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1.
Chi Won Shin Won-gyun Son Min Jang Hyunseok Kim Hyungjoo Han Jeesoo Cha Inhyung Lee 《Veterinary anaesthesia and analgesia》2018,45(6):737-744
Objective
To evaluate endotracheal tube intracuff pressure (Pcuff) changes over time and the effect of these changes on air leak pressure (Pleak).Study design
Prospective experimental study.Animals
A group of nine healthy adult Beagle dogs.Methods
In part I, in vitro measurements of Pcuff were recorded for 1 hour in eight endotracheal tubes subjected to four treatments: room temperature without lubricant (RT0L), room temperature with lubricant (RTWL), body temperature without lubricant (BT0L), and body temperature with lubricant (BTWL). In part II, nine dogs were endotracheally intubated and Pleak was evaluated at Pcuff of 25 mmHg. Subsequently, Pcuff was reset to 25 mmHg (baseline) and Pcuff measurements were recorded every 5 minutes for 1 hour. Subsequently, a second Pleak measurement was recorded at the current Pcuff. The data were analyzed using Wilcoxon signed-rank test, repeated measures anova and Mann–Whitney U test.Results
In part I, Pcuff differed significantly between the RT0L and RTWL treatments at 5–60 minutes, and between the BT0L and BTWL treatments at 5–35, 55 and 60 minutes (p < 0.05). In part II, compared with baseline pressures, mean Pcuff decreased to <18 mmHg at 10 minutes and significant decreases were recorded at 15–60 minutes (Pcuff range: 10.0 ± 4.9 to 13.4 ± 6.3 mmHg, mean ± standard deviation). Significant differences were observed between the first and second Pleak measurements (p = 0.034). Pleak decreased in six of nine dogs, was not changed in two dogs and increased in one dog.Conclusions and clinical relevance
Significant decreases in Pcuff over time were measured. Pleak may decrease during anesthesia and increase the risk for silent pulmonary aspiration. The results indicate the need for testing Pcuff more than once, especially at 10 minutes after the onset of anesthesia. 相似文献2.
Alice R. Bird David J. Bird Matthew W. McMillan 《Veterinary anaesthesia and analgesia》2019,46(1):55-63
Objectives
To determine the endotracheal tube cuff pressure produced with two inflation techniques, in two brands of endotracheal tube in cats. To determine the inspiratory pressure which produces an audible leak when the intracuff pressure is 30 cmH2O.Study design
Prospective, clinical, randomized study.Animals
A total of 40 client-owned healthy adult cats.Methods
Following induction of anaesthesia, endotracheal intubation was performed with a Parker Flex-Tip PFLP (Parker; n = 20) or Flexicare VentiSeal (Flexicare; n = 20) endotracheal tube. For each cat, the endotracheal tube cuff was inflated using two methods, minimum occlusive volume (MOV) and pilot balloon palpation (PBP). Intracuff pressure was recorded. Cuff pressure was then set at 30 cmH2O and the pressure within the breathing system when a manual breath first caused an audible leak was measured.Results
PBP pressure was lower for Parker (36 ± 13 cmH2O) compared with Flexicare (45 ± 13 cmH2O, p = 0.048). MOV pressure was not different between tube types (56 ± 28 versus 66 ± 25 cmH2O for Parker and Flexicare, respectively, p = 0.247). MOV produced a higher pressure than PBP for Parker (56 ± 28 versus 36 ± 13 cmH2O, p = 0.001) and Flexicare (66 ± 25 versus 45 ± 13 cmH2O, p = 0.007). When intracuff pressure was set at 30 cmH2O, 95% of cats did not develop an audible leak until the inspiratory pressure was greater than 10 and 12 cmH2O for Parker and Flexicare tubes, respectively.Conclusions
PBP produced lower cuff pressures than MOV, although both techniques produced a cuff pressure above that at which mucosal blood flow is believed to be restricted. A cuff pressure of 30 cmH2O may be sufficient to prevent audible leak in most cats if respiratory pressures are kept at 10–12 cmH2O or below.Clinical relevance
To ensure a safe endotracheal tube cuff pressure, use of a specifically designed pressure gauge is recommended. 相似文献3.
