Enteral fluid therapy and nutrition in the critical care patient

Enteral fluid therapy [1–3]

The main indication for enteral fluid therapy is mild–moderate dehydration in patients with a functional gastrointestinal tract. It is particularly useful for large intestinal impactions. Fluids can be administered via a large bore or narrow bore nasogastric tube. The tube can be left indwelling or passed repeatedly.
Fluids can be administered as repeated boluses or continuously. The volume administered at one time should not exceed 6-8 l in a 500 kg horse. For treatment of a large colon impaction this volume may be repeated at short intervals – every 30 min to every 4 h. It is very important that the stomach is refluxed before administration and that treatment is delayed if there is more than 2 l of fluid in the stomach. Bolus administration of fluids can result in colic signs – this can be reduced by walking or administration of hyoscine (Buscopan®).
Narrow bore tubes can be connected to an intravenous administration set. This administration set can then be connected to empty intravenous fluid bags which can be filled with nonsterile fluids to provide continuous intragastric fluid administration. Rates of up to 40 ml/kg bwt/h may be tolerated but is advisable to start at slower rates initially, and of course will vary depending on degree of dehydration and condition being treated. It is important that these horses are monitored carefully for development of reflux as it is harder to establish this with a narrow bore tube. Regular ultrasonographic evaluation of the stomach may be helpful and the horse should be closely observed for colic signs.
Horse must be standing or in sternal recumbency  […]