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Le-Bert CR, Bukoski A, Downs J, Hodgson DS, Thombs L, Ridgway SH, Bailey J. Apneustic anesthesia ventilation improves pulmonary function in anesthetized bottlenose dolphins ( Tursiops truncatus). Front Vet Sci 2024; 11:1287478. [PMID: 38645641 PMCID: PMC11027569 DOI: 10.3389/fvets.2024.1287478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/12/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Use of mechanical ventilation during general anesthesia is a necessary practice in the anesthetization of small cetaceans as spontaneous ventilation fails to provide adequate gas exchange. Currently available methods of ventilation do not account for the intermittent breathing strategy of representative species within this infraorder of fully aquatic mammals and may have a significant effect on cardiac and respiratory physiology. Methods To understand the impact of mechanical ventilation on cardiopulmonary function in one small species of cetacean, the bottlenose dolphin (Tursiops truncatus), we compared controlled mechanical ventilation (CMV) to a novel ventilation method known as apneustic anesthesia ventilation (AAV). AAV simulates the normal inspiratory breath-hold pattern of dolphins. Ten anesthetic procedures (dental procedure, n = 9; bronchoscopy, n = 2) were performed on nine dolphins (age range: 10-42 years; mean = 32 years; median = 37 years; female = 3, 40%; male = 6, 60%). In a cross-over study design, dolphins were instrumented and randomly assigned to AAV or CMV as the initial mode of ventilation, then switched to the alternate mode. Baseline cardiopulmonary data were collected and again after 30 min on each mode of ventilation. Cardiac index, stroke volume index, systemic vascular resistance, alveolar dead space, alveolar-arterial oxygen tension gradient, arterial oxygen content, oxygen delivery index, and dynamic respiratory system compliance index were calculated at each of the four time points. Results During AAV, dolphins had higher arterial oxygen tension, higher mean airway pressure, reduced alveolar dead space ventilation and lower alveolar-arterial oxygen difference. Cardiovascular performance was not statistically different between the two modes. Discussion Our study suggests AAV, which more closely resembles the conscious intermittent respiratory pattern phenotype of dolphins, improves ventilation and pulmonary function in the anesthetized dolphin. Future studies should evaluate the cardiopulmonary effects of neutral buoyancy and cardiopulmonary sparing drug protocols to reduce the need for hemodynamic support of current protocols.
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Affiliation(s)
- Carolina R. Le-Bert
- U.S. Navy Marine Mammal Program, Naval Information Warfare Center Pacific, San Diego, CA, United States
| | - Alex Bukoski
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
| | - John Downs
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, United States
- Innovative Veterinary Medicine, Ponte Vedra, FL, United States
| | - David S. Hodgson
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, United States
| | - Lori Thombs
- Department of Statistics, College of Arts and Science, University of Missouri, Columbia, MO, United States
| | - Sam H. Ridgway
- U.S. Navy Marine Mammal Program, National Marine Mammal Foundation, San Diego, CA, United States
| | - James Bailey
- Innovative Veterinary Medicine, Ponte Vedra, FL, United States
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Vicenti C, Otero PE, Briganti A, Rondelli V, Stabile M, Piemontese C, Crovace A, Lacitignola L, Staffieri F. Respiratory Effects of Continuous Positive Airway Pressure Administered during Recovery from General Anesthesia in Brachycephalic Dogs. Vet Sci 2024; 11:75. [PMID: 38393093 PMCID: PMC10893332 DOI: 10.3390/vetsci11020075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to evaluate the benefits of applying 5 cmH2O of CPAP using a pediatric helmet during the recovery phase from general anesthesia in brachycephalic dogs. Brachycephalic dogs undergoing various surgical procedures were included in this study, and a total of 64 subjects were randomly assigned to receive either standard oxygen supplementation (NO-CPAP group) or oxygen supplementation combined with CPAP (CPAP group). This study evaluated arterial blood pH, blood gas partial pressures of O2 and CO2, arterial blood O2 saturation, and related parameters during recovery. The dogs were monitored, and helmet tolerance was assessed using predefined criteria. Of the initially assessed 69 dogs, 64 were enrolled: 32 in the CPAP group and 32 in the NO-CPAP group. Fifteen dogs in the NO-CPAP group were excluded based on predetermined criteria. The CPAP group showed significant improvements in PaO2, PaO2/FiO2, P(A-a)O2, F-Shunt, and respiratory rate compared with the NO-CPAP group (p < 0.001). The incidence of reintubation and helmet intolerance was higher in the NO-CPAP group (18% and 15.6%, respectively) than in the CPAP group (0%). This study highlights the potential benefits of incorporating CPAP, delivered through a pediatric helmet, in the perioperative management of brachycephalic dogs.
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Affiliation(s)
- Caterina Vicenti
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Pablo E Otero
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427CWN, Argentina
| | - Angela Briganti
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, 56122 Pisa, Italy
| | | | - Marzia Stabile
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Claudia Piemontese
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Antonio Crovace
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Luca Lacitignola
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
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Larrabee S, Nugen S, Bruhn A, Porter I, Stowe S, Adler A, Martin-Flores M, Araos J. Three-dimensional electrical impedance tomography to study regional ventilation/perfusion ratios in anesthetized pigs. Am J Physiol Lung Cell Mol Physiol 2023; 325:L638-L646. [PMID: 37724348 DOI: 10.1152/ajplung.00180.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023] Open
Abstract
This study aimed to develop a three-dimensional (3-D) method for assessing ventilation/perfusion (V/Q̇) ratios in a pig model of hemodynamic perturbations using electrical impedance tomography (EIT). To evaluate the physiological coherence of changes in EIT-derived V/Q̇ ratios, global EIT-derived V/Q̇ mismatches were compared with global gold standards. The study found regional heterogeneity in the distribution of V/Q̇ ratios in both the ventrodorsal and craniocaudal directions. Although global EIT-derived indices of V/Q̇ mismatch consistently underestimated both low and high V/Q̇ mismatch compared with global gold standards, the direction of the change was similar. We made the software available at no cost for other researchers to use. Future studies should compare regional V/Q̇ ratios determined by our method against other regional, high-resolution methods.NEW & NOTEWORTHY In this study, we introduce a novel 3-D method for assessing ventilation-perfusion (V/Q̇) ratios using electrical impedance tomography (EIT). Heterogeneity in V/Q̇ distribution showcases the significant potential for enhanced understanding of pulmonary conditions. This work signifies a substantial step forward in the application of EIT for monitoring and managing lung diseases.