Carolina Meira Fabiola B. Joerger Annette P.N. Kutter Andreas Waldmann Simone K. Ringer Stephan H. Böehm Samuel Iff Martina Mosing 《Veterinary anaesthesia and analgesia》2018,45(2):145-157
Objective
To compare the efficacy of three continuous positive airway pressure (CPAP) interfaces in dogs on gas exchange, lung volumes, amount of leak during CPAP and rebreathing in case of equipment failure or disconnection.Study design
Randomized, prospective, crossover, experimental trial.Animals
Ten purpose-bred Beagle dogs.Methods
Dogs were in dorsal recumbency during medetomidine–propofol constant rate infusions, breathing room air. Three interfaces were tested in each dog in a consecutive random order: custom-made mask (M), conical face mask (FM) and helmet (H). End-expiratory lung impedance (EELI) measured by electrical impedance tomography was assessed with no interface (baseline), with the interface only (No-CPAP for 3 minutes) and at 15 minutes of 7 cmH2O CPAP (CPAP-delivery). PaO2 was assessed at No-CPAP and CPAP-delivery, partial pressure of inspired carbon dioxide (PICO2; rebreathing assessment) at No-CPAP and the interface leak (ΔPleak) at CPAP-delivery. Mixed-effects linear regression models were used for statistical analysis (p < 0.05).Results
During CPAP-delivery, all interfaces increased EELI by 7% (p < 0.001). Higher ΔPleak was observed with M and H (9 cmH2O) in comparison with FM (1 cmH2O) (p < 0.001). At No-CPAP, less rebreathing occurred with M (0.5 kPa, 4 mmHg) than with FM (1.8 kPa, 14 mmHg) and with H (1.4 kPa, 11 mmHg), but also lower PaO2 was measured with M (9.3 kPa, 70 mmHg) than with H (11.9 kPa, 90 mmHg) and FM (10.8 kPa, 81 mmHg).Conclusions and clinical relevance
All three interfaces can be used to provide adequate CPAP in dogs. The leak during CPAP-delivery and the risk of rebreathing and hypoxaemia, when CPAP is not maintained, can be significant. Therefore, animals should always be supervised during administration of CPAP with any of the three interfaces. The performance of the custom-made M was not superior to the other interfaces. 相似文献4.
Felipe SRM. Andrade Lara L. Facó Keila K. Ida Luis CLC. Silva Denise T. Fantoni Aline M. Ambrósio 《Veterinary anaesthesia and analgesia》2019,46(1):64-73
Objective
To compare static compliance (Cst) and alveolar–arterial oxygen tension difference [P(a–a)O2] between positive end-expiratory pressures (PEEP) of 7, 12 and 17 cmH2O applied after an alveolar recruitment maneuver (RM) in isoflurane-anesthetized horses.Study design
Prospective, randomized, clinical study.Animals
A group of 30 healthy adult horses undergoing arthroscopic surgery.Methods
Animals in dorsal recumbency and mechanically ventilated with a tidal volume of 14 mL kg?1 and 7 cmH2O PEEP (control; n = 6) were subjected to an RM by increasing PEEP from 7 to 22 cmH2O in 5 cmH2O increments at 5 minute intervals, and then decreased similarly to PEEP of 17 (RM17; n = 8), 12 (RM12; n = 8) or 7 cmH2O (RM7; n = 8). Cst and P(a–a)O2 were assessed prior to (baseline) and after the RM at 5, 10, 15, 20, 40, 60 and 80 minutes after achieving each target PEEP, and during recovery from anesthesia.Results
Post-RM improvements on P(a–a)O2 were maintained (baseline versus 80 minutes) in RM12 [216 ± 77 mmHg (28.8 ± 10.3 kPa) versus 194 ± 39 mmHg (25.9 ± 5.2 kPa)] and RM17 [180 ± 86 mmHg (24.0 ± 11.6 kPa) versus 136 ± 75 mmHg [18.2 ± 10.0 kPa]). The improvements on Cst were maintained only in RM12 (0.80 ± 0.13 versus 0.98 ± 0.13 mL cmH2O?1 kg?1). No such improvements were observed in RM7 and control. No significant differences were observed between groups during recovery from anesthesia.Conclusions
and clinical relevance The 12 and 17 cmH2O PEEP can be used to maintain the improvements on P(a–a)O2 obtained after an RM. Only 12 cmH2O PEEP maintained the post-RM increase on Cst. Such variables were not influenced by the 7 cmH2O PEEP. 相似文献5.
