111/vec.12029
Cover image for Vol. 23 Issue 1

Journal of Veterinary Emergency and Critical Care



Abstract

Objective

To review the clinical use of a lipid-free, ready-made amino acid and glucose parenteral nutrition (PN) solution in dogs.

Design

Retrospective study of dogs from 2006 to 2012 that received this form of PN.

Setting

University veterinary teaching hospital.

Animals

Seventy dogs presented to the hospital for treatment of various diseases in which PN was used as part of patient management. Dogs were administered PN at the discretion of the primary clinician.

Intervention

A lipid-free, ready-made solution containing amino acid (59 g/L) and dextrose (100 g/L) was administered intravenously as a constant rate infusion to provide nutritional support.

Measurements and Main Results

PN was provided for a median of 2.2 days (range 0.5–9.5 days) in the 70 dogs, totaling 168 days of PN. The PN provided a median of 5.5 g/100 kcal of protein (range 1–9.5 g/100 kcal) and a median of 2.2 mg/kg of bodyweight per minute (range 0.8–5.2 mg/kg/min) of glucose, which reflected a median of 57% of the resting energy requirement (range 9–100%). Metabolic complications developed in 43 of 67 dogs where these data were recorded, but the development of hyperkalemia was the only complication associated with a poor outcome (eg, death or euthanasia). Mechanical complications were seen in 28 dogs, and all but one of these occurred when PN was delivered through peripheral catheters. Septic complications were confirmed in 5 dogs.

Conclusions

This form of PN is suitable for clinical use and can provide both protein and calories to ill dogs. It was, however, associated with a high rate of complications and requires careful patient monitoring.

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