Effect of different inspired fractions of oxygen on F-shunt and arterial partial pressure of oxygen in isoflurane-anaesthetized and mechanically ventilated Shetland ponies

Rodriguez, Abraham Calero; Grauw, Janny C. de; Loon, Johannes P.A.M. van

doi:10.1016/j.vaa.2021.05.005

Cited by 5 publications

(4 citation statements)

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“…Mean arterial pressure (MAP) was 79 mmHg; the results of arterial blood gas analysis are presented in Table 1 (further arterial blood gas analysis results were in line with the last arterial blood gas results). For the remainder of anaesthesia, the fraction of inspired oxygen was decreased to 0.65–0.77 as dictated by the experimental study protocol (Calero Rodriguez et al, 2021) and SpO 2 remained 99%–100%. Total anaesthesia time was 187 min.…”

Section: Casementioning

confidence: 99%

Endotracheal tube obstruction due to cuff overinflation or cuff herniation in small equids: A case series

Veen

Grauw

2023

Equine Veterinary Education

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Summary Adequate inflation of the endotracheal tube (ETT) cuff is important to avoid leakage of anaesthetic gases or aspiration of gastric contents and to allow positive pressure ventilation. However, overinflation or herniation of the cuff can cause tracheal mucosal damage and in rare cases even obstruction of the ETT. ETT obstruction due to the cuff itself may be an underrecognised phenomenon in equine practice and we aim to create awareness with this retrospective case series (n = 3). Cases identified between 2014 and 2021 with (partial) ETT obstruction due to cuff overinflation or cuff herniation at the Utrecht University Equine Clinic were selected. Anaesthesia records were examined and presented. Two cases occurred in foals and one in a pony. In each case, high airway pressure was encountered and no or minimal thoracic excursions were visible. In all three cases, cuff deflation led to immediate normalisation of ventilation parameters. When presented with an intubated patient that is difficult to ventilate and high airway pressures exist, ETT cuff overinflation or herniation should be considered as a possible cause; rapid cuff deflation should be included in algorithms for management of ventilation failure due to suspected airway obstruction.

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Section: Casementioning

confidence: 99%

Endotracheal tube obstruction due to cuff overinflation or cuff herniation in small equids: A case series

Veen

Grauw

2023

Equine Veterinary Education

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“…Although elevated FIO 2 readily corrects hypoxemia produced by high alveolar carbon dioxide tension and V/Q mismatch, its use may encourage the formation of absorption atelectasis (2)(3)(4)(5). Thus, the use of FIO 2 < 1 has been investigated, although findings are mixed as to its benefit and may be species dependent [e.g., see (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)]. Furthermore, the use of elevated FIO 2 in animals that are hypoxemic secondary to abnormally high venous admixture masks, rather than treats, the underlying causes (i.e., pulmonary shunt and excessive low V/Q mismatching).…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary effects of apneustic anesthesia ventilation in anesthetized pigs: a new mode of ventilation for anesthetized veterinary species

Bukoski,

Downs,

Hodgson

et al. 2024

Front. Vet. Sci.

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ObjectiveTo compare the cardiopulmonary effects of apneustic anesthesia ventilation (AAV) and conventional mechanical ventilation (CMV) in anesthetized pigs and to describe a new mode of ventilation for anesthetized veterinary species.Study designRandomized, crossover design without washout.AnimalsTwelve healthy, female white Landrace pigs.MethodsFollowing ketamine-midazolam premedication and anesthetic induction with propofol, the trachea was intubated, and each pig was positioned in dorsal recumbency. Anesthesia was maintained with propofol and sufentanil infusions. Pigs were instrumented and their lungs were sequentially ventilated with each mode, in random order, for 1 h according to predefined criteria [fraction of inspired oxygen (FiO2) = 0.21, 10 mL kg−1 tidal volume (VT), and arterial carbon dioxide tension (PaCO2) within 40–45 mmHg]. Cardiopulmonary data were collected at baseline, 30 and 60 min. In 8 pigs, thoracic computed tomography (CT) was performed following the 60 min time point for each mode of ventilation and images were analyzed to quantify lung aeration. The effects of ventilation mode, time, and order were analyzed using repeated measures ANOVA. Paired t-tests were used to compare lung aeration between modes. Significance was defined as p < 0.05.ResultsData from 12 pigs were analyzed. A significant effect of mode was found for heart rate, mean arterial pressure (MAP), pulmonary artery occlusion pressure, cardiac index (CI), stroke volume index, systemic vascular resistance, pulmonary vascular resistance, oxygen delivery index (DO2I), oxygen extraction ratio (O2ER), VT, arterial oxygen tension, arterial hemoglobin saturation, PaCO2, end-tidal carbon dioxide tension, alveolar dead space (VDalv/VTalv), venous admixture (Q.s/Q.t), mean airway pressure, and dynamic compliance index (CRSI). Order effects were also observed for some cardiovascular and respiratory variables. For the eight pigs that underwent thoracic CT, AAV resulted in significantly larger proportions of normally and hyperaerated lung while CMV resulted in larger proportions of hypoaerated and atelectatic lung.ConclusionsIn dorsally recumbent anesthetized pigs, ventilated with FiO2 = 0.21, both modes of ventilation supported adequate oxygenation while AAV resulted in higher CRSI, and lower VDalv/VTalv and Q.s/Q.t, compared with CMV. AAV was also associated with lower MAP, CI, and DO2I and higher O2ER compared with CMV. Further investigation of AAV in anesthetized animals is warranted.