Donna M. White José I. Redondo Alastair R. Mair Fernando Martinez-Taboada 《Veterinary anaesthesia and analgesia》2017,44(5):1076-1084
Objective
The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator.Study design
Prospective, experimental clinical study.Methods
Participants included veterinary students at the beginning (group S1) and end (group S2) of their 2-week anaesthesia rotation and veterinary anaesthetists (group A). The feline airway simulator was designed to simulate an average size feline trachea, intubated with a 4.5 mm low-pressure, high-volume cuffed endotracheal tube, connected to a Bain breathing system with oxygen flow of 2 L minute?1. Participants inflated the on-endotracheal tube cuff by pilot balloon palpation and by instilling the minimum occlusive volume (MOV) required for loss of airway leaks during manual ventilation. Intracuff pressures were measured by manometers obscured to participants and ideally were 20–30 cm H2O. Student t, Fisher exact, and Chi-squared tests were used where appropriate to analyse data (p < 0.05).Results
Participants were 12 students and eight anaesthetists. Measured intracuff pressures for palpation and MOV, respectively, were 19 ± 12 and 29 ± 19 cm H2O for group S1, 10 ± 5 and 20 ± 11 cm H2O for group S2 and 13 ± 6 and 29 ± 18 cm H2O for group A. All groups performed poorly at achieving intracuff pressures within the ideal range. There was no significant difference in intracuff pressures between techniques. Students administered lower (p = 0.02) intracuff pressures using palpation after their training.Conclusions and clinical relevance
When using palpation and MOV for cuff inflation operators rarely achieved optimal intracuff pressures. Experience had no effect on this skill and, as such, a cuff manometer is recommended. 相似文献6.
Caterina Di Bella Luca Lacitignola Salvatore Grasso Paola Centonze Antonella Greco Rossella Ostuni Antonio Crovace Francesco Staffieri 《Veterinary anaesthesia and analgesia》2018,45(5):618-629
Objective
To evaluate the effects of an alveolar recruitment maneuver (ARM) followed by 5 cmH2O positive end-expiratory pressure (PEEP) in dogs undergoing laparoscopy.Study design
Prospective, randomized clinical study.Animals
A group of 20 dogs undergoing laparoscopic ovariectomy.Methods
Dogs were sedated with acepromazine and methadone intramuscularly; anesthesia was induced with propofol intravenously and maintained with inhaled isoflurane. The following baseline ventilatory setting (BVS) was administered: tidal volume of 12 mL kg–1, inspiratory to expiratory ratio of 1:2, inspiratory pause 25% of inspiratory time, no PEEP and a respiratory rate to maintain end-tidal carbon dioxide tension between 5.3 and 7.3 kPa. Then, 10 minutes after the pneumoperitoneum, 10 dogs (RM) underwent a sustained inflation ARM followed by BVS plus 5 cmH2O PEEP, while 10 dogs (NO-RM) were left with BVS throughout the procedure. Gas exchange and respiratory system mechanics were evaluated before the pneumoperitoneum (PPpre), before ARM (PP10), 30 minutes later (PP30) and 20 minutes after pneumoperitoneum discontinuation (PPpost20). Data were analyzed using anova (p < 0.05).Results
The Fshunt at PP30 and PPpost20 was lower (p < 0.001) in the RM (2.3 ± 2.2 and 4.7 ± 3.7%) than in the NO-RM (5.2 ± 2.1 and 11.1 ± 5.2%), and PaO2 at PP30 and PPpost20 was higher (p < 0.001) in the RM (67.3 ± 4.2 and 60.1 ± 9.4 kPa) than in the NO-RM (50.2 ± 7.4 and 45.5 ± 11.1 kPa). Static compliance of the respiratory system at PP30 and PPpost20 was greater (p < 0.001) in the RM (2.4 ± 0.2 and 2.1 ± 0.4 mL cmH2O?1 kg–1) than in the NO-RM (0.9 ± 0.4 and 1.2 ± 0.2 mL cmH2O?1 kg–1).Conclusions and clinical relevance
In dogs undergoing laparoscopy, ARM followed by 5 cmH2O PEEP improves gas exchange and respiratory system mechanics. 相似文献7.
Aline M. Ambrosio Tatiana P.A. Carvalho-Kamakura Keila K. Ida Barbara Varela Felipe S.R.M. Andrade Lara L. Facó Denise T. Fantoni 《Veterinary anaesthesia and analgesia》2017,44(2):254-263
Objective
To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia.Study design
Prospective randomized clinical study.Animals
Fourteen client-owned bitches weighing 26 ± 7 kg undergoing elective ovariohysterectomy.Methods
Isoflurane-anesthetized dogs in dorsal recumbency were ventilated with 0 cmH2O PEEP and pressure-controlled ventilation by adjusting the peak inspiratory pressure (PIP) to achieve a low (7 mL kg?1; n = 7) or a high (12 mL kg?1; n = 7) VT. Ninety minutes after induction (T90), an ARM (PIP 20 cmH2O for 10 seconds, twice with a 10 second interval) was performed followed by the application of 5 cmH2O PEEP for 35 minutes (RM35). The vertical (ventral=0%; dorsal=100%) and horizontal (right=0%; left=100%) center of ventilation (CoV), four regions of interest (ROI) (ventral, central-ventral, central-dorsal, dorsal) identified in electrical impedance tomography images, and cardiopulmonary data were analyzed using two-way repeated measures anova.Results
The low VT was centered in more ventral (nondependent) areas compared with high VT at T90 (CoV: 38.8 ± 2.5% versus 44.6 ± 7.2%; p = 0.0325). The ARM and PEEP shifted the CoV towards dorsal (dependent) areas only during high VT (50.5 ± 7.9% versus 41.1 ± 2.8% during low VT, p = 0.0108), which was more distributed to the central-dorsal ROI compared with low VT (p = 0.0046). The horizontal CoV was centrally distributed and cardiovascular variables remained unchanged throughout regardless of the VT, ARM, and PEEP.Conclusions and clinical relevance
Both low and high VT were poorly distributed to dorsal dependent regions, where ventilation was improved following the current ARM and PEEP only during high VT. Studies on the role of high VT on pulmonary complications are required. 相似文献8.