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Affiliation(s)
- Shannon Larrabee
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
| | - Sarah Nugen
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
| | - Alejandro Bruhn
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ian Porter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
| | - Symon Stowe
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
| | - Andy Adler
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
| | - Joaquin Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
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Sacks M, Raidal S, Catanchin CSM, Hosgood G, Mosing M. Impact of sedation, body position change and continuous positive airway pressure on distribution of ventilation in healthy foals. Front Vet Sci 2023; 9:1075791. [PMID: 36713868 PMCID: PMC9880457 DOI: 10.3389/fvets.2022.1075791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/14/2022] [Indexed: 01/15/2023] Open
Abstract
Background This study aimed to compare the distribution of ventilation measured by electrical impedance tomography (EIT), in foals under varying clinical conditions of sedation, postural changes, and continuous positive airway pressure (CPAP). To support the interpretation of EIT variables, specific spirometry data and F-shunt calculation were also assessed. Materials and methods Six healthy Thoroughbred foals were recruited for this sequential experimental study. EIT and spirometry data was recorded: (1) before and after diazepam-sedation, (2) after moving from standing to right lateral recumbency, (3) in dorsal recumbency during no CPAP (CPAP0) and increasing levels of CPAP of 4, 7, and 10 cmH2O (CPAP4, 7, 10, respectively). Ventral to dorsal (COVVD) and right to left (COVRL) center of ventilation, silent spaces, tidal impedance variation, regional ventilation distribution variables and right to left lung ventilation ratio (R:L) were extracted. Minute ventilation was calculated from tidal volume (VT) and respiratory rate. F-Shunt was calculated from results of arterial blood gas analysis. Statistical analysis was performed using linear mixed effects models (significance determined at p < 0.05). Results (1) Respiratory rate was lower after sedation (p = 0.0004). (2) In right lateral recumbency (compared to standing), the COVVD (p = 0.0012), COVRL (p = 0.0057), left centro-dorsal (p = 0.0071) and dorsal (p < 0.0001) regional ventilation were higher, while the right ventral (p = 0.0016) and dorsal (p = 0.0145) regional ventilation, and R:L (p = 0.0017) were lower. (3) Data of two foals for CPAP10 was excluded from statistical analysis due to prolonged apnea. Stepwise increase of CPAP led to increases of COVVD (p = 0.0028) and VT (p = 0.0011). A reduction of respiratory rate was detected with increasing CPAP levels (p < 0.0001). Conclusions (1) In healthy foals, diazepam administration did not alter distribution of ventilation or minute ventilation, (2) lateral recumbency results in collapse of dependent areas of the lung, and (3) the use of CPAP in dorsal recumbency at increasing pressures improves ventilation in dependent regions, suggesting improvement of ventilation-perfusion mismatch.
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Affiliation(s)
- Muriel Sacks
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia,*Correspondence: Muriel Sacks ✉
| | - Sharanne Raidal
- School of Animal, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Chee Sum Melanie Catanchin
- School of Animal, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Giselle Hosgood
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | - Martina Mosing
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
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Di Bella C, Vicenti C, Araos J, Lacitignola L, Fracassi L, Stabile M, Grasso S, Crovace A, Staffieri F. Effects of two alveolar recruitment maneuvers in an “open-lung” approach during laparoscopy in dogs. Front Vet Sci 2022; 9:904673. [PMID: 36061108 PMCID: PMC9435385 DOI: 10.3389/fvets.2022.904673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this study was to compare the effects of a sustained inflation alveolar recruiting maneuver (ARM) followed by 5 cmH2O of PEEP and a stepwise ARM, in dogs undergoing laparoscopic surgery. Materials and methods Twenty adult dogs were enrolled in this prospective randomized clinical study. Dogs were premedicated with methadone intramuscularly (IM); anesthesia was induced with propofol intravenously (IV) and maintained with inhaled isoflurane in pure oxygen. The baseline ventilatory setting (BVS) was as follows: tidal volume of 15 mL/kg, inspiratory pause of 25%, inspiratory to expiratory ratio of 1:2, and the respiratory rate to maintain the end-tidal carbon dioxide between 45 and 55 mmHg. 10 min after pneumoperitoneum, randomly, 10 dogs underwent sustained inflation ARM followed by 5 cmH2O of PEEP (ARMi), while 10 dogs underwent a stepwise recruitment maneuver followed by the setting of the “best PEEP” (ARMc). Gas exchange, respiratory system mechanics, and hemodynamic were evaluated before the pneumoperitoneum induction (BASE), 10 min after the pneumoperitoneum (PP), 10 min after the recruitment (ARM), and 10 min after the pneumoperitoneum resolution (PostPP). Statistical analysis was performed with the ANOVA test (p < 0.05). Results Static compliance decreased in both groups at PP (ARMc = 1.35 ± 0.21; ARMi = 1.16 ± 0.26 mL/cmH2O/kg) compared to BASE (ARMc = 1.78 ± 0.60; ARMi = 1.66 ± 0.66 mL/cmH2O/kg) and at ARM (ARMc = 1.71 ± 0.41; ARMi = 1.44 ± 0.84 mL/cmH2O/kg) and PostPP (ARMc = 1.75 ± 0.45; ARMi = 1.89 ± 0.59 mL/cmH2O/kg), and it was higher compared to PP and similar to BASE. The PaO2/FiO2, in both groups, was higher at ARM (ARMc = 455.11 ± 85.90; ARMi = 505.40 ± 31.70) and PostPP (ARMc = 521.30 ± 66.20; ARMi = 450.90 ± 70.60) compared to PP (ARMc = 369.53 ± 49.31; ARMi = 394.32 ± 37.72). Conclusion and clinical relevance The two ARMs improve lung function in dogs undergoing laparoscopic surgery similarly. Application of PEEP at the end of the ARMs prolonged the effects of the open-lung strategy.
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Affiliation(s)
- Caterina Di Bella
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Caterina Vicenti
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Joaquin Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Luca Lacitignola
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Laura Fracassi
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Marzia Stabile
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Salvatore Grasso
- Section of Anesthesia and Intensive Care, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Alberto Crovace
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
- *Correspondence: Francesco Staffieri
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Lung aeration and volumes following alveolar recruitment maneuvers with three airway pressures in healthy anesthetized and mechanically ventilated Beagle dogs. Vet Anaesth Analg 2022; 49:443-451. [DOI: 10.1016/j.vaa.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 01/17/2023]
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Martin-Flores M, Araos JD, Daniels ZS, Newman A, Nugen SA, Campoy L. The effects of intraoperative positive end-expiratory pressure and fraction of inspired oxygen on postoperative oxygenation in dogs undergoing stifle surgery. Vet Anaesth Analg 2022; 49:275-281. [DOI: 10.1016/j.vaa.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/27/2022]
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Tucker L, Almeida D, Wendt-Hornickle E, Baldo CF, Allweiler S, Guedes AGP. Effect of 15° Reverse Trendelenburg Position on Arterial Oxygen Tension during Isoflurane Anesthesia in Horses. Animals (Basel) 2022; 12:ani12030353. [PMID: 35158676 PMCID: PMC8833611 DOI: 10.3390/ani12030353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Horses commonly develop low blood oxygen levels during anesthesia, especially when they are placed on their backs. This study investigated whether a 15° head-up tilt, in a homogenous group of anesthetized horses positioned on their backs, would result in better blood oxygen levels as compared to no tilt. The results showed significantly greater blood oxygen levels with tilt compared to no tilt in five out of six horses tested. In one horse the effect was the opposite. The concurrent effect on cardiovascular function remains to be tested in detail. Further studies are needed to confirm these findings in a larger group of horses and to determine the effects on blood pressure and treatment options. Abstract Lower than expected arterial oxygen tension (PaO2) continues to be an unresolved problem in equine anesthesia. The aim of this randomized, crossover, and prospective study using six adult horses is to determine if a 15° reverse Trendelenburg position (RTP) increases PaO2 during inhalation anesthesia. Under constant-dose isoflurane anesthesia, dorsally recumbent horses were positioned either horizontally (HP) or in a 15° RTP for 2 h. Lungs were mechanically ventilated (15 mL/kg, 6 breaths/min). Arterial carbon dioxide tension (PaCO2), PaO2, inspired oxygen fraction (FiO2), and end-tidal carbon dioxide tension (EtCO2) were determined every 30 min during anesthesia. Indices of dead-space ventilation (Vd/Vt), oxygenation (P–F ratio), and perfusion (F–shunt) were calculated. Dobutamine and phenylephrine were used to support mean arterial pressure (MAP). Data are presented as median and range. In one horse, which was deemed an outlier due to its thoracic dimensions and body conformation, indices of oxygenation worsened in RTP compared to HP (median PaO2 438 vs. 568 mmHg; P–F ratio 454 vs. 586 mmHg, and F–shunt 13.0 vs. 5.7 mmHg). This horse was excluded from calculations. In the remaining five horses they were significantly better with RTP compared to HP. Results in remaining five horses showed that PaO2 (502, 467–575 vs. 437, 395–445 mmHg), P-F ratio (518, 484–598 vs. 455, 407–458 mmHg), and F-shunt (10.1, 4.2–11.7 vs. 14.2, 13.8–16.0 mmHg) were significantly different between RTP and HP (p = 0.03). Other variables were not significantly different. In conclusion, the 15° RTP resulted in better oxygenation than HP in dorsally recumbent, isoflurane-anesthetized horses, although worsening of oxygenation may occur in individual horses. A study detailing the cardiovascular consequences of RTP is necessary before it can be recommended for clinical practice.
