Continuous positive airway pressure (CPAP) provision with a pediatric helmet for treatment of hypoxemic acute respiratory failure in dogs

Abstract

Objective: To evaluate arterial blood gas parameters and pulmonary radiography, before and after provision of continuous positive airway pressure (CPAP) via a pediatric helmet in dogs with acute hypoxemic respiratory failure.Design: Single-center, observational study conducted from 2016 to 2017. Setting: University teaching hospital.Animals: Seventeen dogs presenting with clinical signs compatible with respiratory failure, confirmed by arterial blood gas analyses.Interventions: For each animal arterial blood samples and thoracic radiographs were performed at arrival (T 0 ). Hypoxemic dogs (PaO 2 <80 mm Hg), without evidence of pneumothorax or pleural effusion, received CPAP ventilation via a pediatric Helmet for at least 1 hour. At the end of CPAP ventilation, a second arterial blood gas analysis was performed at room air (T 1 ). The F-shunt was also calculated. Measurement and Main Results:Respiratory rate, heart rate and rhythm, mean blood pressure, mucosal membrane color, and rectal temperature were recorded. Tolerance to the helmet was evaluated using a predetermined scoring system. Two dogs were excluded from the study for low tolerance to the helmet. In 15 of 17 dogs, a significant difference between T 0 and T 1 was noted for PaO 2 (60.84 ± 3 mm Hg vs 80.2 ± 5.5 mm Hg), P(A-a)O 2 (52.4 ± 4.4 mm Hg vs 35.2 ± 6 mm Hg), PaO 2 /FiO 2 (289.7 ± 14.3 vs 371 ± 21), and %SO 2 (91.3 vs 98.8). In 15 of 17 dogs, the helmet was well tolerated. F-shunt significantly decreased following provision of CPAP (37%; range, 8.4-68% vs 6%; range, −5.6-64.3%). Conclusion:The use of a pediatric helmet appears to be a suitable device for delivery of CPAP in dogs with hypoxemic acute respiratory failure. The device appears to be reasonably tolerated and improved oxygenation in most dogs.

Effects of continuous positive airway pressure administered by a helmet in cats under general anaesthesia

“…[5][6][7][8] The efficacy of CPAP has been shown in sedated dogs, 8 and in dogs recovering from general anaesthesia or affected by acute respiratory failure. 5,9 Another study showed that 5 cmH 2 O CPAP almost doubled the laryngeal size in anaesthetised dogs using a helmet CPAP device. 10 Similar to other species, sedation or anaesthesia can lead to airway collapse and atelectasis in cats.…”

Comparison of CPAP and oxygen therapy for treatment of postoperative hypoxaemia in dogs

“…2014) and in dogs affected by acute respiratory failure (Ceccherini et al . 2020). We found that CPAP restored normoxaemia within 15 minutes of our canine patients with low SpO 2 .…”

Anaesthetic and perioperative management of a dog with biventricular congestive heart failure and advanced second‐degree atrioventricular block

“…While CPAP is recommended as the first line for ventilatory support of humans with cardiogenic pulmonary oedema, 27 this technique is challenging to adapt to animals. CPAP devices have been tested 33 and applied in canine patients for various pathologies, including canine cardiogenic pulmonary oedema 34 . However, due to patient compliance problems and a lack of experience with these devices in UK veterinary practice, this technique is not in widespread use.…”

“…CPAP devices have been tested 33 and applied in canine patients for various pathologies, including canine cardiogenic pulmonary oedema. 34 However, due to patient compliance problems and a lack of experience with these devices in UK veterinary practice, this technique is not in widespread use. As the patient reported here was already anaesthetised and intubated, the decision was made to continue pressure-controlled MV post-operatively, despite the availability of CPAP equipment at our institution.…”