Use of controlled ventilation in a clinical setting

Mechanical ventilation has long been used to maintain ventilation in humans when the lungs are rendered incapable of oxygenation or when respiration is affected by central nervous system depression, but it has only recently been applied to similar cases in dogs and cats. Although manual ventilation is still the more common form of ventilation in dogs and cats, mechanical intermittent positive-pressure ventilation (IPPV) is a much more efficient and reliable means of maintaining the highest quality of respiratory assistance. With proper training, technicians can use IPPV to support compromised animals until they are capable of maintaining normal oxygen concentrations.     

Sevoflurane anaesthesia in chickens during spontaneous and controlled ventilation

A crossover study design was used to investigate the dose-related effects of sevoflurane at end-tidal concentrations of 2.2 to 4.4 per cent on the respiratory rate, blood gases, heart rate, arterial blood pressure and ocular signs of chickens during spontaneous and controlled ventilation. The mean (sd) carbon dioxide partial pressure (PaCO2) increased as the concentration of sevoflurane increased, and was 86 (29) mmHg at an end-tidal concentration of 4.4 per cent during spontaneous ventilation, but was maintained between 29 and 42 mmHg during controlled ventilation. The heart rate increased as the concentration of sevoflurane increased during spontaneous ventilation, but did not change during controlled ventilation. Sevoflurane decreased arterial blood pressure during both spontaneous and controlled ventilation, but a dose-dependent decrease in arterial blood pressure was observed only during controlled ventilation. The mean arterial blood pressure at an end-tidal concentration of 4.4 per cent was significantly higher during spontaneous ventilation than during controlled ventilation. Controlled ventilation prevented the increases in PaCO2 and heart rate that were observed during spontaneous ventilation. The decrease in arterial blood pressure during spontaneous ventilation was less than that during controlled ventilation, possibly owing to the effects of hypercapnia.     

Dose-related cardiovascular effects of isoflurane in chickens during controlled ventilation

We studied cardiovascular effects of isoflurane in chickens during controlled ventilation. Following the determination of the minimal anesthetic concentration from the response to clamping of a digit, dose-related effect of isoflurane on heart rate and arterial pressure were studied. The minimal anesthetic concentration of isoflurane was 1.25 +/- 0.13% (mean +/- SD, n=9). There was a dose-dependent decrease in arterial pressure. The heart rate did not change significantly over a range of 1 to 2 times the minimal anesthetic concentration.     

Cardiopulmonary effects of controlled versus spontaneous ventilation in pigeons anesthetized for coelioscopy

OBJECTIVE: To evaluate the cardiorespiratory effects of controlled versus spontaneous ventilation in pigeons anesthetized for coelioscopy. DESIGN: Prospective study. ANIMALS: 30 healthy adult pigeons (Columbia livia). PROCEDURE: During isoflurane anesthesia, 15 pigeons were allowed to breathe spontaneously (SP group) and 15 were mechanically ventilated (MV group) by use of a pressure-limited ventilator. In each group, cardiopulmonary variables (including end-tidal CO2 concentration [ETCO2]) were measured before (baseline), during, and after coelioscopy. An arterial blood sample was collected for blood gas analyses from each pigeon before coelioscopy and after the procedure, when the caudal thoracic air sac was still open. RESULTS: At baseline, hypoventilation was greater in the SP group than the MV group. Compared with the SP group values, ETCO2 overestimated PaCO2 to a greater degree in the MV group. Cardiovascular variables were not different between groups. After coelioscopy (when the air sac was open), PaCO2 had decreased significantly from baseline in the MV group. In the SP group, hypoventilation worsened despite an increase in respiratory rate. After coelioscopy, PaO2 in the SP group had decreased from baseline and was lower than PaO2 in the MV group; arterial blood pressure and heart rate in the MV group had decreased from baseline and were lower than values in the SP group. CONCLUSIONS AND CLINICAL RELEVANCE: In adult pigeons, controlled ventilation delivered by a pressure-limited device was not associated with clinically important adverse cardiopulmonary changes but may be associated with respiratory alkalosis and cardiovascular depression when air sac integrity has been disrupted.     