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Affiliation(s)
- Laura Tucker
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; (L.T.); (D.A.); (E.W.-H.); (C.F.B.); (S.A.)
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Daniel Almeida
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; (L.T.); (D.A.); (E.W.-H.); (C.F.B.); (S.A.)
| | - Erin Wendt-Hornickle
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; (L.T.); (D.A.); (E.W.-H.); (C.F.B.); (S.A.)
| | - Caroline F. Baldo
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; (L.T.); (D.A.); (E.W.-H.); (C.F.B.); (S.A.)
- Boston Scientific, Research and Technology Center, Arden Hills, MN 55112, USA
| | - Sandra Allweiler
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; (L.T.); (D.A.); (E.W.-H.); (C.F.B.); (S.A.)
| | - Alonso G. P. Guedes
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; (L.T.); (D.A.); (E.W.-H.); (C.F.B.); (S.A.)
- Correspondence:
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Annalaura S, Luiz PME, Robert I RR, Gareth J J, Francesco S. Use of the peripheral oxygen saturation to inspired oxygen fraction diagram to assess gas exchange in horses under general anaesthesia and mechanical ventilation. J Equine Vet Sci 2022; 111:103874. [DOI: 10.1016/j.jevs.2022.103874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/17/2022] [Indexed: 12/01/2022]
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Bleul U, Wey C, Meira C, Waldmann A, Mosing M. Assessment of Postnatal Pulmonary Adaption in Bovine Neonates Using Electric Impedance Tomography (EIT). Animals (Basel) 2021; 11:3216. [PMID: 34827949 PMCID: PMC8614262 DOI: 10.3390/ani11113216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 01/06/2023] Open
Abstract
Several aspects of postnatal pulmonary adaption in the bovine neonate remain unclear, particularly the dynamics and regional ventilation of the lungs. We used electric impedance tomography (EIT) to measure changes in ventilation in the first 3 weeks of life in 20 non-sedated neonatal calves born without difficulty in sternal recumbency. Arterial blood gas variables were determined in the first 24 h after birth. Immediately after birth, dorsal parts of the lungs had 4.53% ± 2.82% nondependent silent spaces (NSS), and ventral parts had 5.23% ± 2.66% dependent silent spaces (DSS). The latter increased in the first hour, presumably because of gravity-driven ventral movement of residual amniotic fluid. The remaining lung regions had good ventilation immediately after birth, and the percentage of lung regions with high ventilation increased significantly during the study period. The centre of ventilation was always dorsal to and on the right of the theoretical centre of ventilation. The right lung was responsible for a significantly larger proportion of ventilation (63.84% ± 12.74%, p < 0.00001) compared with the left lung. In the right lung, the centrodorsal lung area was the most ventilated, whereas, in the left lung, it was the centroventral area. Tidal impedance changes, serving as a surrogate for tidal volume, increased in the first 3 weeks of life (p < 0.00001). This study shows the dynamic changes in lung ventilation in the bovine neonate according to EIT measurements. The findings form a basis for the recognition of structural and functional lung disorders in neonatal calves.
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Affiliation(s)
- Ulrich Bleul
- Department of Farm Animals, Clinic of Reproductive Medicine, Vetsuisse-Faculty University Zurich, 8057 Zurich, Switzerland;
| | - Corina Wey
- Department of Farm Animals, Clinic of Reproductive Medicine, Vetsuisse-Faculty University Zurich, 8057 Zurich, Switzerland;
| | - Carolina Meira
- Department of Clinical Diagnostics and Services, Section Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zürich, Switzerland;
| | - Andreas Waldmann
- Department of Anesthesiology and Intensive Care Medicine, Rostock University Medical Center, 39071 Rostock, Germany;
| | - Martina Mosing
- Department of Veterinary Anaesthesia and Analgesia, School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch 6150, Australia;
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Dupont J, Gougnard A, Salciccia A, Detilleux J, Serteyn D, Sandersen C. Comparison of single-breath continuous positive airway pressure manoeuvre with inhaled salbutamol to improve oxygenation in horses anaesthetized for laparotomy. Vet Anaesth Analg 2021; 49:85-94. [PMID: 34872855 DOI: 10.1016/j.vaa.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/30/2021] [Accepted: 06/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the efficacy of single-breath continuous positive airway pressure manoeuvre (CPAP-M) with inhaled salbutamol, and a combination of both. STUDY DESIGN Randomized, clinical study. ANIMALS A total of 62 client-owned horses (American Society of Anesthesiologists status III-V) anaesthetized for laparotomy. METHODS Horses were premedicated with intravenous (IV) xylazine (0.4-0.6 mg kg-1), anaesthesia was induced with midazolam (0.06 mg kg-1 IV) and ketamine (2.2 mg kg-1 IV) and maintained with isoflurane in oxygen using volume-controlled ventilation without positive end-expiratory pressure. If PaO2 was < 100 mmHg (13.3 kPa), either a CPAP-M (50 cmH2O for 45 seconds) or salbutamol (0.002 mg kg-1) was administered. The intervention was considered successful if PaO2 reached 100 mmHg (13.3 kPa). If PaO2 remained < 100 mmHg (13.3 kPa), treatments were switched. PaO2/FiO2 ratio and estimated shunt fraction (F-shunt) were derived from data obtained from arterial blood gas measurements. Dynamic compliance (Cdyn) was calculated from variables recorded at the moment of arterial blood analysis. Fisher's exact tests compared success rates between treatments, and linear models were performed to test whether the treatment modified the values of the measurements; p < 0.05. RESULTS Salbutamol was the first intervention in 28 horses and was effective in 22 horses. CPAP-M was the first intervention in 34 horses and was effective in 26 horses. CPAP-M after salbutamol was performed in six horses, with four responders, and salbutamol after CPAP-M was administered to eight horses, with one responder. Salbutamol, but not CPAP-M, significantly decreased F-shunt. Both salbutamol and CPAP-M significantly increased Cdyn. CONCLUSIONS AND CLINICAL RELEVANCE Salbutamol and CPAP-M were comparably effective in improving oxygenation and Cdyn in anaesthetized horses with PaO2 < 100 mmHg (13.3 kPa). Whether combining both treatments might be beneficial needs to be confirmed on a larger number of horses.
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Affiliation(s)
- Julien Dupont
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.
