An alveolar recruitment maneuver followed by positive end-expiratory pressure improves lung function in healthy dogs undergoing laparoscopy

Bella, Caterina Di; Lacitignola, Luca; Grasso, Salvatore; Centonze, Paola; Greco, Antonella; Ostuni, Rossella; Crovace, Antonio; Staffieri, Francesco

doi:10.1016/j.vaa.2018.03.007

Cited by 19 publications

(21 citation statements)

References 35 publications

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“…The use of pulmonary recruitment during retrieval is a common procedure. However, recruitment leads to the production of inflammatory mediators and pulmonary edema that may negatively affect the results of the transplant (28 –35). In our study, PEEP 2 animals presented more lesions and PEEP 5 presented focal septal thickening, possibly characterizing greater pulmonary injury compared to animals treated with PEEP 10.…”

Section: Discussionmentioning

confidence: 99%

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Gonçalves‐Ferri

Martins-Celini

Sansano

et al. 2019

Braz J Med Biol Res

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Atelectasis and inadequate oxygenation in lung donors is a common problem during the retrieval of these organs. Nevertheless, the use of high positive end-expiratory pressure (PEEP) is not habitual during procedures of lung retrieval. Twenty-one Sprague-Dawley male consanguineous rats were used in the study. The animals were divided into 3 groups according to the level of PEEP used: low (2 cmH 2 O), moderate (5 cmH 2 O), and high (10 cmH 2 O). Animals were ventilated with a tidal volume of 6 mL/kg. Before lung removal, the lungs were inspected for the presence of atelectasis. When atelectasis was detected, alveolar recruitment maneuvers were performed. Blood gasometric analysis was performed immediately. Finally, the lungs were retrieved, weighed, and submitted to histological analysis. The animals submitted to higher PEEP showed higher levels of oxygenation with the same tidal volumes PO 2 =262.14 (PEEP 2), 382.4 (PEEP 5), and 477.0 (PEEP 10). The occurrence of atelectasis was rare in animals with a PEEP of 10 cmH 2 O, which therefore required less frequent recruitment maneuvers (need for recruitment: PEEP 2=100%, PEEP 5 =100%, and PEEP 10=14.3%). There was no change in hemodynamic stability, occurrence of pulmonary edema, or other histological injuries with the use of high PEEP. The use of high PEEP (10 cmH 2 O) was feasible and probably a beneficial strategy for the prevention of atelectasis and the optimization of oxygenation during lung retrieval. Clinical studies should be performed to confirm this hypothesis.

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Section: Discussionmentioning

confidence: 99%

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Gonçalves‐Ferri

Martins-Celini

Sansano

et al. 2019

Braz J Med Biol Res

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“…While we cannot exclude that hypercapnia was caused by an inadequate minute volume, the high PIP could have been a consequence of a decreased respiratory compliance due to atelectasis, presence of pleural effusion or, possibly, the presence of undiagnosed pulmonary oedema. After the arterial blood gas result, an RM with the implementation of PEEP 42,43 was performed and the f R was increased.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management and complications during cutting balloon and high‐pressure balloon dilation in a dog with a double‐chambered right ventricle

Sambugaro¹,

Gennaro²,

Vettorato³

2021

Vet Record Case Reports

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A 3‐month‐old female Cocker Spaniel was presented for investigation of a V/VI left basilar heart murmur and diagnosed with a double‐chambered right ventricle. Atenolol was prescribed for 3 months before surgical correction of the congenital anomaly, combining cutting balloon and high‐pressure balloon (CB‐HPB) dilation. A few days before the intervention, the dog showed signs of right‐sided congestive heart failure and it was treated with furosemide, benazepril/spironolactone and pleural effusion were drained. During CB‐HPB dilation, cardiac index and systemic arterial blood pressure suddenly decreased on two occasions probably secondary to a dynamic right ventricular outflow tract obstruction. Cardiac arrest occurred and cardiopulmonary resuscitation was unsuccessful.

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“…The application of PEEP counterbalances the hydrostatic forces leading to pulmonary oedema, redistributing the extravascular fluid from the alveoli into perivascular interstitium and maintaining airway patency 47. PEEP also improves gas exchange and recruits alveolar units 48. Application of PEEP up to 13 cmH 2 O improved alveolar gas exchange in experimentally induced canine pulmonary oedema 49 50.…”

Section: Discussionmentioning

confidence: 99%

Postobstructive negative pressure pulmonary oedema in a dog

Louro¹,

Raszplewicz²,

Hodgkiss-Geere³

et al. 2019

Vet Record Case Reports

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A 4-month-old English bulldog was anaesthetised for investigation and management of chronic urinary incontinence. In the postanaesthetic period, the patient developed respiratory distress, with marked cough and increased inspiratory effort. Diagnostic imaging suggested pulmonary oedema. After excluding all other causes of cardiogenic and non-cardiogenic pulmonary oedema, it was hypothesised that the patient developed postanaesthetic negative pressure pulmonary oedema, suspected to have been exacerbated by tracheal intubation with an oversized endotracheal tube leading to laryngeal swelling and obstruction. The animal was treated with oxygen supplementation, corticosteroids and β-2 adrenergic receptor agonists. The patient recovered from the event and was discharged from the hospital after 48 hours. This article discusses in further details other management options of negative pressure pulmonary oedema. This is the first case report discussing the pathophysiology, critical care and management of postanaesthetic negative pressure pulmonary oedema in a dog.

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An alveolar recruitment maneuver followed by positive end-expiratory pressure improves lung function in healthy dogs undergoing laparoscopy

Cited by 19 publications

References 35 publications

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Anaesthetic management and complications during cutting balloon and high‐pressure balloon dilation in a dog with a double‐chambered right ventricle

Postobstructive negative pressure pulmonary oedema in a dog

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