EL ESPECIALISTA RESPONDE: What is the current state-of-the-art for medullary trauma in Veterinary Medicine? Currently maintaining blood pressure in the normal range with fluid support, Mannitol 1/2-1gm/kg IV, Oxygen administration and nutritional support. In human medicine there is concensus that steroids do not have enough benefit to outweigh the risks. I think the majority of veterinary neurologists would agree with this in patients with traumatic brain injury. While some research has been done with PEG (Polyethylene Glycol) there is not enough evidence to support its common use. Anne Anne Elizabeth Katherman, D.V.M., M.S. Diplomate ACVIM-Specialty of Neurology - practicing veterinary neurologist and inveterate beach wanderer ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Regardless of the location acute mgmt for acute neuronal cell / CNS trauma remains the relatively the same and requires addressing and maintaining: 1. Hemodynamic stability and normotension 2. Oxygenation (PaO2) and Ventilation (PaCO2) 3. Use hyperosmotics to address potential signs of or impending ICHP (intracranial hypertension) as well as parenchymal cytotoxic edema 4. Analgesia / sedation as needed to relieve pain, stress, anxiety which all contribute to elevated ICP 5. Maintain appropriate thermoregulation 6. Keep head and neck elevated and avoid jugular compressions >>> Is Manitol a drug for medulary trauma also? > And what about low inflammatory doses of pred. for medulary trauma?
Posted on: Sun, 16 Jun 2013 18:44:34 +0000