| | - Alexandra Gougnard
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Alexandra Salciccia
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Johann Detilleux
- Quantitative Genetics Group, Department of Veterinary Management of Animal Resources, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Didier Serteyn
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Charlotte Sandersen
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
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Araos J, Lacitignola L, de Monte V, Stabile M, Porter I, Hurtado DE, Perez A, Crovace A, Grasso S, Martin-Flores M, Staffieri F. Evaluation of Lung Aeration and Respiratory System Mechanics in Obese Dogs Ventilated With Tidal Volumes Based on Ideal vs. Current Body Weight. Front Vet Sci 2021; 8:704863. [PMID: 34660755 PMCID: PMC8517180 DOI: 10.3389/fvets.2021.704863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/06/2021] [Indexed: 11/23/2022] Open
Abstract
We describe the respiratory mechanics and lung aeration in anesthetized obese dogs ventilated with tidal volumes (VT) based on ideal (VTi) vs. current (VTc) body weight. Six dogs with body condition scores ≥ 8/9 were included. End-expiratory respiratory mechanics and end-expiratory CT-scan were obtained at baseline for each dog. Thereafter, dogs were ventilated with VT 15 ml kg−1 based on VTi and VTc, applied randomly. Respiratory mechanics and CT-scan were repeated at end-inspiration during VTi and VTc. Data analyzed with linear mixed models and reported as mean ± SD or median [range]. Statistical significance p < 0.05. The elastance of the lung, chest wall and respiratory system indexed by ideal body weight (IBW) were positively correlated with body fat percentage, whereas the functional residual capacity indexed by IBW was negatively correlated with body fat percentage. At end-expiration, aeration (%) was: hyperaeration 0.03 [0.00–3.35], normoaeration 69.7 [44.6–82.2], hypoaeration 29.3 [13.6–49.4] and nonaeration (1.06% [0.37–6.02]). Next to the diaphragm, normoaeration dropped to 12 ± 11% and hypoaeration increased to 90 ± 8%. No differences in aeration between groups were found at end-inspiration. Airway driving pressure (cm H2O) was higher (p = 0.002) during VTc (9.8 ± 0.7) compared with VTi (7.6 ± 0.4). Lung strain was higher (p = 0.014) during VTc (55 ± 21%) than VTi (38 ± 10%). The stress index was higher (p = 0.012) during VTc (SI = 1.07 [0.14]) compared with VTi (SI = 0.93 [0.18]). This study indicates that body fat percentage influences the magnitude of lung, chest wall, and total respiratory system elastance and resistance, as well as functional residual capacity. Further, these results indicate that obese dogs have extensive areas of hypoaerated lungs, especially in caudodorsal regions. Finally, lung strain and airway driving pressure, surrogates of lung deformation, are higher during VTc than during VTi, suggesting that in obese anesthetized dogs, ventilation protocols based on IBW may be advantageous.
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Affiliation(s)
- Joaquin Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Luca Lacitignola
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation D.E.O.T., "Aldo Moro" University of Bari, Bari, Italy
| | - Valentina de Monte
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation D.E.O.T., "Aldo Moro" University of Bari, Bari, Italy
| | - Marzia Stabile
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation D.E.O.T., "Aldo Moro" University of Bari, Bari, Italy
| | - Ian Porter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Daniel E Hurtado
- Department of Structural and Geotechnical Engineering, School of Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile
| | - Agustín Perez
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Antonio Crovace
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation D.E.O.T., "Aldo Moro" University of Bari, Bari, Italy
| | - Salvatore Grasso
- Section of Anesthesia and Intensive Care, Department of Emergency and Organ Transplantation D.E.O.T., "Aldo Moro" University of Bari, Bari, Italy
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation D.E.O.T., "Aldo Moro" University of Bari, Bari, Italy
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Savvas I, Pavlidou K, Braun C, Schauvliege S, Staffieri F, Moens Y. Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis. Animals (Basel) 2021; 11:ani11082245. [PMID: 34438703 PMCID: PMC8388394 DOI: 10.3390/ani11082245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023] Open
Abstract
In anaesthetized horses, pronounced ventilation/perfusion mismatching often occurs. Several authors have investigated the effect of lower inspired oxygen fractions (FiO2) to reduce formation of absorption atelectasis. This systematic review compared the effects of low (<0.6) and high (>0.8) FiO2 on the arterial oxygen tension (PaO2), the alveolar-to-arterial oxygen tension difference (P(A-a)O2), and the PaO2/FiO2 ratio in horses during inhalation anaesthesia. Using the Systematic Review Protocol for Animal Intervention Studies, four experimental and one clinical investigations were deemed suitable for inclusion. A meta-analysis was performed on the four experimental studies. The PaO2 was significantly lower (p = 0.0007, mean difference -23.54 kPa, 95% CI -37.18, -9.90) with a lower FiO2. However, the P(A-a)O2 was also significantly lower (p < 0.00001, mean difference -20.80 kPa, 95% CI -26.28, -15.32) when using a low FiO2. For the PaO2/FiO2 ratio, only one study fitted the inclusion criteria, so no meta-analysis was performed. It is concluded that, while only a limited number of studies are available, the use of a higher FiO2 in horses during inhalation anaesthesia will result in higher levels of PaO2, but also a larger P(A-a)O2 difference. Further studies are needed to increase the level of evidence on this subject.
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Affiliation(s)
- Ioannis Savvas
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 546 27 Thessaloniki, Greece;
- Correspondence:
| | - Kiriaki Pavlidou
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 546 27 Thessaloniki, Greece;
| | - Christina Braun
- Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, 1210 Vienna, Austria; (C.B.); (Y.M.)
| | - Stijn Schauvliege
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari Aldo Moro, 70010 Bari, Italy;
| | - Yves Moens
- Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, 1210 Vienna, Austria; (C.B.); (Y.M.)
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Use of Electrical Impedance Tomography (EIT) to Estimate Tidal Volume in Anaesthetized Horses Undergoing Elective Surgery. Animals (Basel) 2021; 11:ani11051350. [PMID: 34068514 PMCID: PMC8151473 DOI: 10.3390/ani11051350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/05/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary The aim of this study was to explore the usefulness of electrical impedance tomography (EIT), a novel monitoring tool measuring impedance change, to estimate tidal volume (volume of gas in litres moved in and out the airways and lungs with each breath) in anaesthetised horses. The results of this study, performed in clinical cases, demonstrated that there was a positive linear relationship between tidal volume measurements obtained with spirometry and impedance changes measured by EIT within each subject and this individual relationship could be used to estimate tidal volume that showed acceptable agreement with a measured tidal volume in each horse. Thus, EIT can be used to observe changes in tidal volume by the means of impedance changes. However, absolute measurement of tidal volume is only possible after establishment of the individual relationship. Abstract This study explores the application of electric impedance tomography (EIT) to estimate tidal volume (VT) by measuring impedance change per breath (∆Zbreath). Seventeen healthy horses were anaesthetised and mechanically ventilated for elective procedures requiring dorsal recumbency. Spirometric VT (VTSPIRO) and ∆Zbreath were recorded periodically; up to six times throughout anaesthesia. Part 1 assessed these variables at incremental delivered VT of 10, 12 and 15 mL/kg. Part 2 estimated VT (VTEIT) in litres from ∆Zbreath at three additional measurement points using a line of best fit obtained from Part 1. During part 2, VT was adjusted to maintain end-tidal carbon dioxide between 45–55 mmHg. Linear regression determined the correlation between VTSPIRO and ∆Zbreath (part 1). Estimated VTEIT was assessed for agreement with measured VTSPIRO using Bland Altman analysis (part 2). Marked variability in slope and intercepts was observed across horses. Strong positive correlation between ∆Zbreath and VTSPIRO was found in each horse (R2 0.9–0.99). The agreement between VTEIT and VTSPIRO was good with bias (LOA) of 0.26 (−0.36–0.88) L. These results suggest that, in anaesthetised horses, EIT can be used to monitor and estimate VT after establishing the individual relationship between these variables.
