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The Veterinary record2021; 188(3); e5; doi: 10.1002/vetr.5

Comparison of liberal and goal-directed fluid therapy after small intestinal surgery for strangulating lesions in horses.

Abstract: There are few guidelines for the appropriate mode of fluid administration during and after colic surgery, and is challenging to reach the right balance while avoiding overhydration. This study aimed to compare goal-directed fluid therapy (GDFT) and 'liberal' fluid regimens (LFRs) in horses undergoing small intestinal surgery. Methods: Eighteen horses subjected to small intestinal surgery were matched according to the surgical lesion, type of anastomosis, length of resection, and duration of clinical signs. Horses in the LFR group were administered intravenous (IV) fluids for at least 24 h. In the GDFT group, IV fluids were administered only when considered necessary based on clinical parameters. Postoperative reflux (POR), packed cell volume, total protein, heart rate, venous lactate level, complications, and long-term survival rates were compared. Results: Three horses in the LFR and one in the GDFT group developed POR. Horses in the GDFT group had a shorter time interval to first oral water intake and shorter hospitalisation time. Postoperative complication rates and survival were not different between groups. Conclusions: Further studies are necessary to set guidelines for the evaluation of hydration status and to plan postoperative fluid administration; however, GDFT may be a valid alternative to liberal fluid therapy after colic surgery.
© 2021 British Veterinary Association.
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Publication Date: 2021-10-16 PubMed ID: 34651880DOI: 10.1002/vetr.5Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study is an analysis of the effectiveness of two fluid therapy methods, goal-directed fluid therapy (GDFT) and liberal fluid therapy (LFR), in horses after they have undergone small intestinal surgery. The research highlights that there is a need for more study before specific guidelines can be outlined, but suggests that goal-directed fluid therapy may be a valid option.

Research Methodology

  • The study involved 18 horses that underwent small intestinal surgery. The selection was on the basis of parameters like the type of surgical lesion, type of anastomosis, length of resection, and duration of clinical signs.
  • The horses were divided into two groups. One group followed the liberal fluid therapy method (LFR), where they were administered intravenous (IV) fluids for at least 24 hours.
  • The other group followed the goal-directed fluid therapy (GDFT) method. Here, fluids were administered only when deemed necessary based on clinical parameters.
  • The researchers made comparison of postoperative reflux, packed cell volume, total protein, heart rate, venous lactate level, complications, and long-term survival rates amongst the two groups.

Research Findings

  • In the group that followed LFR, three horses developed postoperative reflux, while in the GDFT group, only one horse had this issue.
  • The results showed that horses in the GDFT group had a shorter time interval to the first oral water intake, as well as a shorter hospitalisation time.
  • However, there was no significant difference in postoperative complication rates and survival between the two groups.

Conclusion

  • The study concludes that there is a need for further research to establish definitive guidelines for evaluating hydration status and planning postoperative fluid administration in horses that have undergone small intestinal surgery.
  • Nevertheless, the findings suggest that goal-directed fluid therapy (GDFT) could be a viable alternative to liberal fluid therapy.

Cite This Article

APA
Giusto G, Vercelli C, Gandini M. (2021). Comparison of liberal and goal-directed fluid therapy after small intestinal surgery for strangulating lesions in horses. Vet Rec, 188(3), e5. https://doi.org/10.1002/vetr.5

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English
Volume: 188
Issue: 3
Pages: e5

Researcher Affiliations

Giusto, Gessica
  • Department of Veterinary Sciences of Turin, University of Turin, Turin, Italy.
Vercelli, Cristina
  • Department of Veterinary Sciences of Turin, University of Turin, Turin, Italy.
Gandini, Marco
  • Department of Veterinary Sciences of Turin, University of Turin, Turin, Italy.

MeSH Terms

  • Animals
  • Colic / surgery
  • Colic / veterinary
  • Digestive System Surgical Procedures / veterinary
  • Fluid Therapy / veterinary
  • Goals
  • Horse Diseases / surgery
  • Horses
  • Postoperative Complications / veterinary

