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61.
Objective To compare the cardiopulmonary effects of the head‐down position, with or without capnoperitoneum, in halothane‐anesthetized horses. Study design Prospective randomized study. Animals Five ponies (four mares, one stallion; bodyweight 302 ± 38.4 kg [mean ± SD]) were used. Methods The ponies were anesthetized with xylazine, guiafenesin, ketamine, and maintained with halothane/oxygen and lungs were ventilated to 40 ± 2 mm Hg (5.3 ± 0.3 kPa) end‐tidal CO2 tension. After baseline cardiopulmonary measurements, ponies were kept in horizontal position for 30 minutes, then tilted head‐down 30° to the horizontal position for 60 minutes, and then returned to a horizontal position for final measurements. Capnoperitoneum (intra‐abdominal pressure: 12 mm Hg [1.6 kPa]) was introduced after baseline cardiopulmonary measurements, until 5 minutes before the final measurements (treatment INS). Ponies in the control treatment (CON) did not receive capnoperitoneum. Cardiopulmonary data were collected every 10 minutes following the baseline measurements until recovery. Results In the head‐down position, in both treatments, significant decreases were observed in PaO2, and significant increases were observed in PaCO2, right atrial blood pressure, arterial to end‐tidal CO2 gradient, calculated Vd/Vt and ratios. During the head‐down position, in CON there was decreased cardiac index, and in INS, there were decreases in arterial plasma pH and increases in mean systemic arterial and airway pressures. Treatment INS developed ventilation–perfusion mismatch earlier in the study, and had longer recovery times compared to CON. Conclusion Cardiac index and systemic blood pressure appeared to be preserved in INS during the head‐down position, but ventilation–perfusion mismatch appeared earlier with head‐down position and capnoperitoneum. Clinical relevance Healthy ponies tolerate capnoperitoneum at 12 mm Hg (1.6 kPa) intra‐abdominal pressure when tilted head down 30° to the horizontal position.  相似文献   
62.
Cardiopulmonary effects of laparoscopic surgery were investigated in five crossbred dogs (21 ± 1.9 kg). Premedicated dogs were anesthetized with thiopental and maintained with halothane at 1.5 times minimum alveolar concentration in oxygen. Controlled ventilation maintained partial pressure of end-tidal co2 at 40 ± 2 mm Hg. Vecuronium was used for skeletal muscle relaxation. After instrumentation and stabilization, baseline measurements were made of cardiac output (thermodilution technique), mean systemic, mean pulmonary arterial and pulmonary wedge pressures, heart rate, saphenous vein and central venous pressures, and minute ventilation. Baseline arterial and mixed venous blood samples were drawn for analysis of pH, Pao2, Paco2, Pvo2, Pvco2, and bicarbonate concentrations. Systemic and pulmonary vascular resistances, oxygen delivery and consumption, shunt fraction, and dead space ventilation were calculated using standard formulas. Abdominal insufflation using co2 to a pressure of 15 mm Hg for 180 minutes resulted in significant ( P <.05) increases in heart rate (15 to 180 minutes), minute ventilation (75 to 135 minutes), and saphenous vein pressure (15 to 180 minutes), and decreases in pH (60 to 180 minutes) and Pao2 (60 to 180 minutes). For 30 minutes after desufflation, there was a significant decrease in Pao2, and increases in cardiac output, o2 delivery, and heart rate, compared with baseline. There was a significant increase in shunt fraction and decrease in pH at 15 minutes after desufflation only. The changes were within physiologically acceptable limits in these healthy, ventilated dogs.  相似文献   
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