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Di Bella C, Araos J, Lacitignola L, Grasso S, De Marzo L, Crovace AM, Staffieri F. Effects of continuous positive airway pressure administered by a helmet in cats under general anaesthesia. J Feline Med Surg 2021; 23:337-343. [PMID: 32840420 PMCID: PMC10812219 DOI: 10.1177/1098612x20951279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the respiratory effects of non-invasive continuous positive airway pressure (CPAP) administered by a helmet in healthy cats under anaesthesia. METHODS Fifteen healthy male cats scheduled for castration were anaesthetised with medetomidine (20 µg/kg), ketamine (10 mg/kg) and buprenorphine (20 µg/kg) intramuscularly. When an adequate level of anaesthesia was achieved, a paediatric helmet was placed on all subjects. The helmet was connected to a Venturi valve supplied with medical air and cats received the following phases of treatments: 0 cmH2O (pre-CPAP), 5 cmH2O (CPAP) and 0 cmH2O (post-CPAP). Each treatment lasted 10 mins. At the end of each phase an arterial blood sample was drawn. The following data were also collected: mean arterial pressure, respiratory rate, heart rate and the anaesthesia level score (0 = awake, 10 = deep anaesthesia). The alveolar to arterial oxygen gradient (P[A-a]O2) and the venous admixture (Fshunt) were also estimated. Data were analysed with two-way ANOVA (P <0.05). RESULTS The arterial partial pressure of oxygen was higher (P <0.001) at CPAP (103.2 ± 5.1 mmHg) vs pre-CPAP (77.5 ± 7.4 mmHg) and post-CPAP (84.6 ± 8.1 mmHg). The P(A-a)O2 and the Fshunt were lower (P <0.001) at CPAP (4.4 ± 2.3 mmHg; 7.4 ± 3.1%) vs pre-CPAP (18.9 ± 6.4 mmHg; 22.8 ± 4.6%) and post-CPAP (15.6 ± 7.3 mmHg; 20.9 ± 4.6 %). No other parameters differed between groups. CONCLUSIONS AND RELEVANCE Non-invasive CPAP applied by a helmet improves oxygenation in cats under injectable general anaesthesia.
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Affiliation(s)
- Caterina Di Bella
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari ‘Aldo Moro’, Valenzano, Bari, Italy
| | - Joaquin Araos
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Luca Lacitignola
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari ‘Aldo Moro’, Valenzano, Bari, Italy
| | - Salvatore Grasso
- Section of Anaesthesia and Intensive Care, Department of Emergency and Organs Transplantation, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Linda De Marzo
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari ‘Aldo Moro’, Valenzano, Bari, Italy
| | - Alberto Maria Crovace
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari ‘Aldo Moro’, Valenzano, Bari, Italy
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari ‘Aldo Moro’, Valenzano, Bari, Italy
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Kadwa AR, Brown GJ, Buck R. Anaesthetic management of a bovine for ventral midline coeliotomy approach to hysterotomy. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Abdur Rahmaan Kadwa
- Department of Companion Animal Clinical Studies Faculty of Veterinary Science, University of Pretoria South Africa
| | - Geoffrey James Brown
- Department of Companion Animal Clinical Studies Faculty of Veterinary Science, University of Pretoria South Africa
| | - Roxanne Buck
- Department of Companion Animal Clinical Studies Faculty of Veterinary Science, University of Pretoria South Africa
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Cerullo M, Driessen B, Douglas H, Hopster K. Changes in Arterial Blood Pressure and Oxygen Tension as a Result of Hoisting in Isoflurane Anesthetized Healthy Adult Horses. Front Vet Sci 2020; 7:601326. [PMID: 33324704 PMCID: PMC7723898 DOI: 10.3389/fvets.2020.601326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background: In anesthetized adult horses, changes in recumbency can influence the cardiovascular system but how arterial blood pressures and oxygen tension change in isoflurane anesthetized animals as a direct result of hoisting has not been investigated. Objective: To evaluate effects of hoisting on hemodynamic function and pulmonary gas exchange in isoflurane-anesthetized horses. Study Design: Prospective, experimental study. Methods: Six adult horses were anesthetized three times using isoflurane in pure oxygen (inspired fraction 0.9-1.0), and allowed breathing spontaneously in lateral recumbency. After 45 min horses were hoisted using a single hoist-hobble system for 5 min and returned into left lateral recumbency. Heart rate (HR), respiratory rate (RR), and systolic (SAP), diastolic (DAP), and mean arterial blood pressures (MAP) were measured every minute starting from 5 min before to 5 min after hoisting. Arterial blood gas samples were collected before, during, and after hoisting. Results: Significant changes in hemodynamic parameters and PaO2 but not PaCO2 were found between baseline recordings and measurements obtained during and early after hoisting. The MAP decreased within the 1st min of hoisting from a mean of 74 ± 17 mmHg at baseline to 57 ± 20 mmHg (p < 0.05). Thereafter, it rapidly recovered to baseline before continuing to rise to higher than baseline values and then remaining elevated for 5 min after horses were returned into lateral recumbency. Simultaneously, the HR increased by 6-9 beats per min during the initial 3 min of hoisting before returning close to baseline values (p < 0.05). The PaO2 decreased significantly from a mean of 324.9 ±137.0 mmHg at baseline to a mean of 141.3 ± 104.2 mmHg during hoisting (p < 0.001) without recovering any more to baseline values. Clinical significance: Hoisting an adult horse during or at the end of isoflurane anesthesia carries the risk of a precipitous, though short-lived (1-2 min), drop in arterial blood pressures and a persistent decrease in arterial oxygenation. While in systemically healthy animals the observed functional impairments were not life-threatening, they may be more severe in systemically compromised horses.Therefore, arterial blood pressures and oxygenation must be carefully monitored when hoisting sick equine patients during or at the end of inhalant anesthesia.
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Affiliation(s)
- Michelle Cerullo
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
| | - Bernd Driessen
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
| | - Hope Douglas
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
| | - Klaus Hopster
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
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Trenholme HN, Barletta M, Quandt JE, Reed RA, Kleine SA, Hofmeister EH. Arterial oxygenation in anesthetized horses placed in a 5-degree reverse Trendelenburg position. Res Vet Sci 2020; 135:304-309. [PMID: 33066990 DOI: 10.1016/j.rvsc.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 11/17/2022]
Abstract
Low arterial oxygen is a common complication in anesthetized horses and placing the animal in reverse Trendelenburg (RT) position may treat hypoxemia. The objective of this study was to assess the arterial partial pressure of oxygen (PaO2) in horses placed in a 5-degree RT compared to horizontal (H) position. Client-owned healthy horses (n = 60) undergoing elective surgeries were enrolled in a randomized controlled clinical study. Horses were sedated with butorphanol, an α2-adrenoceptor agonist, ± acepromazine and induced with ketamine combined with a benzodiazepine, propofol, or guaifenesin. Anesthesia was maintained with isoflurane in oxygen with mechanical ventilation. Each group (RT and H) included 30 horses, 10 in each recumbency (dorsal, right and left lateral). Arterial blood gas analyses (aBG) were performed following arterial catheter placement then hourly. Time first-to-last aBG, changes in PaO2, dynamic compliance (Cdyn), estimated pulmonary shunt fraction (F-shunt), and alveolar dead space to tidal volume ratio (VD/VT) were evaluated with a 2-way analysis of variance. Statistical significance was set at p < .05. Overall, PaO2 increased in all groups; however no significant difference was found between recumbencies (dorsal, right and left lateral) and RT versus H in changes over time for PaO2 (p = .064 and p = .070, respectively), Cdyn (p = .721 and p = .672, respectively), F-shunt (p = .055 and p = .054, respectively), or VD/VT (p = .616 and p = .064, respectively). In healthy anesthetized horses, 5-degree RT did not affect changes in PaO2 as compared to H position.
