Chirurgia dróg oddechowych. Syndrom brachycefaliczny – cz. II

Medical therapy

Medical therapy for the upper airways

Patients presented with acute signs of respiratory distress should be treated accordingly with cooling, tranquilizers, oxygen therapy and anti-inflammatory drugs. However, relief of upper airway obstruction is the mainstay of BS treatment.

Medical therapy for the upper GI tract

In one study (Poncet et al., 2006), the influence of upper airway surgical treatment on improvement in gastrointestinal signs has been studied. In this study, when an inflammatory gastrointestinal disease was observed endoscopically, a medical treatment, based on inhibition of hydrogen ion secretion (omeprazole 0.7 mg/kg per os every 24 hours) and prokinetic medication (cisapride 0.2 mg/kg per every 8 hours), was recommended immediately after surgery. If distal esophagitis was noted, an antacid was prescribed for 15 days (magnesium hydroxide, 1 ml/kg per os after meals).

Following histological results, medical treatment was adjusted for each case. For moderate to severe gastritis a two month course of treatment was recommended, including an inhibitor of hydrogen ion secretion (omeprazole, 0.7 mg/kg per os every 24 hours), a prokinetic (cisapride, 0.2 mg/kg per os every 8 hours) and a surface protector (sucralfate, 1 g per os every 12 hours apart from the meals). For severe gastritis and/or duodenitis with parietal fibrosis, the same treatment was advised for 3 months and corticosteroids were added (prednisolone starting at 0.5 mg/kg per os every 12 hours).

This study also suggested that after surgical treatment of the upper airways and despite discontinuation of medical treatment in more than 80% of the cases, a clear improvement of upper gastrointestinal tract disease was observed. In the cases where a control gastroesophageal endoscopy could be obtained 6 months after upper airway surgery, it always showed complete resolution of the gastroesophageal endoscopic and histopathologic signs. These findings support the...

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