The mapleson ''E'' circuit and controlled ventilation using an air piston in dogs

The use of a Mapleson 'E' circuit for controlled ventilation is described and its function investigated. Twelve Labrador dogs were anaesthestised and ventilated using an 'air piston'. Fresh gas flows to attain low, normal or high arterial levels of carbon dioxide were found to be independent of minute volume, providing a relatively large tidal volume is used to minimise the ratio of anatomical dead space to tidal volume (V_Danat/V_t). At normocapnia economy of fresh gas usage is demonstrated.     

Cardiopulmonary effects of hypercapnia during controlled intermittent positive pressure ventilation in the horse.

The cardiopulmonary effects of eucapnia (arterial CO2 tension [PaCO2] 40.4 +/- 2.9 mm Hg, mean +/- SD), mild hypercapnia (PaCO2, 59.1 +/- 3.5 mm Hg), moderate hypercapnia (PaCO2, 82.6 +/- 4.9 mm Hg), and severe hypercapnia (PaCO2, 110.3 +/- 12.2 mm Hg) were studied in 8 horses during isoflurane anesthesia with volume controlled intermittent positive pressure ventilation (IPPV) and neuromuscular blockade. The sequence of changes in PaCO2 was randomized. Mild hypercapnia produced bradycardia resulting in a significant (P < 0.05) decrease in cardiac index (CI) and oxygen delivery (DO2), while hemoglobin concentration (Hb), the hematocrit (Hct), systolic blood pressure (SBP), mean blood pressure (MBP), systemic vascular resistance (SVR), and venous admixture (QS/QT) increased significantly. Moderate hypercapnia resulted in a significant rise in CI, stroke index (SI), SBP, MBP, mean pulmonary artery pressure (PAP), Hct, Hb, arterial oxygen content (CaO2), mixed venous oxygen content (CvO2), and DO2, with heart rate (HR) staying below eucapnic levels. Severe hypercapnia resulted in a marked rise in HR, CI, SI, SBP, PAP, Hct, Hb, CaO2, CvO2, and DO2. Systemic vascular resistance was significantly decreased, while MBP levels were not different from those during moderate hypercapnia. No cardiac arrhythmias were recorded with any of the ranges of PaCO2. Norepinephrine levels increased progressively with each increase in PaCO2, whereas plasma cortisol levels remained unchanged. It was concluded that hypercapnia in isoflurane-anesthetized horses elicits a biphasic cardiopulmonary response, with mild hypercapnia producing a fall in CI and DO2 despite an increase in MBP, while moderate and severe hypercapnia produce an augmentation of the cardiopulmonary performance and DO2.     

A study of cardiovascular function under controlled and spontaneous ventilation in isoflurane–medetomidine anaesthetized horses

Objective To determine, in mildly hypercapnic horses under isoflurane–medetomidine balanced anaesthesia, whether there is a difference in cardiovascular function between spontaneous ventilation (SV) and intermittent positive pressure ventilation (IPPV). Study design Prospective randomized clinical study. Animals Sixty horses, undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. Methods Horses were sedated with medetomidine and anaesthesia was induced with ketamine and diazepam. Anaesthesia was maintained with isoflurane and a constant rate infusion of medetomidine. Horses were assigned to either SV or IPPV for the duration of anaesthesia. Horses in group IPPV were maintained mildly hypercapnic (arterial partial pressure of carbon dioxide (PaCO₂) 50–60 mmHg, 6.7–8 kPa). Mean arterial blood pressure (MAP) was maintained above 70 mmHg by an infusion of dobutamine administered to effect. Heart rate (HR), respiratory rate (f_R), arterial blood pressure and inspiratory and expiratory gases were monitored continuously. A bolus of ketamine was administered when horses showed nystagmus. Cardiac output was measured using lithium dilution. Arterial blood‐gas analysis was performed regularly. Recovery time was noted and recovery quality scored. Results There were no differences between groups concerning age, weight, body position during anaesthesia and anaesthetic duration. Respiratory rate was significantly higher in group IPPV. Significantly more horses in group IPPV received supplemental ketamine. There were no other significant differences between groups. All horses recovered from anaesthesia without complications. Conclusions There was no difference in cardiovascular function in horses undergoing elective surgery during isoflurane–medetomidine anaesthesia with SV in comparison with IPPV, provided the horses are maintained slightly hypercapnic. Clinical relevance In horses with health status ASA I and II, cardiovascular function under general anaesthesia is equal with or without IPPV if the PaCO₂ is maintained at 50–60 mmHg.     