Klaus Hopster Karl Rohn Bernhard Ohnesorge Sabine B.R. Kästner 《Veterinary anaesthesia and analgesia》2017,44(1):121-126
Objective
To compare the effects of controlled mechanical ventilation (CMV) and constant positive end-expiratory pressure (PEEP) and interposed recruitment manoeuvres (RMs) with those of CMV without PEEP on gas exchange during general anaesthesia and the early recovery period.Study design
Prospective, randomized clinical trial.Animals
A total of 48 Warmblood horses undergoing elective surgery in lateral (Lat) (n = 24) or dorsal (Dors) (n = 24) recumbency.Methods
Premedication (romifidine), induction (diazepam and ketamine) and maintenance (isoflurane in oxygen) were identical in all horses. Groups Lat- CMV and Dors-CMV (each n = 12) were ventilated using CMV. Groups Lat-RM and Dors-RM (each n = 12) were ventilated using CMV with constant PEEP (10 cmH2O) and intermittent RMs (three consecutive breaths with peak inspiratory pressure of 60 cmH2O, 80 cmH2O and 60 cmH2O, respectively). RMs were applied as required to maintain PaO2 at > 400 mmHg (> 53.3 kPa). Dobutamine was given to maintain mean arterial blood pressure at > 60 mmHg. Physiological parameters were recorded every 10 minutes. Arterial blood gases were measured intra- and postoperatively. Statistical analyses were conducted using analyses of variance (anova), t tests and the Mann–Whitney U-test.Results
Horses in Dors-RM had higher PaO2 values [478 ± 35 mmHg (63.7 ± 4.6 kPa)] than horses in Dors-CMV [324 ± 45 mmHg (43.2 ± 6 kPa)] during anaesthesia and the early recovery period. There were no differences between horses in groups Lat-CMV and Lat-RM. Other measured parameters did not differ between groups.Conclusions and clinical relevance
Ventilation with CMV, constant PEEP and interposed RM provided improved arterial oxygenation in horses in dorsal recumbency that lasted into the early recovery period, but had no benefit in horses in lateral recumbency. This mode of ventilation may provide a clinically practicable method of improving oxygenation in anaesthetized horses, especially in dorsal recumbency. 相似文献9.
Sandra Wenger Désirée Müllhaupt Stefanie Ohlerth Sarah Prasse Karina Klein Bianca da Silva Valente Martina Mosing 《Veterinary anaesthesia and analgesia》2017,44(3):529-537
Objective
To compare airway management during induction of anaesthesia, spontaneous ventilation (SV) and controlled mechanical ventilation (CMV), using an endotracheal tube (ETT), laryngeal mask (LM), rabbit-specific supraglottic airway device (v-gel) or facemask (FM).Study design
Prospective randomized crossover experiment.Animals
Ten New Zealand White rabbits.Methods
After premedication, rabbits were randomly allocated to four groups: 1) ETT; 2) LM; 3) v-gel or 4) FM. The required dose of propofol, duration and number of attempts to place an airway device and leakage during SV and CMV at different peak inspiratory pressures (6, 10, 12, 14 and 16 cmH2O) were recorded. Computed tomography (CT) of the head, neck and abdomen were performed before and after CMV.Results
Significantly less propofol and time [2.0 ± 0.5 mg kg?1, 82 ± 34 seconds, p < 0.001] were needed to place the FM compared to the three other groups [v-gel 5.1 ± 2.1 mg kg?1, 302 ± 124 seconds; LM 4.8 ± 1.2 mg kg?1, 275 ± 89 seconds; ETT 5.5 ± 1.4 mg kg?1, 315 ± 147 seconds]. A leak > 25% of the tidal volume occurred at the lowest pressure in FM [median (range), 6 (6–8) cmH2O], which was significantly lower than with v-gel [16 (6–no leak at 16) cmH2O], LM [>16 (6–no leak at 16)] or ETT [>16 (no leak at 16) cmH2O] (p < 0.001). On CT images, the height and width of the larynx were significantly smaller with v-gel in comparison to FM and LM (p = 0.004). A significant increase in the amount of gas in the stomach (p = 0.007), but not gastric volume, was detected in FM and LM.Conclusions and clinical relevance
The v-gel is a practical alternative to LM and ETT for airway management and CMV, but can compress the larynx. The FM is easily placed, but significant leakage occurs during CMV. 相似文献10.