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“…Na análise do grupo gravitacional, o dado de perfusão bruta foi usado com a divisão em ROI isomassa, o que de fato normalizou a perfusão para a massa de tecido pulmonar, já que cada ROI, apesar de tamanhos diferentes, continha a mesma massa de tecido na TC (Figura 23 C) (26) O aumento do shunt/mistura venosa, diferente do esperado, somente foi significante na comparação entre PEEP titulada (fase 1) e a PEEP 0 com FiO2 1 (fase 3). Se o shunt fosse semelhante nas fases 2 e 3, seria esperado que na fase 2 (PEEP=0 e FiO2 0,4) a mistura venosa fosse maior do que o shunt na fase 3 pois não há uma relação linear entre FiO2 menores que 1 e a mistura venosa (20,50) . Mas não foi o que foi observado.…”

Section: Discussionunclassified

“…No entanto, não é bem estabelecido qual é a contribuição do mecanismo de "absorção de gases" na formação da atelectasia, apesar de estudos mostrarem que o colapso de vias aéreas ocorre em uma porcentagem de pacientes submetidos a anestesia geral (4,16,17) . Considerando os efeitos da FiO2 elevada na formação de atelectasia no intraoperatório, alguns autores recomendam não usar FiO2 alta durante a anestesia, com o intuito de reduzir a atelectasia, shunt e hipoxemia (18,19) , apesar do efeito sobre o shunt e melhora da oxigenação ser questionável (20) .…”

Section: Repercussões Pulmonares Causadas Pela Anestesia Geral E Vent...unclassified

Efeito da FiO2 e volume pulmonar sobre a distribuição da perfusão em pulmão saudável sob ventilação mecânica monitorizado por tomografia computadorizada e tomografia de impedância elétrica : estudo experimental em suínos

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Efeito da FiO2 e volume pulmonar sobre a distribuição da perfusão em pulmão saudável sob ventilação mecânica monitorizado por tomografia computadorizada e tomografia de impedância elétrica : estudo experimental em suínos São Paulo 2023 BRUNO MOREIRA RIBEIRO Efeito da FiO2 e volume pulmonar sobre a distribuição da perfusão em pulmão saudável sob ventilação mecânica monitorizado por tomografia computadorizada e tomografia de impedância elétrica : estudo experimental em suínos

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Effect of different inspired fractions of oxygen on F-shunt and arterial partial pressure of oxygen in isoflurane-anaesthetized and mechanically ventilated Shetland ponies

Abstract: Please cite this article as: Rodriguez AC, de Grauw JC, van Loon JPAM, Effect of different inspired fractions of oxygen on F-shunt and arterial partial pressure of oxygen in isoflurane-anaesthetized and mechanically ventilated Shetland ponies, Veterinary Anaesthesia and Analgesia,

Cited by 5 publications

References 11 publications

Endotracheal tube obstruction due to cuff overinflation or cuff herniation in small equids: A case series

Endotracheal tube obstruction due to cuff overinflation or cuff herniation in small equids: A case series

Cardiopulmonary effects of apneustic anesthesia ventilation in anesthetized pigs: a new mode of ventilation for anesthetized veterinary species

Efeito da FiO2 e volume pulmonar sobre a distribuição da perfusão em pulmão saudável sob ventilação mecânica monitorizado por tomografia computadorizada e tomografia de impedância elétrica : estudo experimental em suínos

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