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Affiliation(s)
- H Nicole Trenholme
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
| | - Jane E Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Rachel A Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Stephanie A Kleine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
| | - Erik H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
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Ceccherini G, Lippi I, Citi S, Perondi F, Pamapanini M, Guidi G, Briganti A. Continuous positive airway pressure (CPAP) provision with a pediatric helmet for treatment of hypoxemic acute respiratory failure in dogs. J Vet Emerg Crit Care (San Antonio) 2019; 30:41-49. [PMID: 31872531 DOI: 10.1111/vec.12920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 10/02/2018] [Accepted: 11/24/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate arterial blood gas parameters and pulmonary radiography, before and after provision of continuous positive airway pressure (CPAP) via a pediatric helmet in dogs with acute hypoxemic respiratory failure. DESIGN Single-center, observational study conducted from 2016 to 2017. SETTING University teaching hospital. ANIMALS Seventeen dogs presenting with clinical signs compatible with respiratory failure, confirmed by arterial blood gas analyses. INTERVENTIONS For each animal arterial blood samples and thoracic radiographs were performed at arrival (T0 ). Hypoxemic dogs (PaO2 <80 mm Hg), without evidence of pneumothorax or pleural effusion, received CPAP ventilation via a pediatric Helmet for at least 1 hour. At the end of CPAP ventilation, a second arterial blood gas analysis was performed at room air (T1 ). The F-shunt was also calculated. MEASUREMENT AND MAIN RESULTS Respiratory rate, heart rate and rhythm, mean blood pressure, mucosal membrane color, and rectal temperature were recorded. Tolerance to the helmet was evaluated using a predetermined scoring system. Two dogs were excluded from the study for low tolerance to the helmet. In 15 of 17 dogs, a significant difference between T0 and T1 was noted for PaO2 (60.84 ± 3 mm Hg vs 80.2 ± 5.5 mm Hg), P(A-a)O2 (52.4 ± 4.4 mm Hg vs 35.2 ± 6 mm Hg), PaO2 /FiO2 (289.7 ± 14.3 vs 371 ± 21), and %SO2 (91.3 vs 98.8). In 15 of 17 dogs, the helmet was well tolerated. F-shunt significantly decreased following provision of CPAP (37%; range, 8.4-68% vs 6%; range, -5.6-64.3%). CONCLUSION The use of a pediatric helmet appears to be a suitable device for delivery of CPAP in dogs with hypoxemic acute respiratory failure. The device appears to be reasonably tolerated and improved oxygenation in most dogs.
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Affiliation(s)
- Gianila Ceccherini
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
| | - Ilaria Lippi
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
| | - Simonetta Citi
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
| | - Francesca Perondi
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
| | - Michela Pamapanini
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
| | - Grazia Guidi
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
| | - Angela Briganti
- Department of Veterinary Science, Veterinary Teaching Hospital, University of Pisa, San Piero a Grado, Italy
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Dupont J, Serteyn D, Sandersen C. Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse. Front Vet Sci 2018; 5:235. [PMID: 30327770 PMCID: PMC6174201 DOI: 10.3389/fvets.2018.00235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/10/2018] [Indexed: 01/26/2023] Open
Abstract
Horses are susceptible to developing large areas of pulmonary atelectasis during recumbency and anesthesia. The subsequent pulmonary shunt is responsible for significant impairment of oxygenation. Since ventilation perfusion mismatch persists into the post-operative period, hypoxemia remains an important concern in the recovery stall. This case report describes the diagnosis and supportive therapy of persistent hypoxemia in a 914 kg draft horse after isoflurane anesthesia. It highlights how challenging it can be to deal with hypoxemia after disconnection from the anesthesia machine and how life-threatening it can become if refractory to treatment. Furthermore, it stresses the point on the interactions between hypoxemia and other factors, such as residual drug effects and hypothermia, that should also be considered in the case of delayed recovery from general anesthesia.
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Affiliation(s)
- Julien Dupont
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Didier Serteyn
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Charlotte Sandersen
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
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Hopster K, Duffee LR, Hopster-Iversen CCS, Driessen B. Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture. Am J Vet Res 2018; 79:1021-1027. [DOI: 10.2460/ajvr.79.10.1021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Evangelista F, Tayari H, Degani M, Nocera I, Briganti A. Sedative and Respiratory Effects of Intramuscular Detomidine and Butorphanol in Donkeys Sedated for Bronchoalveolar Lavage. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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23
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Comparison of different methods to calculate venous admixture in anaesthetized horses. Vet Anaesth Analg 2018; 45:640-647. [DOI: 10.1016/j.vaa.2018.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 02/12/2018] [Accepted: 02/15/2018] [Indexed: 11/20/2022]
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24
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Di Bella C, Lacitignola L, Grasso S, Centonze P, Greco A, Ostuni R, Crovace A, Staffieri F. An alveolar recruitment maneuver followed by positive end-expiratory pressure improves lung function in healthy dogs undergoing laparoscopy. Vet Anaesth Analg 2018; 45:618-629. [DOI: 10.1016/j.vaa.2018.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/27/2018] [Accepted: 03/07/2018] [Indexed: 01/16/2023]
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25
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De Monte V, Bufalari A, Grasso S, Ferrulli F, Crovace AM, Lacitignola L, Staffieri F. Respiratory effects of low versus high tidal volume with or without positive end-expiratory pressure in anesthetized dogs with healthy lungs. Am J Vet Res 2018; 79:496-504. [DOI: 10.2460/ajvr.79.5.496] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Uquillas E, Dart CM, Perkins NR, Dart AJ. Effect of reducing inspired oxygen concentration on oxygenation parameters during general anaesthesia in horses in lateral or dorsal recumbency. Aust Vet J 2017; 96:46-53. [PMID: 29265178 DOI: 10.1111/avj.12662] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 05/26/2017] [Accepted: 06/22/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the effects of two concentrations of oxygen delivered to the anaesthetic breathing circuit on oxygenation in mechanically ventilated horses anaesthetised with isoflurane and positioned in dorsal or lateral recumbency. METHODS Selected respiratory parameters and blood lactate were measured and oxygenation indices calculated, before and during general anaesthesia, in 24 laterally or dorsally recumbent horses. Horses were randomly assigned to receive 100% or 60% oxygen during anaesthesia. All horses were anaesthetised using the same protocol and intermittent positive pressure ventilation (IPPV) was commenced immediately following anaesthetic induction and endotracheal intubation. Arterial blood gas analysis was performed and oxygenation indices calculated before premedication, immediately after induction, at 10 and 45 min after the commencement of mechanical ventilation, and in recovery. RESULTS During anaesthesia, the arterial partial pressure of oxygen was adequate in all horses, regardless of position of recumbency or the concentration of oxygen provided. At 10 and 45 min after commencing IPPV, the arterial partial pressure of oxygen was lower in horses in dorsal recumbency compared with those in lateral recumbency, irrespective of the concentration of oxygen supplied. Based on oxygenation indices, pulmonary function during general anaesthesia in horses placed in dorsal recumbency was more compromised than in horses in lateral recumbency, irrespective of the concentration of oxygen provided. CONCLUSION During general anaesthesia, using oxygen at a concentration of 60% instead of 100% maintains adequate arterial oxygenation in horses in dorsal or lateral recumbency. However, it will not reduce pulmonary function abnormalities induced by anaesthesia and recumbency.