Accuracy of pulse oximetry and capnography in healthy and compromised horses during spontaneous and controlled ventilation

The objective of this prospective clinical study was to evaluate the accuracy of pulse oximetry and capnography in healthy and compromised horses during general anesthesia with spontaneous and controlled ventilation. Horses anesthetized in a dorsal recumbency position for arthroscopy (n = 20) or colic surgery (n = 16) were instrumented with an earlobe probe from the pulse oximeter positioned on the tip of the tongue and a sample line inserted at the Y-piece for capnography. The horses were allowed to breathe spontaneously (SV) for the first 20 min after induction, and thereafter ventilation was controlled (IPPV). Arterial blood, for blood gas analysis, was drawn 20 min after induction and 20 min after IPPV was started. Relationships between oxygen saturation as determined by pulse oximetry (S_pO₂), arterial oxygen saturation (S_aO₂)_, arterial carbon dioxide partial pressure (P_aCO₂), and end tidal carbon dioxide (P_(et)CO₂), several physiological variables, and the accuracy of pulse oximetry and capnography, were evaluated by Bland–Altman or regression analysis. In the present study, both S_pO₂ and P_(et)CO₂ provided a relatively poor indication of S_aO₂ and P_aCO₂, respectively, in both healthy and compromised horses, especially during SV. A difference in heart rate obtained by pulse oximetry, ECG, or palpation is significantly correlated with any pulse oximeter inaccuracy. If blood gas analysis is not available, ventilation to P_(et)CO₂ of 35 to 45 mmHg should maintain the P_aCO₂ within a normal range. However, especially in compromised horses, it should never substitute blood gas analysis.     

Determination of the minimum anesthetic concentration and cardiovascular dose response for sevoflurane in chickens during controlled ventilation

OBJECTIVE: To determine the minimum anesthetic concentration for sevoflurane and effects of various multiples of minimum anesthetic concentration on arterial pressure and heart rate during controlled ventilation in chickens. STUDY DESIGN: Prospective experimental study. ANIMALS: Seven healthy chickens, 6 to 8 months old, weighing 1.6 to 3.4 kg. METHODS: A rebreathing, semiclosed anesthetic circuit was used. Anesthesia was induced by mask with sevoflurane in oxygen. Each chicken was endotracheally intubated, then controlled ventilation was started and the end-tidal CO2 partial pressure was maintained at 30 to 40 mm Hg. Body temperature was maintained at 39.5 degrees to 41.0 degrees C. The inspired and end-tidal sevoflurane concentration were monitored with a multigas monitor. Minimum anesthetic concentration was determined as the minimal end-tidal sevoflurane concentration which prevented gross purposeful movement in response to clamping a toe for 1 minute. After the determination, the cardiovascular effects of sevoflurane at 1.0, 1.5, and 2.0 times the minimum anesthetic concentration were determined. RESULTS: The minimum anesthetic concentration for sevoflurane was 2.21% + 0.32% (mean +/- SD). Mean arterial pressure and heart rate at minimum anesthetic concentration were 84 +/- 13 mm Hg and 150 +/- 58 beats/min, respectively. There was a dose-dependent decrease in arterial pressure. The heart rate did not change significantly over the range 1 to 2 x minimum anesthetic concentration. No cardiac arrhythmias developed throughout the experiments. CONCLUSIONS AND CLINICAL RELEVANCE: The minimum anesthetic concentration for sevoflurane in chickens was within the range of minimum alveolar concentration reported in mammals. When the concentration of sevoflurane is increased during controlled ventilation in chickens, decrease in arterial pressure should be expected.     

