Hansen Sonya C, Hlusko Katelyn C, Matz Brad M, Bacek Lenore M
Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL.
J Vet Emerg Crit Care (San Antonio). 2019 Sep;29(5):514-520. doi: 10.1111/vec.12882. Epub 2019 Aug 26.
To describe the postoperative use of gastrostomy tubes (GT) in dogs with septic peritonitis. A secondary objective was to identify factors associated with GT placement and use that may be related to outcome.
Retrospective study.
University teaching hospital.
Twenty-four dogs diagnosed with septic peritonitis with GT placement at the time of exploratory laparotomy.
None.
Eighteen dogs (75%) survived to discharge. Eighteen dogs (75%) had a gastrointestinal source of septic peritonitis. Complications were reported in 12/24 (50%) patients. Four dogs (16.6%) had non-GT-related complications such as vomiting, regurgitation, or increased gastric residual volume. GT-related complications occurred in 8/24 (33.3%) dogs, the majority of which (6/8 [75%]) were minor and did not necessitate removal of the GT. Two dogs had major complications that required removal of the GT. Significant differences between survivors and nonsurvivors were found between the length of time after placement of the GT to when they began eating and outcome (discharge versus death versus euthanasia) (P = 0.03), and GT dwell time (length of time the GT was in place) and outcome (P = 0.006). Clinically relevant correlations were found between the time after placement of the GT until feeding and time after placement until voluntarily eating (P = 0.0349), time after placement of the GT until voluntarily eating and length of hospitalization (P = 0.0391), and time after placement of the GT until feeding and length of hospitalization (P = 0.036).
GTs can be placed during exploratory laparotomy in dogs with septic peritonitis. They facilitate early enteral nutrition and are associated with few clinically significant complications. Prospective studies are needed to determine the optimal postoperative feeding plan and the effects of early enteral nutrition on serum albumin concentration in this patient population.
描述脓毒性腹膜炎犬术后胃造口管（GT）的使用情况。次要目的是确定与GT放置和使用相关的、可能与预后有关的因素。
回顾性研究。
大学教学医院。
24只在剖腹探查术时被诊断为脓毒性腹膜炎并放置了GT的犬。
无。
18只犬（75%）存活至出院。18只犬（75%）的脓毒性腹膜炎源于胃肠道。12/24（50%）的患者报告有并发症。4只犬（16.6%）有与GT无关的并发症，如呕吐、反流或胃残余量增加。8/24（33.3%）的犬发生了与GT相关的并发症，其中大多数（6/8 [75%]）为轻微并发症，无需拔除GT。2只犬出现了需要拔除GT的严重并发症。在GT放置后开始进食的时间与预后（出院与死亡与安乐死）之间（P = 0.03），以及GT留置时间（GT放置的时间长度）与预后之间（P = 0.006），存活者与非存活者之间存在显著差异。在GT放置后至进食的时间与放置后至自主进食的时间之间（P = 0.0349）、GT放置后至自主进食的时间与住院时间之间（P = 0.0391），以及GT放置后至进食的时间与住院时间之间（P = 0.036）发现了具有临床相关性的关联。
在患有脓毒性腹膜炎的犬进行剖腹探查术时可放置GT。它们有助于早期肠内营养，且临床上显著并发症较少。需要进行前瞻性研究以确定该患者群体的最佳术后喂养方案以及早期肠内营养对血清白蛋白浓度的影响。
