Complications in Equine Surgery. Группа авторов

Читать онлайн книгу.

Complications in Equine Surgery - Группа авторов


Скачать книгу
reconstruct the vein [16, 19].

       Expected outcome

      Most cases of thrombophlebitis will resolve uneventfully, but may require prolonged antimicrobial therapy. Sequellae may include cosmetic blemish, permanent occlusion of the affected vein, residual edema or varicosities in the area drained by the affected vein, and laryngeal hemiplegia. Septic embolization and dissemination of infection to internal locations may occur and may be associated with additional morbidity and mortality.

       Definition

      Needle emboli, catheter fragmentation, and loss of the guidewire are causes of intravascular foreign bodies during catheter placement and/or management of indwelling catheters [1, 5, 8, 20].

       Risk factors

       Use of small gauge (20 gauge or smaller) needles, inadequate restraint of a fractious patient, or manufacturer defect. Risk factors for loss of guidewires identified in human medicine and relevant to veterinary medicine are inexperience in the technique or equipment, lack of adequate supervision, distractions during catheter placement, and high workload [21]. Patient restraint and resistant during the procedure would be important in equine settings.

       Catheter kinking and breakage should be considered for any catheter type, especially as duration of catheterization increases, and clinicians should be most alert to failure in catheters made of stiffer materials (polytetrafluoroethylene, polyethylene, polypropylene) and over‐the‐needle stylet catheters, because they have to be stiffer to allow insertion.

Photo depicts local abscessation of a jugular thrombophlebitis with complete thrombosis of the right jugular vein at the level of the abscess and 10 cm caudally.

      Source: Courtesy of Pablo Espinosa.

       Pathogenesis

Photo depicts polyurethane catheter removed from a jugular vein 48 hours after being placed. The catheter is seen to have multiple areas of bending and kinking.

      Source: Julie E. Dechant.

       Diagnosis

Photo depicts lateral radiograph of the cranial cervical region (cranial to the left of the image) in a horse that was referred for treatment and removal of a needle fragment that broke off during attempted venipuncture of the left jugular vein. An intravenous catheter was placed in the contralateral (right) jugular vein. The needle fragment was located medial to the jugular vein in the cranial cervical region.

      Source: Courtesy of the University of California, Davis Veterinary Medical Teaching Hospital Diagnostic Imaging Service.

       Treatment

       Expected outcome

      In general, it is believed that intravascular foreign bodies located within the pulmonary vasculature carry a low risk of complications [1, 8].

       Vascular Air Embolism/Bleeding

       Definition

       Vascular air embolism is the aspiration of a significant amount of air from the


Скачать книгу