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Affiliation(s)
- E Uquillas
- Research and Clinical Trials Unit, University Veterinary Teaching Hospital Camden, School of Veterinary Science, University of Sydney, 410 Werombi Road, Camden, New South Wales, 2570, Australia
| | - C M Dart
- Research and Clinical Trials Unit, University Veterinary Teaching Hospital Camden, School of Veterinary Science, University of Sydney, 410 Werombi Road, Camden, New South Wales, 2570, Australia
| | - N R Perkins
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - A J Dart
- Research and Clinical Trials Unit, University Veterinary Teaching Hospital Camden, School of Veterinary Science, University of Sydney, 410 Werombi Road, Camden, New South Wales, 2570, Australia
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Wiklund M, Granswed I, Nyman G. Pulsed inhaled nitric oxide improves arterial oxygenation in colic horses undergoing abdominal surgery. Vet Anaesth Analg 2017; 44:1139-1148. [DOI: 10.1016/j.vaa.2016.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 10/25/2016] [Accepted: 11/24/2016] [Indexed: 11/16/2022]
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Araújo MA, Deschk M, Wagatsuma JT, Floriano BP, Siqueira CE, Oliva VNLS, Santos PSP. Cardiopulmonary effects of reverse Trendelenburg position at 5° and 10° in sevoflurane-anesthetized steers. Vet Anaesth Analg 2017; 44:854-864. [DOI: 10.1016/j.vaa.2017.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 03/24/2017] [Accepted: 03/30/2017] [Indexed: 12/27/2022]
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Menzies MPL, Ringer SK, Conrot A, Theurillat R, Kluge K, Kutter AP, Jackson M, Thormann W, Bettschart-Wolfensberger R. Cardiopulmonary effects and anaesthesia recovery quality in horses anaesthetized with isoflurane and low-dose S-ketamine or medetomidine infusions. Vet Anaesth Analg 2016; 43:623-634. [PMID: 26915545 DOI: 10.1111/vaa.12359] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 09/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate cardiopulmonary effects and anaesthesia recovery quality in horses anaesthetized with isoflurane receiving medetomidine or S-ketamine infusions. STUDY DESIGN Randomized, blinded, prospective clinical trial. ANIMALS Fifty horses undergoing elective surgery. METHODS After acepromazine and flunixin meglumine premedication, horses received medetomidine (7 μg kg-1 ) intravenously (IV). Anaesthesia was induced with midazolam and racemic ketamine (Med treatment group; 2.2 mg kg-1 ; n = 25) or S-ketamine (S-ket treatment group; 1.1 mg kg-1 ; n = 25) IV and maintained with isoflurane in oxygen/air and medetomidine (Med; 3.5 μg kg-1 hour-1 ) or S-ketamine (S-ket; 0.5 mg kg-1 hour-1 ). All horses were mechanically ventilated. Cardiopulmonary variables were evaluated. Isoflurane end-tidal concentrations (Fe'Iso), dobutamine requirements and thiopental boli were recorded. Plasma samples were collected in six horses to evaluate S-ketamine and S-norketamine concentrations. After surgery, medetomidine 2 μg kg-1 was administered IV. Four independent observers scored recovery using a visual analogue scale and a numerical rating scale. RESULTS Both groups required similar mean Fe'Iso (1%). However, S-ket horses needed more thiopental boli. Median intraoperative cardiac index values were higher with S-ket (4.5 L minute-1 m-2 ) than Med (3.9 L minute-1 m-2 ). Overall, there were no differences in heart rate, blood pressure or dobutamine requirements; however, horses in S-ket showed higher heart rate values at 30 minutes after anaesthesia induction. Compared with Med horses, S-ket horses showed decreased PaO2 and increased pulmonary venous admixture values estimated with the Fshunt calculation. Recoveries were shorter and of poorer quality with S-ket. During infusion, S-ketamine and S-norketamine plasma concentrations lay in the ranges of 0.209-0.917 μg mL-1 and 0.250-0.723 μg mL-1 , respectively. CONCLUSIONS AND CLINICAL RELEVANCE Despite the higher intraoperative cardiac index with S-ket, both protocols were considered to provide acceptable cardiovascular function. However, recovery quality was significantly better in the Med group.
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Affiliation(s)
- M Paula Larenza Menzies
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Simone K Ringer
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Aude Conrot
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Regula Theurillat
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Berne, Berne, Switzerland
| | - Katharina Kluge
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Annette Pn Kutter
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Michelle Jackson
- Clinic for Equine Surgery, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Wolfgang Thormann
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Berne, Berne, Switzerland
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Edmark L, Östberg E, Scheer H, Wallquist W, Hedenstierna G, Zetterström H. Preserved oxygenation in obese patients receiving protective ventilation during laparoscopic surgery: a randomized controlled study. Acta Anaesthesiol Scand 2016; 60:26-35. [PMID: 26235391 DOI: 10.1111/aas.12588] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 05/28/2015] [Accepted: 06/08/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Venous admixture from atelectasis and airway closure impedes oxygenation during general anaesthesia. We tested the hypothesis that continuous positive airway pressure (CPAP) during pre-oxygenation and reduced fraction of inspiratory oxygen (FIO2 ) during emergence from anaesthesia can improve oxygenation in patients with obesity undergoing laparoscopic surgery. METHODS In the intervention group (n = 20, median BMI 41.9), a CPAP of 10 cmH2 O was used during pre-oxygenation and induction of anaesthesia, but no CPAP was used in the control group (n = 20, median BMI 38.1). During anaesthesia, all patients were ventilated in volume-controlled mode with an FIO2 of 0.4 and a positive end-expiratory pressure (PEEP) of 10 cmH2 O. During emergence, before extubation, the control group was given an FIO2 of 1.0 and the intervention group was divided into two subgroups, which were given an FIO2 of 1.0 or 0.31. Oxygenation was assessed perioperatively by the estimated venous admixture (EVA). RESULTS The median EVA before pre-oxygenation was about 8% in both groups. During anaesthesia after intubation, the median EVA was 8.2% in the intervention vs. 13.2% in the control group (P = 0.048). After CO2 pneumoperitoneum, the median EVA was 8.4% in the intervention vs. 9.9% in the control group (P > 0.05). One hour post-operatively, oxygenation had deteriorated in patients given an FIO2 of 1.0 during emergence but not in patients given an FIO2 of 0.31. CONCLUSIONS A CPAP of 10 cmH2 O during pre-oxygenation and induction, followed by PEEP after intubation, seemed to preserve oxygenation during anaesthesia. Post-operative oxygenation depended on the FIO2 used during emergence.
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Affiliation(s)
- L. Edmark
- Department of Anaesthesiology and Intensive Care; Västmanland Hospital Västerås; Västerås Sweden
| | - E. Östberg
- Department of Anaesthesiology and Intensive Care; Västmanland Hospital Västerås; Västerås Sweden
| | - H. Scheer
- Department of Anaesthesiology and Intensive Care; Västmanland Hospital Västerås; Västerås Sweden
| | - W. Wallquist
- Department of Anaesthesiology and Intensive Care; Västmanland Hospital Västerås; Västerås Sweden
| | - G. Hedenstierna
- Department of Medical Sciences, Clinical Physiology; Uppsala University; Uppsala Sweden
| | - H. Zetterström
- Department of Surgical Sciences, Anaesthesiology and Critical Care Medicine; Uppsala University; Uppsala Sweden
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Wolf SJ, Reske AP, Hammermüller S, Costa ELV, Spieth PM, Hepp P, Carvalho AR, Kraßler J, Wrigge H, Amato MBP, Reske AW. Correlation of lung collapse and gas exchange - a computer tomographic study in sheep and pigs with atelectasis in otherwise normal lungs. PLoS One 2015; 10:e0135272. [PMID: 26258686 PMCID: PMC4530863 DOI: 10.1371/journal.pone.0135272] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 07/20/2015] [Indexed: 11/18/2022] Open
Abstract
Background Atelectasis can provoke pulmonary and non-pulmonary complications after general anaesthesia. Unfortunately, there is no instrument to estimate atelectasis and prompt changes of mechanical ventilation during general anaesthesia. Although arterial partial pressure of oxygen (PaO2) and intrapulmonary shunt have both been suggested to correlate with atelectasis, studies yielded inconsistent results. Therefore, we investigated these correlations. Methods Shunt, PaO2 and atelectasis were measured in 11 sheep and 23 pigs with otherwise normal lungs. In pigs, contrasting measurements were available 12 hours after induction of acute respiratory distress syndrome (ARDS). Atelectasis was calculated by computed tomography relative to total lung mass (Mtotal). We logarithmically transformed PaO2 (lnPaO2) to linearize its relationships with shunt and atelectasis. Data are given as median (interquartile range). Results Mtotal was 768 (715–884) g in sheep and 543 (503–583) g in pigs. Atelectasis was 26 (16–47) % in sheep and 18 (13–23) % in pigs. PaO2 (FiO2 = 1.0) was 242 (106–414) mmHg in sheep and 480 (437–514) mmHg in pigs. Shunt was 39 (29–51) % in sheep and 15 (11–20) % in pigs. Atelectasis correlated closely with lnPaO2 (R2 = 0.78) and shunt (R2 = 0.79) in sheep (P-values<0.0001). The correlation of atelectasis with lnPaO2 (R2 = 0.63) and shunt (R2 = 0.34) was weaker in pigs, but R2 increased to 0.71 for lnPaO2 and 0.72 for shunt 12 hours after induction of ARDS. In both, sheep and pigs, changes in atelectasis correlated strongly with corresponding changes in lnPaO2 and shunt. Discussion and Conclusion In lung-healthy sheep, atelectasis correlates closely with lnPaO2 and shunt, when blood gases are measured during ventilation with pure oxygen. In lung-healthy pigs, these correlations were significantly weaker, likely because pigs have stronger hypoxic pulmonary vasoconstriction (HPV) than sheep and humans. Nevertheless, correlations improved also in pigs after blunting of HPV during ARDS. In humans, the observed relationships may aid in assessing anaesthesia-related atelectasis.