Peripheral α2-adrenoceptor antagonism affects the absorption of intramuscularly coadministered drugs
Ira J. Kallio-Kujala Marja R. Raekallio Juhana Honkavaara Rachel C. Bennett Heta Turunen Mika Scheinin Heidi Hautajärvi Outi Vainio 《Veterinary anaesthesia and analgesia》2018,45(4):405-413
Objective
We determined the possible effects of a peripherally acting α2-adrenoceptor antagonist, MK-467, on the absorption of intramuscularly (IM) coadministered medetomidine, butorphanol and midazolam.Study design
Randomized, experimental, blinded crossover study.Animals
Six healthy Beagle dogs.Methods
Two IM treatments were administered: 1) medetomidine hydrochloride (20 μg kg–1) + butorphanol (100 μg kg–1) + midazolam (200 μg kg–1; MBM) and 2) MBM + MK-467 hydrochloride (500 μg kg–1; MBM–MK), mixed in a syringe. Heart rate was recorded at regular intervals. Sedation was assessed with visual analog scales (0–100 mm). Drug concentrations in plasma were analyzed with liquid chromatography–tandem mass spectrometry, with chiral separation of dex- and levomedetomidine. Maximum drug concentrations in plasma (Cmax) and time to Cmax (Tmax) were determined. Paired t-tests, with Bonferroni correction when appropriate, were used for comparisons between the treatments.Results
Data from five dogs were analyzed. Heart rate was significantly higher from 20 to 90 minutes after MBM–MK. The Tmax values for midazolam and levomedetomidine (mean ± standard deviation) were approximately halved with coadministration of MK-467, from 23 ± 9 to 11 ± 6 minutes (p = 0.049) for midazolam and from 32 ± 15 to 18 ± 6 minutes for levomedetomidine (p = 0.036), respectively.Conclusions and clinical relevance
MK-467 accelerated the absorption of IM coadministered drugs. This is clinically relevant as it may hasten the onset of peak sedative effects. 相似文献11.
Sarah E. Bigby Thierry Beths Sébastien Bauquier Jennifer E. Carter 《Veterinary anaesthesia and analgesia》2017,44(5):1007-1015
Objective
To compare incidence and duration of postinduction apnoea in dogs after premedication with methadone and acepromazine (MA) or methadone and dexmedetomidine (MD) followed by induction with propofol (P) or alfaxalone (A).Study design
Prospective, randomized clinical trial.Animals
A total of 32 American Society of Anesthesiologists class I dogs (15 females, 17 males), aged between 4 months and 4 years, weighing between 3 and 46 kg.Methods
Dogs were randomly allocated to be administered MA+P, MA+A, MD+P or MD+A (methadone 0.5 mg kg?1 and acepromazine 0.05 mg kg?1 or dexmedetomidine 5 μg kg?1). Induction agents were administered intravenously via syringe driver (P at 4 mg kg?1 minute?1 or A at 2 mg kg?1 minute?1) until successful endotracheal intubation and the endotracheal tube connected to a circle system with oxygen flow at 2 L minute?1. Oxygen saturation of haemoglobin (SpO2), end tidal partial pressure of carbon dioxide and respiratory rate were monitored continuously. If apnoea (≥ 30 seconds without breathing) occurred, the duration until first spontaneous breath was measured. If SpO2 decreased below 90% the experiment was stopped and manual ventilation initiated. Data were analysed with general linear models with significance set at p ≤ 0.05.Results
There was no statistical difference in the incidence (11 of 16 dogs in A groups and 12 of 16 dogs in P groups), or mean ± standard deviation duration (A groups 125 ± 113 seconds, P groups 119 ± 109 seconds) of apnoea. The SpO2 of one dog in the MD+P group decreased below 90% during the apnoeic period.Conclusions and clinical relevance
Propofol and alfaxalone both cause postinduction apnoea and the incidence and duration of apnoea is not influenced by the use of acepromazine or dexmedetomidine in premedication. Monitoring of respiration is recommended when using these premedication and induction agent combinations. 相似文献12.