Evaluation of laryngeal mask as an alternative to endotracheal intubation in cats anesthetized under spontaneous or controlled ventilation

OBJECTIVE: To compare the cardiorespiratory effects and incidence of gastroesophageal reflux with the use of a laryngeal mask airway (LMA) or endotracheal tube (ET) in anesthetized cats during spontaneous (SV) or controlled ventilation (CV). STUDY DESIGN: Prospective randomized experimental trial. ANIMALS: Thirty-two adult crossbred cats, weighing 2.7 +/- 0.4 kg. METHODS: The cats were sedated with intramuscular (IM) methotrimeprazine (0.5 mg kg(-1)) and buprenorphine (0.005 mg kg(-1)), followed 30 minutes later by induction of anesthesia with intravenous (IV) thiopental (12.5-20 mg kg(-1)). An ET was used in 16 cats and an LMA in the remaining 16 animals. Anesthesia was maintained with 0.5 minimum alveolar concentration (0.6%) of halothane in oxygen using a Mapleson D breathing system. Cats in both groups were further divided into two equal groups (n = 8), undergoing either SV or CV. Neuromuscular blockade with pancuronium (0.06 mg kg(-1)) was used to facilitate CV. Heart and respiratory rates, direct arterial blood pressure, capnometry (PE'CO2) and arterial blood gases were measured. Gastric reflux and possible aspiration was investigated by intragastric administration of 5 mL of radiographic contrast immediately after induction of anesthesia. Cervical and thoracic radiographs were taken at the end of anesthesia. Data were analyzed using anova followed by Student-Newman-Keuls, Kruskal-Wallis or Friedman test where appropriate. RESULTS: Values for PaCO2 and PE'CO2 were higher in spontaneously breathing cats with the LMA when compared with other groups. Values of PaO2 and hemoglobin oxygen saturation did not differ between groups. Gastroesophageal reflux occurred in four of eight and two of eight cats undergoing CV with ET or LMA, respectively. There was no tracheal or pulmonary aspiration in any cases. CONCLUSIONS AND CLINICAL RELEVANCE: The use of an LMA may be used as an alternative to endotracheal intubation in anesthetized cats. Although aspiration was not observed, gastric reflux may occur in mechanically ventilated animals.     

Evaluation of Elevent, a ventilator manufactured in Czechoslovakia for controlled ventilation during inhalation anesthesia in dogs]

Controlled breathing during halothane inhalation anesthesia was tested experimentally in fifty clinically healthy test dogs. In the first group the breathing regime was evaluated when a new Czechoslovak electronic ventilator Elvent was used in the course of 120-minute anaesthesia in 10 dogs. In the second group controlled ventilation was used in 40 dogs in the course of 180-minute anaesthesia with an administration of pipecurium as muscle relaxant. In the course of these experiments a total of 28 parameters was investigated to evaluate the effects of the given breathing regimes on the dog organism. An evaluation of the dynamics of changes in the target parameters indicated that the following model of ventilation programme with these parameters was the best: breathing rate 15-20 breaths per min., per-minute breathing capacity 1.5-3.5 l per min., breathing capacity from 0.15 to 0.25 l, inspiration length 0.8 to 1.2 s and twofold expiration length.     

Hemodynamic and respiratory responses to variable arterial partial pressure of oxygen in halothane-anesthetized horses during spontaneous and controlled ventilation.

Cardiovascular and respiratory responses to variable PaO2 were measured in 6 horses anesthetized only with halothane during spontaneous (SV) and controlled (CV) ventilation. The minimal alveolar concentration (MAC) for halothane in oxygen was determined in each spontaneously breathing horse prior to establishing PaO2 study conditions--mean +/- SEM, 0.95 +/- 0.03 vol%. The PaO2 conditions of > 250, 120, 80, and 50 mm of Hg were studied in each horse anesthetized at 1.2 MAC of halothane and positioned in left lateral recumbency. In response to a decrease in PaO2, total peripheral resistance and systolic and diastolic arterial blood pressure decreased (P < 0.05) during SV. Cardiac output tended to increase because heart rate increased (P < 0.05) during these same conditions. During CV, cardiovascular function was usually less than it was at comparable PaO2 during SV (P < 0.05). Heart rate, cardiac output, and left ventricular work increased (P < 0.05) in response to a decrease in PaO2, whereas total peripheral resistance decreased (P < 0.05). During SV, cardiac output and stroke volume increased and arterial blood pressure and total peripheral resistance decreased with duration of anesthesia at PaO2 > 250 mm of Hg. During SV, minute expired volume increased (P < 0.05) because respiratory frequency tended to increase as PaO2 decreased. Decrease in PaCO2 (P < 0.05) also accompanied these respiratory changes. Although oxygen utilization was nearly constant over all treatment periods, oxygen delivery decreased (P < 0.05) with decrease in PaO2, and was less (P < 0.05) during CV, compared with SV, for comparable PaO2 values.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cardiovascular effects of halothane anesthesia after diazepam and ketamine administration in beavers (Castor canadensis) during spontaneous or controlled ventilation