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Affiliation(s)
- Samuel J. Wolf
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Alexander P. Reske
- Anaesthesiology and Intensive Care Medicine, Fachkrankenhaus Coswig, Coswig/Meißen, Germany
| | - Sören Hammermüller
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Eduardo L. V. Costa
- Cardio-Pulmonary Department, Pulmonary Division, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
- Research and Education Institute, Hospital Sírio Libanês, São Paulo, Brazil
| | - Peter M. Spieth
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Pierre Hepp
- Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Alysson R. Carvalho
- Carlos Chagas Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jens Kraßler
- Anaesthesiology and Intensive Care Medicine, Fachkrankenhaus Coswig, Coswig/Meißen, Germany
| | - Hermann Wrigge
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Marcelo B. P. Amato
- Cardio-Pulmonary Department, Pulmonary Division, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Andreas W. Reske
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
- * E-mail:
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Briganti A, Portela D, Grasso S, Sgorbini M, Tayari H, Bassini JF, Vitale V, Romano M, Crovace A, Breghi G, Staffieri F. Accuracy of different oxygenation indices in estimating intrapulmonary shunting at increasing infusion rates of dobutamine in horses under general anaesthesia. Vet J 2015; 204:351-6. [DOI: 10.1016/j.tvjl.2015.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/10/2015] [Accepted: 04/06/2015] [Indexed: 11/25/2022]
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De Monte V, Staffieri F, Di Meo A, Vannucci J, Bufalari A. Comparison of ketamine-dexmedetomidine-methadone and tiletamine-zolazepam-methadone combinations for short-term anaesthesia in domestic pigs. Vet J 2015; 205:364-8. [PMID: 26070949 DOI: 10.1016/j.tvjl.2015.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 05/15/2015] [Accepted: 05/17/2015] [Indexed: 11/24/2022]
Abstract
Cardiorespiratory effects, quality of induction, depth of anaesthesia and quality of recovery were compared in pigs anaesthetised with 8 mg/kg ketamine, 20 µg/kg dexmedetomidine and 0.2 mg/kg methadone (KDM, n = 18) or 8 mg/kg tiletamine-zolazepam and 0.2 mg/kg methadone (TZM, n = 9). Anaesthesia with KDM was partially reversed in nine animals with 0.2 mg/kg atipamezole (KDMat). Sedation was observed earlier in the TZM group (47.2 ± 25.3 s) than the KDM group (91.5 ± 37.4 s). Sternal and lateral recumbency were achieved earlier in the TZM group (76.3 ± 36.5 s and 132.1 ± 30.5 s, respectively) than in the KDM group (149.1 ± 58.7 s and 249.2 ± 84.0 s, respectively). PaO2, SaO2 and PaO2:FiO2 were lower in the TZM group (68.7 ± 4.1 mmHg, 93.4 ± 1.4% and 327.2 ± 19.9 mmHg, respectively) than in the KDM group (80.4 ± 5.9 mmHg, 95.7 ± 1.0% and 380.4 ± 25.6 mmHg, respectively). Fshunt and P(A-a)O2 were higher in the TZM group (24.0 ± 11.8% and 31.4 ± 3.8 mmHg, respectively) than in the KDM group (13.4 ± 3.2% and 20.7 ± 7.4 mmHg, respectively). Times from drug injection to first head movements, sternal recumbency and standing/walking were significantly shorter in the KDM group (45.1 ± 10.5, 48.4 ± 12.6 and 54.4 ± 17.8 min, respectively) than in the TZM group (57.8 ± 11.4, 93.1 ± 14.2 and 165.7 ± 56.6 min, respectively). The median recovery score was higher in the TZM group than in the KDMnoat and KDMat subgroups. Both drug combinations provided adequate anaesthesia for minor procedures lasting about 30 min, but TZM was associated with a poor recovery and oxygenation.
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Affiliation(s)
- V De Monte
- Department of Veterinary Medicine, University of Perugia, via San Costanzo 4, 06126 Perugia, Italy.
| | - F Staffieri
- Department of Emergencies and Organ Transplantation, Section of Veterinary Clinics and Animal Production, University of Bari, Str per Casamassima km3, 70010 Bari, Italy
| | - A Di Meo
- Department of Veterinary Medicine, University of Perugia, via San Costanzo 4, 06126 Perugia, Italy
| | - J Vannucci
- Thoracic Surgery Unit, Ospedale Santa Maria della Misericordia Loc. S. Andrea Fratte, 06134, Perugia, Italy
| | - A Bufalari
- Department of Veterinary Medicine, University of Perugia, via San Costanzo 4, 06126 Perugia, Italy
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Laricchiuta P, De Monte V, Campolo M, Grano F, Crovace A, Staffieri F. Immobilization of captive tigers (Panthera tigris) with a combination of tiletamine, zolazepam, and detomidine. Zoo Biol 2014; 34:40-5. [PMID: 25136814 DOI: 10.1002/zoo.21157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 05/27/2014] [Accepted: 07/02/2014] [Indexed: 11/09/2022]
Abstract
The aims of this study were to evaluate the effects of the administration of a combination of tiletamine-zolazepam and detomidine (TZD) in 9 tigers (Panthera tigris). Nine captive tigers were immobilized with tiletamine-zolazepam and detomidine administered intramuscularly. At the end of the procedure immobilization was partially reversed with atipamezole. Lateral recumbency was achieved in 15.6 ± 5.9 min. The median induction score [scored 1 (excellent) to 4 (poor)] was 1. The immobilization score [scored 1 (poor) to 6 (too deep)] was 5 (4-5) at all study times. After atipamezole administration, all tigers experienced severe ataxia and incoordination. Median recovery score [scored 1 (excellent) to 4 (poor)] was 2.5 (range 2-3). No neurologic and/or important adverse reactions were noticed within 5 days after recovery. The combination tiletamine-zolazepam with detomidine proved to be effective in immobilizing captive healthy tigers but it maybe associated with hypertension and ataxia during recovery. Zoo Biol. 34:40-45, 2015. © 2014 Wiley Periodicals Inc.
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Affiliation(s)
- P Laricchiuta
- Centro Veterinario Einaudi, Bari, Italy; Naples' Zoo, Napoli, Italy
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Mosing M, German A, Holden S, MacFarlane P, Biourge V, Morris P, Iff I. Oxygenation and ventilation characteristics in obese sedated dogs before and after weight loss: A clinical trial. Vet J 2013; 198:367-71. [PMID: 24048017 DOI: 10.1016/j.tvjl.2013.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 06/26/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
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Ambrósio AM, Ida KK, Souto MTMR, Oshiro AH, Fantoni DT. Effects of positive end‐expiratory pressure titration on gas exchange, respiratory mechanics and hemodynamics in anesthetized horses. Vet Anaesth Analg 2013; 40:564-72. [DOI: 10.1111/vaa.12068] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 05/02/2013] [Indexed: 12/22/2022]
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