The Veterinary clinics of North America. Small animal practice
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Vet. Clin. North Am. Small Anim. Pract. · Sep 2015
ReviewPostoperative Hemostasis Monitoring and Management.
Although postoperative hemorrhage is an understood sequela, surgery also elicits an inflammatory response that may result in a hypercoagulable state and risk for venous or arterial thromboembolism. Postoperative venous thromboembolism is well documented in humans and is multifactorial in nature; however, evidence for its presence in veterinary medicine remains sparse. There is no consensus on the ideal type, dose, and duration of thromboprophylactic therapy in the perioperative period. Regardless, coagulation perturbations secondary to surgical stress are important considerations for the perioperative patient to reduce the possible fatal risks of hemorrhage or thrombosis.
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Vet. Clin. North Am. Small Anim. Pract. · Sep 2015
ReviewAssessment of Fluid Balance and the Approach to Fluid Therapy in the Perioperative Patient.
Perioperative patients can be highly dynamic and have various metabolic, physiologic, and organ system derangements that necessitate smart monitoring strategies and careful fluid therapy. The interplay between changing patient status, therapeutic interventions, and patient response makes effective monitoring crucial to successful treatment. Monitoring the perioperative patient and an approach to fluid therapy are discussed in this text.
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Perioperative complications commonly include oxygenation and ventilation abnormalities. The best outcome is associated with prevention. Ventilation impairment may be due to either neurologic compromise such as cervical intervertebral disk disease or severe parenchymal disease, while oxygenation failure may result from either the underlying disease or severe complications such as aspiration pneumonia, volume overload, pulmonary thromboembolism, or acute respiratory distress syndrome. This article reviews the approach to the patient with perioperative complications and provides recommendations on the management approach.
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Vet. Clin. North Am. Small Anim. Pract. · Sep 2015
ReviewPerioperative Blood Pressure Control and Management.
Blood pressure monitoring and management is a vital part of the perianesthetic period. Disturbances in blood pressure, especially hypotension, can have significant impacts on the well-being of small animal patients. ⋯ If hypotension is encountered, the initial response is to provide appropriate fluid therapy. If this is inadequate, other interventions can be used to increase blood pressure and thereby increase perfusion.