Wednesday, August 28, 2019

Maintaining hydration with rectal fluid

Administering water via the rectum can be a useful way of giving large volumes of fluid, a recent study suggests.

Common to the management of many disease conditions is the need to maintain fluid balance.

This may require large volumes of fluid to be administered over a short time. Intravenous administration introduces fluid directly to the circulation. Administration into the stomach via nasogastric tube is another option, but may not always be possible.

Another option, often not considered, is administering fluid into the rectum.

In a randomised controlled experimental trial, Adeel Khan and colleagues compared the effect of fluids administered rectally with fluids given by the nasogastric (NGT) and intravenous (iv) routes.

They gave six healthy horses each of three treatments (intravenous hartmann’s solution; polyionic solution through a nasogastric tube; and tap water per rectum.)

For the rectal administration, faeces were manually removed from rectum, and fluid introduced through a catheter tied to the tail. Horses tolerated the procedure well.

To assess the effect of the various routes of fluid administration, the researchers monitored changes in the blood. They found that the packed cell volume fell over time with all treatments, indicating the fluids had been absorbed. Total solids in the blood fell with intravenous and rectal fluid administration.

A report of the research, published in the Equine Veterinary journal concludes: “Rectal fluid administration requires clinical evaluation, but may offer an inexpensive, safe alternative or adjunct to i.v. fluid administration, particularly when administration via NGT is not possible or contraindicated.”

For more details, see:

Continuous fluid infusion per rectum compared with intravenous and nasogastric fluid administration in horses
A. Khan, G. D. Hallowell, C. Underwood, A. W. van Eps 
Equine Veterinary Journal (2019)

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