Fourteen adult beavers (Castor canadensis) weighing 16.5 +/- 4.14 kg (mean +/- SD) were anesthetized for surgical implantation of radio telemetry devices. Beavers were anesthetized with diazepam (0.1 mg/kg) and ketamine (25 mg/kg) administered IM, which provided smooth anesthetic induction and facilitated tracheal intubation. Anesthesia was maintained with halothane in oxygen via a semiclosed circle anesthetic circuit. Values for heart rate, respiratory rate, esophageal temperature, direct arterial blood pressure, end-tidal halothane concentration, and end-tidal CO2 tension were recorded every 15 minutes during the surgical procedure. Arterial blood samples were collected every 30 minutes to determine pH, PaO2, and PaCO2. Values for plasma bicarbonate, total CO2, and base excess were calculated. Ventilation was spontaneous in 7 beavers and controlled to maintain normocapnia (PaCO2 approx 40 mm of Hg) in 7 others. Vaporizer settings were adjusted to maintain a light surgical plane of anesthesia. Throughout the surgical procedure, all beavers had mean arterial pressure less than 60 mm of Hg and esophageal temperature less than 35 C. Mean values for arterial pH, end-tidal CO2, PaO2, and PaCO2 were significantly (P less than 0.05) different in spontaneously ventilating beavers, compared with those in which ventilation was controlled. Respiratory acidosis during halothane anesthesia was observed in spontaneously ventilating beavers, but not in beavers maintained with controlled ventilation. All beavers recovered unremarkably from anesthesia.     

浅析猪舍通风设计与靶向通风介绍

文章分析了目前在猪场设计中常用的几种通风模式的优缺点，指出了猪舍通风需要解决的问题和方法。并提出了靶向通风系统在猪舍特别是楼房猪舍通风中的应用。提出靶向通风可以很好地解决目前楼房猪舍中存在的空气过滤和除臭两个问题。     

Severe seizures associated with traumatic brain injury managed by controlled hypothermia,pharmacologic coma,and mechanical ventilation in a dog

Objective – To describe the management and outcome of a dog presenting with intractable seizures associated with traumatic brain injury. Case Summary – A spayed female Wheaten Terrier was presented to an emergency clinic with neurologic deficits (modified Glasgow coma scale of 10) shortly after a road traffic accident. Seizures were uncontrolled despite aggressive pharmacologic intervention. Controlled hypothermia to achieve a rectal temperature of 33–35°C (91.4–95°F) was initiated as a protective measure to reduce intracranial pressure and cerebral metabolic rate, and to assist with seizure control. Intubation and mechanical ventilation were required to protect the airway and manage hypercapnia associated with hypoventilation. The patient went on to make a full recovery, although behavioral changes were noted by the owners for an 8‐week period following injury. New or Unique Information Provided – To the author's knowledge, this is the first instance of therapeutic hypothermia reported in the veterinary literature. A short review of this treatment modality is provided.     

鸡舍的通风

封闭式鸡舍的通风系统包括排气扇、运气扇、水帘、布帘及加热降温设施等。一个运用良好的通风系统，可以产生较好的鸡舍环境，获得较佳的经济效益。 1春夏季通风管理 　　在阴雨天气，易造成舍内垫料板结和氨味加重，此时应调低风扇的开启温度，加强通风及垫料的管理，如更换、翻动等。在夏季，鸡舍内应做好密封工作，堵塞布帘、天花板、墙缝等漏洞，防止出现漏风，遇高温高湿天气，鸡群因体热难以散发易应激发病。此时因湿度大，开启水帘降温作用低，甚至对鸡群产生反作用，应多开风扇并努力提高风速。鸡舍过风截面积太大的可考虑用塑料薄…