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41.

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   
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Capillary sampling in swine can be performed as an accurate assay of arterial blood gases. Studies with swine provided results similar to, or slightly more favorable than, those reported for human beings, depending upon which cutaneous technique was used on human beings. On the basis of free flow or arterilization of the cutaneous sample and of the correlation between capillary and arterial pH, CO2 partial pressure (PCO2), and O2 partial pressure (PO2) values, the capillary sampling technique of complete incisement of a 2-mm section from the tip of the warmed porcine ear could be a substitution technique for arterial blood sampling. Free flow with this technique was maximized and high correlation coefficients (r) for pH (r = 0.96), PCO2 (r = 0.82), and PO2 (r = 0.90) capillary-arterial values (n = 37) were obtained.  相似文献   
44.
Mycotic pneumonia in mariculture-reared green sea turtles   总被引:1,自引:0,他引:1  
Microbiologic examination of 29 juvenile green sea turtles with a buoyancy abnormality revealed pulmonary infection with Sporotrichium sp, Cladosporium sp, and Paecilomyces sp. Histologic examination of the lungs revealed granulomatous lesions containing branching septate hyphae. The diagnosis was mycotic pneumonia.  相似文献   
45.
This is a case of coccidioidomycosis in a dog, examined for vomiting and labored breathing. Physical examination and thoracic and abdominal imaging revealed pleural and peritoneal effusions, both of which exhibited neutrophilic inflammation with a substantial eosinophilic component. The dog had positive IgM and IgG coccidioidomycosis titers at initial evaluation. The eosinophilic component of the inflammation was attributed to coccidioidomycosis. The dog underwent approximately 6 months of fluconazole treatment, with both effusions and clinical signs improving after 6 weeks. Three months after cessation of antifungal treatment, the dog developed a mid-diaphyseal lytic and proliferative lesion in the left radius caused by Coccidioides spp. This case illustrates the importance of consideration of coccidioidomycosis when an eosinophilic cavitary effusion is present in dogs that live in or have traveled to endemic regions.  相似文献   
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Squamous cell carcinoma of the nasal planum was diagnosed in 17 dogs over a period of 11 years. Ulceration, bleeding and sneezing were the most common clinical signs. One dog had cytological evidence of metastasis to the local lymph node. The dogs were treated by surgical resection, fractionated megavoltage irradiation, or a combination of the two. Surgical resection gave the most favourable results; four of six dogs were cured but a recurrence of the tumour was predicted in the other two on the basis of incomplete or marginal resection. Radiotherapy alone was not as effective; one of four dogs was cured, and the tumour recurred in the others within 24 weeks (median eight weeks). Combined surgical resection and radiotherapy did not produce a cure in any of the seven remaining dogs, and the tumour recurred within 12 weeks (median nine weeks). Three dogs had cytological evidence of lymph node metastasis when the tumour recurred. The dogs' prognosis was adversely affected by the interval between their initial examination and treatment, but there was no apparent association between the histological grade of the tumour and the clinical outcome.  相似文献   
49.
A four-year-old, entire male whippet was presented with a three-day history of lethargy, inappetence, occasional retching, a soft cough and intermittent episodes of haemoptysis. Clinical and laboratory findings, and thoracic radiographic and ultrasonographic studies suggested a diagnosis of lung lobe torsion. A concurrent lung lobe torsion of the right cranial and right middle lung lobes was confirmed at exploratory thoracotomy. Management included resection of both the affected lung lobes. No obvious underlying aetiology for the condition was apparent. The dog made a full recovery from the procedure and at the time of writing (11 months postoperatively) was reported to be well, exercising normally and showing no breathing abnormalities.  相似文献   
50.
Hypersensitivities to foods afflict both dogs and cats. Clinical signs are highly variable, although pruritus is almost always present. Diagnosis and therapy are discussed.  相似文献   
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