Background: Megaesophagus carries a poor to guarded prognosis due to death from aspiration pneumonia. Options for medical management of regurgitation are limited to strategic oral or gastrostomy tube feeding.
Objectives: To describe the use and efficacy of intermittent esophageal suctioning to prevent regurgitation and associated episodes of aspiration pneumonia in dogs with megaesophagus.
Animals: Four dogs with acquired idiopathic megaesophagus and recurrent aspiration pneumonia.
Methods: Retrospective review of medical records of dogs with megaesophagus in which intermittent suctioning of esophageal content was employed for management of recurrent aspiration pneumonia.
Results: Intermittent suctioning of the esophagus was initiated in 4 dogs after failure of strict gastrostomy tube feeding failed to prevent regurgitation and repeated episodes of aspiration pneumonia. Suctioning was accomplished by esophagostomy tube in 3 dogs and per os in 1 dog. After initiation of esophageal suctioning, dogs survived for a median of 13.5 additional months (range, 10-30 months) during which time 2 dogs had no additional episodes of aspiration pneumonia and 2 dogs had infrequent episodes of pneumonia, but aspiration was suspected to be a contributing factor in their death. Complications included clogging of the esophagostomy tube, esophagostomy site infections, and esophagitis.
Conclusions And Clinical Importance: Use of intermittent esophageal suctioning in dogs with megaesophagus that continue to regurgitate despite gastrostomy tube feedings can reduce or abolish clinical episodes of aspiration pneumonia.
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http://dx.doi.org/10.1111/jvim.14527 | DOI Listing |
Indian J Thorac Cardiovasc Surg
February 2025
Institute of Heart and Lung Transplantation & Mechanical Circulatory Support, MGM Healthcare, Nelson Manickam Road, Aminjikarai, Chennai, Tamil Nadu India 600029.
Aspiration pneumonia is a serious problem in the elderly due to weakened swallowing reflexes or underlying gastroesophageal reflux disease (GERD). This can lead to acute respiratory distress syndrome (ARDS), which can become life-threatening, sometimes requiring extra corporeal membrane oxygenation (ECMO) support. Lung transplantation is a possible therapeutic option for patients with no signs of lung recovery despite prolonged ECMO support.
View Article and Find Full Text PDFEmerg Med Int
January 2025
Emergency Department, Kaifeng Central Hospital, Kaifeng, China.
International guidelines recommend early enteral nutrition (EEN) for critically ill patients. However, evidence supporting the optimal timing of EN in patients diagnosed with cardiogenic shock (CS) is lacking. As such, this study aimed to compare the clinical outcomes and safety of EEN versus delayed EN in patients diagnosed with CS.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anesthesiology, Medical Faculty, Heidelberg University, 69120, Heidelberg, Germany.
Invasive infections with Aspergillus fumigatus in ICU patients are linked to high morbidity and mortality. Diagnosing invasive pulmonary aspergillosis (IPA) in non-immunosuppressed patients is difficult, as Aspergillus antigen (galactomannan [GM]) may have other causes. This retrospective study analyzed 160 ICU surgical patients with positive GM in broncho-alveolar lavage fluid (BALF), classifying them based on AspICU criteria for suspected IPA (pIPA) or aspiration.
View Article and Find Full Text PDFJ Vet Med Sci
January 2025
Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University.
A 9-year-old spayed female mixed breed dog weighing 6.8 kg with a history of previous splenectomy for hemangiosarcoma 4 years earlier was referred for a hepatic mass lesion. Although the dog did not have a clinical sign, a computed tomography revealed a solitary mass in the left medial lobe of the liver.
View Article and Find Full Text PDFSeizure
January 2025
University of Adelaide, Adelaide SA 5005, Australia; Flinders University, Bedford Park SA 5042, Australia; Lyell McEwin Hospital, Elizabeth Vale SA 5112, Australia; Department of Neurology and the Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA 02138, USA.
Purpose: Epilepsia partialis continua (EPC) is form of focal motor status epilepticus, with limited guidelines regarding effective pharmacological management. This systematic review aimed to describe previously utilized pharmacological management strategies for EPC, with a focus on patient outcomes.
Methods: A systematic review of the databases PubMed, EMBASE, and SCOPUS was performed from inception to May 2024.
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