Application of Airway Pressure Therapy in Veterinary Critical Care: Part I: Respiratory Mechanics and Hypoxemia

Over the past several decades, recognition of acute respiratory failure as the cause of death in patients suffering from various clinical conditions has prompted aggressiv investigation into the area of respiratory physiology and supportive respiratory care. With the evolution of emergency medicine and critical care services in both human and veterinary medicine, many patients previously considered unsalvageable due to the severity of their underlying disease are now being resuscitated and successfully supported, creating a new population of critically ill patients. Where only a decade ago these patients would have succumbed to their underlying disease, they now survive long enough to manifest the complications of shock and tissue injury in the form of acute respiratory failure. Investigation into the pathophysiology and treatment of this acute respiratory distress syndrom (ARDS) has facilitated increased clinical application of respiratory theerapy and machanical ventilation.¹ The purpose of this paper is to provide a basic review of respiratory mechanics and the pathophysiology of hypoxemia as they relate to airway pressure therapy in veterinary patients and to review the use of airway pressure therapy in veterinary patients This paper is divided into two parts; part I reviews respiratory mechanics and hypoxemia as they apply to respiratory therapy, while part II deals specifically with airway pressure therapy andits use in clinical cases.     

Polysaccharide-induced protection of carp, Cyprinus carpio L., against bacterial infection

Abstract. The efficacy of 10 polysaccharides (curdlan, inulin, krestin, laminaran, lentinan, levan, schizophylian, selerogiucan, yeast glucan and zymosan) to enhance protection of carp, Cyprinus carpio L., against bacterial infection was investigated. Carp were intraperitoneally injected with the polysaceharides (2–l0 mgkg^-1) on days 1 and 4, and challenged with Edwardsiella tarda on day 7. Among the polysaccharides tested, lentinan, schizophyllan and scleroglucan, which are l,6-branchcd-β-l,3-glucans, significantly increased the survival rate. They also induced a protective effect against Aeromonas hydrophila at a dose of 5 mg kg^-1. The ability of the polysaccharides to activate the alternative complement pathway (ACP) was examined by incubating the polysaccharides with carp serum and measuring the residual ACP activity. At a final concentration of 0.l mgml^-1, l,6-branched-β-1,3-glucans greatly reduced (76–77%) the ACP activity. Therefore, it is suggested that the protective effect of the l,6-branched-β-1,3-glucans may be associated with the activation of ACP.     

The disposition of suxibuzone in the horse

A high performance liquid chromatographic method is described to determine the anti-inflammatory drug suxibuzone (SXB) and its major metabolites phenylbutazone (PBZ) and oxyphenbutazone (OPBZ) in equine plasma and urine. When suxibuzone (6 mg/kg) was administered intravenously (i.v.) or orally (p.o.) no parent drug was detected in plasma or in urine. The disposition of the metabolite PBZ (i.v.) could be described by a 2 compartment model with a P half-life varying from 7.40 to 8.35 h. Due to severe side effects the use of i.v. suxibuzone should not be encouraged in the horse. PBZ and OPBZ were detected in plasma and urine after p.o. SXB administration. Peak plasma PBZ concentrations (8.8 ± 3.0 μg/ml) occurred 6 h after oral dosing and the terminal exponential constant was 0.11 ± 0.01 h^-1. Phenylbutazone and oxyphenbutazone were detectable in urine (> 1 μg/ml) for at least 36 h, after p.o. administration.
SXB was not hydrolyzed in vitro by horse plasma. Equine liver homogenates however appeared to have a very high capacity for hydrolysing SXB, indicating that first-pass effect could be responsible for the rapid disappearance of this NSAID in the horse.     

Development of Chinese Near-isogenic Line of Rice and Their Differentiating Ability of Pathogenic Races of Blast Fungus

The rice( Oryza L. ) variety, Lijiangxintuanheigu(LTH), is a universally susceptible variety. A set of near-isogenic lines (NILs) of rice which has single resistance gene for each line was developed by use of LTH as recurrent parent and Kusabue,Tsuyuake, K1, PiNo. 4, K60 and BL1, which are from Kiyosawa‘s differential varieties(KDV), as donor parents. Differentiating ability of these NILs to Philippine isolates was compared with that of their donor parents, KDV and IRRI‘ s NILs. The results of comparative studies were as follows: (1) Differentiating ability of Chinese NILs to Philippine isolates was much stronger than that of their donor parents and that of KDV. (2) Chinese NILs had similar ability to differentiate races to IRRI‘s NILs or higher differentiating ability than them. But IRRI‘s NILs almost had no differentiating ability to isolates from japonica rice-growing regions. They can not be used to differentiate races of isolates from japonica ricegrowing regions. Whereas, Chinese NILs can be used to differentiate races of isolates from both japonica ricegrowing regions and indica rice-growing regions. It was concluded that the set of Chinese NILs can be used as international differentials.     