Tamas D. Ambrisko Johannes Schramel Klaus Hopster Sabine Kästner Yves Moens 《Veterinary anaesthesia and analgesia》2017,44(2):264-272
Objective
To examine changes in the distribution of ventilation and regional lung compliances in anaesthetized horses during the alveolar recruitment manoeuvre (ARM).Study design
Experimental study in which a series of treatments were administered in a fixed order on one occasion.Animals
Five adult Warmblood horses.Methods
Animals were anaesthetized (xylazine, midazolam–ketamine, isoflurane), placed in dorsal recumbency and ventilated with 100% oxygen using peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) of 20 cmH2O and 0 cmH2O, respectively. Thoracic electrical impedance tomography (EIT), spirometry and routine anaesthesia monitoring were performed. At 90 minutes after induction of anaesthesia, PIP and PEEP were increased in steps of 5 cmH2O to 50 cmH2O and 30 cmH2O, respectively, and then decreased to baseline values. Each step lasted 10 minutes. Data were recorded and functional EIT images were created using three breaths at the end of each step. Arterial blood samples were analysed. Values for left-to-right and sternal-to-dorsal centre of ventilation (COV), lung compliances and Bohr dead space were calculated.Results
Distribution of ventilation drifted leftward and dorsally during recruitment. Mean ± standard deviation (SD) values at baseline and highest airway pressures, respectively, were 49.9 ± 0.7% and 48.0 ± 0.6% for left-to-right COV (p = 0.009), and 46.3 ± 2.0% and 54.6 ± 2.0% for sternal-to-dorsal COV (p = 0.0001). Compliance of dependent lung regions and PaO2 increased, whereas compliance of non-dependent lung regions decreased during ARM and then returned to baseline (p < 0.001). Bohr dead space decreased after ARM (p = 0.007). Interestingly, PaO2 correlated to the compliance of the dependent lung (r2 = 0.71, p < 0.001).Conclusions and clinical relevance
The proportion of tidal volume distributed to dependent and left lung regions increased during ARM, presumably as a result of opening atelectasis. Monitoring compliance of the dependent lung with EIT may substitute PaO2 measurements during ARM to identify an optimal PEEP. 相似文献13.
Allan J. Williamson Joao H.N. Soares Noah D. Pavlisko Robert McAlister Council-Troche Natalia Henao-Guerrero 《Veterinary anaesthesia and analgesia》2017,44(4):738-745
Objective
To characterize the isoflurane-sparing effects of a high and a low dose of fentanyl in dogs, and its effects on mean arterial pressure (MAP) and heart rate (HR).Study design
Prospective, randomized crossover trial.Animals
Eight healthy male Beagle dogs weighing 12.1 ± 1.6 kg [mean ± standard deviation (SD)] and approximate age 1 year.Methods
Dogs were anesthetized using isoflurane and minimum alveolar concentration (MAC) was determined in duplicate by the bracketing method using an electrical stimulus on the tarsus. Animals were administered fentanyl: low dose (33 μg kg?1 loading dose, 0.2 μg kg?1 minute?1) or high dose (102 μg kg?1 loading dose, 0.8 μg kg?1 minute?1) and MAC was re-determined (MACISO-F). Blood was collected for analysis of plasma fentanyl concentrations before administration and after MACISO-F determination. All values are presented as mean ± SD.Results
Isoflurane MAC (MACISO) was 1.30 ± 0.23% in the low dose treatment, which significantly decreased to 0.75 ± 0.22% (average MAC reduction 42.3 ± 9.4%). MACISO was 1.30 ± 0.18% in the high dose treatment, which significantly decreased to 0.30 ± 0.11% (average MAC reduction 76.9 ± 7.4%). Mean fentanyl plasma concentrations were 6.2 and 29.5 ng mL?1 for low and high dose treatments, respectively. MAP increased significantly only in the high dose treatment (from 81 ± 8 to 92 ± 9 mmHg). HR decreased significantly in both treatments from 108 ± 25 to 61 ± 14 beats minute?1 with the low dose and from 95 ± 14 to 42 ± 4 beats minute?1 with the high dose.Conclusions and clinical relevance
Fentanyl administration resulted in a dose-dependent isoflurane MAC-sparing effect with bradycardia at both doses and an increase in MAP only at high dose. Further evaluation is needed to determine the effects of fentanyl on the overall cardiovascular function. 相似文献14.