References

This article includes 29 references
  1. Muir WW, Ueyama Y, Noel‐Morgan J, Kilborne A, Page J. A systematic review of the quality of IV fluid therapy in veterinary medicine.. Front Vet Sci 2017;4:127.
  2. Freeman DE, Mooney A, Giguère S, Claire J, Evetts C, Diskant P. Effect of feed deprivation on daily water consumption in healthy horses.. Equine Vet J 2020;9.
  3. Raftery AG, Morgan RA, MacFarlane PD. Perioperative trends in plasma colloid osmotic pressure in horses undergoing surgery.. J Vet Emerg Crit Care 2016;26:93–100.
  4. Espinosa P, Le Jeune SS, Cenani A, Kass PH, Brosnan RJ. Investigation of perioperative and anesthetic variables affecting short‐term survival of horses with small intestinal strangulating lesions.. Vet Surg 2017;46:345–53.
  5. Bragg D, El‐Sharkawy AM, Psaltis E, Maxwell‐Armstrong CA, Lobo DN. Postoperative ileus: recent developments in pathophysiology and management.. Clin Nutr 2015;34:367–76.
  6. Marjanovic G, Villain C, Juettner E, Hausen AZ, Hoeppner J, Theodor Hopt U. Impact of different crystalloid volume regimes on intestinal anastomotic stability.. Ann Surg 2009;249:181–5.
  7. Brandstrup B, Tønnesen H, Beier‐Holgersen R, Hjortsø E, Ørding H, Lindorff‐Larsen K. Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor‐blinded multicenter trial.. Ann Surg 2003;238(5):641–8.
  8. Freeman D. Post‐operative reflux–a surgeon's perspective.. Equine Vet Educ 2018;30:671–80.
  9. Merritt AM, Blikslager AT. Post operative ileus: to be or not to be?. Equine Vet J 2008;40:295–6.
  10. Hoaglund EL, Hess AM, Hassel DM. Retrospective evaluation of the effect of intravenous fluid administration on development of postoperative reflux in horses with colic (2004–2012): 194 horses.. J Vet Emerg Crit Care (San Antonio) 2018;28(6):566–72.
  11. Bateman RM, Sharpe MD, Jagger JE, Ellis CG, Solé‐Violán J, López‐Rodríguez M. 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15–18 March 2016 [published correction appears in Crit Care. 2016 Oct 24;20:347].. Crit Care 2016;20(Suppl 2):94.
  12. Scheeren TW, Wiesenack C, Gerlach H, Marx G. Goal‐directed intraoperative fluid therapy guided by stroke volume and its variation in high‐risk surgical patients: a prospective randomized multicentre study.. J Clin Monit Comput 2013;27(3):225–33.
  13. Zakhaleva J, Tam J, Denoya PI, Bishawi M, Bergamaschi R. The impact of intravenous fluid administration on complication rates in bowel surgery within an enhanced recovery protocol: a randomized controlled trial.. Colorectal Dis 2013;15(7):892–9.
  14. Calvo‐Vecino JM, Ripollés‐Melchor J, Mythen MG, Casans‐Francés R, Balik A, Artacho JP. Effect of goal‐directed haemodynamic therapy on postoperative complications in low‐moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial).. Br J Anaesth 2018;120(4):734–44.
  15. Marqués FJ, Higgins S, Chapuis R, Waldner C. The effect of inadequate presample blood volume withdrawal from intravenous catheter and extension sets on measured circulating L‐blood lactate concentration in horses receiving lactated Ringer's solution.. J Vet Intern Med 2017;31(1):51–4.
  16. Archer DC. Colic surgery: keeping it affordable for horse owners.. Vet Rec 2019;185(16):505–7.
  17. Freeman DE. Fifty years of colic surgery.. Equine Vet J 2018;50(4):423–35.
  18. Uemura K, Tatewaki M, Harris MB, Ueno T, Mantyh CR, Pappas TN. Magnitude of abdominal incision affects the duration of postoperative ileus in rats.. Surg Endosc 2004;18(4):606–10.
  19. Wind J, Polle SW, Fung Kon Jin PH, Dejong CHC, von Meyenfeldt MF, Ubbink DT. Systematic review of enhanced recovery programmes in colonic surgery.. Br J Surg 2006;93(7):800–9.
  20. Story SK, Chamberlain RS. A comprehensive review of evidence‐based strategies to prevent and treat postoperative ileus.. Dig Surg 2009;26(4):265–75.
  21. Freeman DE. Post operative ileus (POI): another perspective.. Equine Vet J 2008;40(4):297–8.
  22. Freeman DE, Schaeffer DJ, Cleary OB. Long‐term survival in horses with strangulating obstruction of the small intestine managed without resection.. Equine Vet J 2014;46(6):711–7.
  23. Blikslager AT. Gastric impaction and large colon volvulus: can one lead to the other?. Equine Vet Educ 2015;27:460–1.
  24. Valle E, Giusto G, Penazzi L, Giribaldi M, Bergero D, João Fradinho M. Preliminary results on the association with feeding and recovery length in equine colic patients after laparotomy.. J Anim Physiol Anim Nutr (Berl) 2019;103(4):1233–41.
  25. Underwood C, Southwood LL, Walton RM, Johnson AL. Hepatic and metabolic changes in surgical colic patients: a pilot study.. J Vet Emerg Crit Care (San Antonio) 2010;20(6):578–86.
  26. Tennent‐Brown B. Blood lactate measurement and interpretation in critically ill equine adults and neonates.. Vet Clin North Am Equine Pract 2014;30(2):399–413.
  27. Edner AH, Nyman GC, Essén‐Gustavsson B. Metabolism before, during and after anaesthesia in colic and healthy horses.. Acta Vet Scand 2007;49(1).
    doi: 10.1186/1751-0147-49-34google scholar: lookup
  28. Marik PE, Lemson J. Fluid responsiveness: an evolution of our understanding.. Br J Anaesth 2014;112(4):617–20.
  29. Gardner A, Dockery A, Quam V. Exploratory celiotomy in the horse secondary to acute colic: a review of indications and success rates.. Top Companion Anim Med 2019;34:1–9.

Citations

This article has been cited 1 times.
  1. Spadari A, Gialletti R, Gandini M, Valle E, Cerullo A, Cavallini D, Bertoletti A, Rinnovati R, Forni G, Scilimati N, Giusto G. Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study.. Animals (Basel) 2023 Mar 20;13(6).
    doi: 10.3390/ani13061107pubmed: 36978647google scholar: lookup
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