Edema pulmonar secundario a obstrucción de vía aerea superior en pacientes anestesiados

La presentación súbita del edema pulmonar agudo en el trans o postanestesico sin que exista patología subyacente conocida debe analizarse considerando el antecedente de obstrucción de vía aerea superior en cualquier momento de la anestesia, que por un mecanismo fisiopatológico poco claro se esta reportando en la literatura médica, cursa con una evolución rápida y su terapéutica no difiere de las medidas tradicionales en estos casos. Es importante ademas la identificación temprana de cualquier factor de riesgo agregado que pueda desencadenar una intubación endotraqueal dificultosa que desencadene laringoespasmo, complicación temida que puede ser catastrófica si luego se presenta edema pulmonar. La presente revisión recopila la casuistica reportada, así como los posibles mecanismos que determinan el aparecimiento de esta entidad, su manejo terapéutico y de soporte vital.

[The effect of extrusion on the acceptability and digestibility of diets for growing dogs]. / Efecto de la extrusión sobre la aceptabilidad y digestibilidad de dietas para perros en crecimiento.

Eight German Shepherd pups, about 75 days old and a live weight of 11 kg at the beginning of the trial, were used to assay a diet formulated according to NRC, 1985 (Nutrient Requirements of Dogs). The diet was administered either pelletized (PD) or extruded (ED). Acceptability was evaluated through a cafeteria test, and diet utilization by a digestion trial, wherein dry matter (DM), crude protein (CP), ether extract (EE), crude fiber (CF), nitrogen-free extract (NFE), energy (E), Ca and P were considered. At the beginning and at the end of the digestibility trial, venous blood samples were obtained to run biochemical profiles. Results of the cafeteria test showed that extrusion-cooking improved significantly (P greater than 0.01) diet consumption, which for the ED was 512 and for the PD, 253 g/animal/day. Extrusion also improved significantly (P less than 0.01), the digestibility of DM, CP, EE, NFE and E, reaching values of 82.6, 75.2, 83.9, 90.8 and 83.6% for ED, and 68.0, 64.6, 76.7, 73.5 and 69.7 for PD, respectively. For CF, Ca and P, there was no effect (P greater than 0.05) of extrusion over digestibility. The biochemical profiles, only exhibited minor changes, all figures being considered within the normal range for puppies. It is concluded that extrusion-cooking significantly improves acceptability and biological utilization of normal diets for dogs.