Barbara Ambros Maria Valentina Carrozzo Teela Jones 《Veterinary anaesthesia and analgesia》2018,45(4):452-458
Objective
To compare time to desaturation after induction of anesthesia following administration of oxygen via face mask or flow-by for 3 minutes.Study design
Randomized crossover study.Animals
A group of six healthy adult dogs weighing 15.0 ± 3.4 kg.Methods
Dogs were anesthetized twice separated by 14 days. Intramuscular administration of dexmedetomidine (4 μg kg?1), acepromazine (0.01 mg kg?1) and butorphanol (0.2 mg kg?1) provided sedation for percutaneous insertion of a catheter into the tracheal lumen. The tip was advanced to the thoracic inlet and position confirmed using fluoroscopy. Using a sample aspiration rate 200 mL minute?1, inspired (FIO2) and end-tidal oxygen (Fe′O2) were measured. Oxygen (100 mL kg?1 minute?1) was delivered into a circle delivery system and administered to the dog for 3 minutes via face mask or flow-by from the circle Y-piece 2.5 cm from the nares. Then, propofol was administered to induce anesthesia and apnea. A pulse oximeter (lingual probe) measured hemoglobin saturation (SpO2). At SpO2 90% (desaturation point), an endotracheal tube was inserted to allow administration of oxygen and artificial ventilation. Arterial blood and data were collected at baseline (before oxygen administration), 5 seconds after induction of anesthesia, and every 30 seconds until the desaturation point was reached. Data were analyzed using an unpaired and paired t test with (p < 0.05).Results
FIO2, Fe′O2 and PaO2 (mean ± standard deviation) were significantly higher after mask preoxygenation [89.7 ± 5.5%, 83.0 ± 7.6% and 394 ± 112 mmHg (52.4 ± 14.9 kPa)] compared with flow-by [30.0 ± 5.4%, 22.7 ± 3.8% and 133 ± 22 mmHg (17.7 ± 2.9 kPa)], respectively. Time to desaturation was significantly longer after mask treatment compared with flow-by (187 ± 67 versus 66 ± 17 seconds).Conclusions and clinical relevance
Mask preoxygenation provided longer time to desaturation compared with the flow-by technique tested. 相似文献15.
Kazumasu Sasaki Tatsushi Mutoh Tomoko Mutoh Ryuta Kawashima Hirokazu Tsubone 《Veterinary anaesthesia and analgesia》2017,44(1):7-16
Objective
To compare electrical velocimetry (EV) noninvasive measures of cardiac output (CO) and stroke volume variation (SVV) in dogs undergoing cardiovascular surgery with those obtained with the conventional thermodilution technique using a pulmonary artery catheter.Study design
Prospective experimental trial.Animals
Seven adult Beagle dogs with a median weight of 13.6 kg.Methods
Simultaneous, coupled cardiac index (CI; CO indexed to body surface area) measurements by EV (CIEV) and the reference pulmonary artery catheter thermodilution method (CIPAC) were obtained in seven sevoflurane-anaesthetized, mechanically ventilated dogs undergoing experimental open-chest cardiovascular surgery for isolated right ventricular failure. Relationships between SVV or central venous pressure (CVP) and stroke volume (SV) were analysed to estimate fluid responsiveness. Haemodynamic data were recorded intraoperatively and before and after fluid challenge.Results
Bland–Altman analysis of 332 matched sets of CI data revealed an overall bias and precision of – 0.22 ± 0.52 L minute?1 m?2 for CIEV and CIPAC (percentage error: 30.4%). Trend analysis showed a concordance of 88% for CIEV. SVV showed a significant positive correlation (r2 = 0.442, p < 0.0001) with SV changes to a volume loading of 200 mL, but CVP did not (r2 = 0.0002, p = 0.94). Better prediction of SV responsiveness (rise of SV index of ≥ 10%) was observed for SVV (0.74 ± 0.09; p = 0.014) with a significant area under the receiver operating characteristic curve in comparison with CVP (0.53 ± 0.98; p = 0.78), with a cut-off value of 14.5% (60% specificity and 83% sensitivity).Conclusions and clinical relevance
In dogs undergoing cardiovascular surgery, EV provided accurate CO measurements compared with CIPAC, although its trending ability was poor. Further, SVV by EV, but not CVP, reliably predicted fluid responsiveness during mechanical ventilation in dogs. 相似文献16.
Zuzana Drábková Johannes P. Schramel Radovan Kabeš 《Veterinary anaesthesia and analgesia》2018,45(1):73-77
Objective
To compare two methods of Bohr–Enghoff physiological dead space to tidal volume ratio (Vd/VtBohr–Enghoff) determination using a mixing chamber and an E-CAiOVX metabolic monitor.Study design
Prospective, clinical, method-comparison study.Animals
Twenty horses anaesthetized for elective orthopaedic procedures.Methods
Horses were anaesthetized with isoflurane in oxygen and the lungs were mechanically ventilated (Vt 15 ± 2 mL kg?1). Arterial blood was sampled to provide arterial partial pressure of carbon dioxide (PaCO2) for dead space calculation using a metabolic monitor. Mixed expired partial pressure of carbon dioxide (PēCO2) obtained from the custom-made mixing chamber was recorded at the time of arterial blood sampling. Dead space fraction was calculated using the Enghoff modification of the Bohr equation. Agreement between the methods was assessed by Bland–Altman test. A clinically acceptable error was defined to be ≤ 10%.Results
Forty-nine simultaneous Vd/VtBohr–Enghoff results were obtained. There was no clinically significant bias between the mixing chamber and E-CAiOVX. The limits of agreement were within a priori defined error (bias ± 95% limits of agreement: ?0.022 ± 0.078).Conclusions and clinical relevance
Acceptable agreement was found between the two methods. The E-CAiOVX metabolic monitor might be a suitable device for measuring Vd/VtBohr–Enghoff in anaesthetized horses. 相似文献17.