Adrenergic and peptidergic innervation of the trachealis muscle in the normal horse: a preliminary report

The tone of respiratory smooth muscle is largely determined by the input from autonomic nerves. The distribution of adrenergic and selected nonadrenergic, non-cholinergic (NANC) nerves in the normal equine trachealis muscle was investigated using immunohistochemistry. The smooth muscle of the trachealis was found to contain numerous nerves immunoreactive for an enzymatic marker of adrenergic nerves, as well as many nerves immunoreactive for a putative NANC neurotransmitter, peptide histidine isoleucine, a potent bronchodilator. The tissues surrounding the respiratory smooth muscle contained numerous nerves immunoreactive for the neuropeptides substance P and calcitonin gene-related peptide, which can cause marked vasodilation and bronchoconstriction. The complex innervation of the equine trachea should be kept in mind when interpreting the results of physiological experiments.     

Quantitative analysis of canine plasma lipoproteins

A combined ultracentrifugationl/precipitation method for the measurement of lipoprotein cholesterol concentrations was developed and validated for use with canine plasma. Very low density lipoproteins (VLDL) were isolated by flotation ultracentrifugation and low density lipoproteins (LDL) separated from high density lipoproteins (HDL) by precipitation with heparin-manganese chloride. Effective separation of these classes was confirmed by agarose gel electrophoresis of native lipoproteins and by sodium dodecyl sulphate polyacrylamide gel electrophoresis of their apolipoprotein distributions. There was trace contamination of the LDL precipitate with HDL, but this represented less than 4 and 9 per cent of the total plasma HDL in normo- and hypercholesterolaemic dogs, respectively. The intra-assay and interassay coefficients of variation for LDL- and HDL-cholesterol concentrations were between 3·3 and 6·9 per cent, and 7·2 and 9·0 per cent, respectively, for plasma cholesterol concentrations between 2·67 and 8·14 mmoll/litre. The intra-assay coefficient of variation for VLDL-cholesterol was 53·8 and 18·4 per cent at plasma cholesterol concentrations of 2·67 and 8·14 mmol/litre, respectively. The interassay coefficient of variation for VLDL was 22·5 per cent. Storage of plasma at -20°C for between two and eight weeks did not affect VLDL-cholesterol concentrations, but led to an increase in LDL-cholesterol and a decrease in HDL-cholesterol concentrations of approximately 10 per cent. The method described is appropriate for the measurement of lipoprotein concentrations in plasma from normo- and hypercholesterolaemic dogs, but samples should not be subjected to prolonged storage before analysis.     

A Prospective Study Of Intravenous Catheter Contamination

A one year prospective study was conducted to determine the association between intravenous catheter contamination and increased dwell time, and to identify any related risk factors. Intravenous catheters obtained from 23 cats and 98 dogs in the Intensive Care Unit at the Ontario Veterinary College with dwell times > 72 hours for the test group (n=58) and < 72 hours for a corresponding control group (n=63) were cultured between April 1991 and March 1992. One hundred and twenty one catheters were cultured, 16 jugular, 99 cephalic, and 6 saphenous. The overall contamination rate was 13 out of 121 catheters cultured (10.7%); 9/63 (14.3%) control and 4/58 (6.9%) test catheters. The bacteria isolated were E.aerogenes, S.aureus (3), P.aeruginosa, P.multocida, and Bacillus sp (7). The Bacillus sp positive catheters (5 control and 2 test) were placed during a five day period, and contaminated gauze squares were identified as the source of infection in these catheters. After these were removed from the study, the group infection rate was 6.9% control and 3.6% test. There was no significant difference between groups and no associated risk factors were identified. We conclude that intravenous dwell time need not be restricted to <72 hours.     

The ACVD task force on canine atopic dermatitis (VI): IgE-induced immediate and late-phase reactions, two inflammatory sequences at sites of intradermal allergen injections.

Intradermal testing is a common diagnostic procedure used in the evaluation of dogs with suspected atopic dermatitis (AD). To do this, most investigators assess the appearance of wheals that develop at the sites of intradermal allergen injections. However, wheals are rarely seen in dogs with naturally occurring AD. Furthermore, infiltration of inflammatory cells into the injection sites can occur 6-24h later, a phenomenon known as the late-phase reaction. The histological appearance of these late-phase reactions closely approximates that seen in the natural disease, suggesting that they might be more relevant than the immediate reactions. In this paper, we review the literature on immediate and late-phase reactions and re-assess the evidence for using current intradermal testing procedures as a diagnostic test in dogs.     

Application of Airway Pressure Therapy in Veterinary Critical Care: Part II: Airway Pressure Therapy

As the specialties of emergency medicine and critical care have grown and evolved in both human and veterinary medicine, so has the need for more advanced care of patients with primary lung disease. Treatment of acute respiratory failure has been the focus of several articles in the human medical literature of the past few years.^1,8 This paper deals with airway pressure therapy and its application in cases of acute respiratory failure in veterinary medicine. The reader is referred to part I of this paper for a reveiw of respiratory mechanics and hypoxemia as they apply to respiratory therapy.