The hairy lizard: heterothermia affects anaesthetic requirements in the Arabian oryx (Oryx leucoryx)
Mads F. Bertelsen Osama Mohammed Tobias Wang Paul R. Manger David Michael Scantlebury Khairi Ismael Nigel C. Bennett Abdulaziz Alagaili 《Veterinary anaesthesia and analgesia》2017,44(4):899-904
Objective
To study the effect of heterothermia on anaesthetic drug requirements in semi-free ranging Arabian oryx and to assess the temperature quotient (Q10) of oxygen consumption.Study design
Prospective observational study and controlled metabolic experiment.Animals
Sixty-eight anaesthetic events in 59 Arabian oryx from Mahazat As-Sayd protected area, Saudi ArabiaMethods
Anaesthesia was induced by remote injection of 25 mg ketamine, 10 mg midazolam and 0.5 mg medetomidine with a variable amount of etorphine based on a target dosage of 20 μg kg–1 and subjective assessment of body mass. Animals not recumbent within 15 minutes or insufficiently anaesthetized were physically restrained and administered supplementary etorphine intravenously depending on the anaesthetic depth. Body temperature (Tb) was measured rectally immediately upon handling of each animal. From six anaesthetized oryx, expiratory gasses for oxygen analysis and metabolic rate calculation were collected at two Tbs; before and after submersion in ice water for approximately 30 minutes.Results
Forty-two animals (62%) became recumbent with the initial dose, with a mean induction time (± standard deviation) of 9 ± 2 minutes. The remaining animals could be handled but needed 0.3 ± 0.1 mg etorphine intravenously to reach the desired level of anaesthesia. There was a significant positive correlation between Tb and effective etorphine dosage (R2 = 0.48, p < 0.0001). Average Tb of the six animals in which metabolic rate was measured decreased from 40.0 ± 0.5°C immediately after induction to 35.5 ± 0.5°C after cooling. This reduction was associated with a reduction in oxygen uptake from 3.11 ± 0.33 to 2.22 ± 0.29 mL O2 minute–1 kg–1, reflected in Q10 of 2.17 ± 0.14.Conclusions and clinical relevance
Tb significantly affects anaesthetic requirements in Arabian oryx and should be considered when selecting dosages for anaesthetic induction for species showing diurnal heterothermy. 相似文献18.
19.
Josiane Lauper Vincent Marolf Olivier Levionnois Esther Schelling Mireille Meylan Claudia Spadavecchia 《Veterinary anaesthesia and analgesia》2017,44(2):281-286
Objective
To investigate whether an intravenous (IV) lidocaine bolus in calves premedicated with xylazine-butorphanol reduces the amount of ketamine required to allow endotracheal intubation.Study design
Randomized, prospective clinical study.Animals
In total, 41 calves scheduled for elective umbilical surgery.Methods
Calves were randomly assigned to one of two groups (L: lidocaine or S: saline). The calves were administered xylazine (0.07 mg kg?1) and butorphanol (0.1 mg kg?1) intramuscularly and 10 minutes later lidocaine (2 mg kg?1; group L) or saline (group S) IV over 1 minute. After 2 minutes, ketamine (2.5 mg kg?1) was injected IV. If the depth of anaesthesia was insufficient for intubation, additional ketamine (1 mg kg?1) was administered every minute until intubation was successful. The amount of ketamine required for intubation, respiratory rate, pulse rate, arterial pressures, the depth of sedation and conditions of endotracheal intubation after induction of anaesthesia were compared between the two groups.Results
The calves in group L were sedated more deeply than those in group S; however, neither the median (range) amount of ketamine required for intubation, 3.5 (2.5–4.5) mg kg?1 and 3.5 (2.5–3.5) mg kg?1, respectively, nor the induction quality differed significantly between the groups.Conclusion and clinical relevance
A bolus of lidocaine (2 mg kg?1) administered 10 minutes after xylazine-butorphanol in calves deepened the degree of sedation but did not decrease the requirement of ketamine for endotracheal intubation. No adverse effects were recorded in the physiological variables measured. 相似文献20.
Kazumasu Sasaki Tatsushi Mutoh Tomoko Mutoh Yasuyuki Taki Ryuta Kawashima 《Veterinary anaesthesia and analgesia》2017,44(4):719-726