Effect of fixed value positive end expiratory pressure valves on canine thoracic volume and atelectasis

Allison, Asher; Huizing, Xander; Jolliffe, Colette; Schaafsma, I. A.

doi:10.1111/jsap.12710

Cited by 7 publications

(17 citation statements)

References 38 publications

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“…The mean lung attenuation of the current study's population was significantly higher than the most recently published report's values. 12,27 Except, the subgroup of dogs weighing > 30 kg did not have mean lung attenuation significantly different than the previous higher mean lung attenuation values (Table 5). Expiratory mean lung attenuation has previously been reported as −713 HU.…”

Section: Comparison To Prior Published Datamentioning

confidence: 53%

“…We hypothesized that scans performed using this method would have mean lung attenuation and lung volume measurements consistent with previously documented measurements for thoracic scans of anesthetized normal dogs. 12,26,27 Additionally, we hypothesized that the amount of poorly aerated and atelectatic lung would be reduced compared to what has been documented for normal dogs under general anesthesia. 11…”

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confidence: 99%

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Minimal atelectasis and poorly aerated lung on thoracic CT images of normal dogs acquired under sedation

Hunt

Wallack

2021

Vet Radiology Ultrasound

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General anesthesia optimizes image quality of thoracic CT in dogs by providing patient immobilization and respiratory control. However, it also comes with disadvantages that may serve as a detractor to the use of CT in veterinary practice. With the use of multidetector helical CT combined with injectable sedation for restraint, parameters such as atelectasis and poorly aerated lung should not be appreciably different from what has been observed in dogs under general anesthesia. This prospective pilot study aimed to evaluate the mean lung attenuation and the amount of atelectasis and poorly aerated lung on thoracic CT images acquired under injectable sedation in normal dogs.The entire thorax of 10 client-owned dogs was scanned. Attenuation measurements were generated by three-dimensional reconstruction software. Mean ± SD lung attenuation was -707.0 ± 60.0. Atelectasis was not identified on any of the scans. Hypoinflated lung, the percentage of lung parenchyma with attenuation greater than -500 and -250 Hounsfield units (HU), was 10.7 ± 4.7% and 2.4 ± 1.2% (mean ± SD), respectively.There was no significant change in these percentages over time. Compared to previously published data, thoracic CT images obtained under sedation had mean attenuation comparable to normal expiratory lung and a lower percentage of poorly aerated lung compared to that of anesthetized dogs. Using sedation to complete canine thoracic CT does not itself lead to alterations of lung attenuation and may confer less hypoinflation and atelectasis than general anesthesia.

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Section: Comparison To Prior Published Datamentioning

confidence: 53%

mentioning

confidence: 99%

Minimal atelectasis and poorly aerated lung on thoracic CT images of normal dogs acquired under sedation

Hunt

Wallack

2021

Vet Radiology Ultrasound

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“…In our study, we chose to use a 100% FiO 2 . Indeed, in the veterinary literature, 100% FiO 2 is still commonly used during thoracic CTA procedure (36,(54)(55)(56)(57). This protocol was selected when the present study started in 2013 and was maintained throughout the study to allow obtention of comparable measures of the heart and pulmonary vasculature.…”

Section: Discussionmentioning

confidence: 99%

Utility of Computed Tomographic Angiography for Pulmonary Hypertension Assessment in a Cohort of West Highland White Terriers With or Without Canine Idiopathic Pulmonary Fibrosis

Soliveres

Entee

Couvreur³

et al. 2021

Front. Vet. Sci.

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West Highland white terriers (WHWTs) affected with canine idiopathic pulmonary fibrosis (CIPF) are at risk of developing precapillary pulmonary hypertension (PH). In humans, thoracic computed tomography angiography (CTA) is commonly used to diagnose and monitor patients with lower airway diseases. In such patients, CTA helps to identify comorbidities, such as PH, that could negatively impact prognosis. Diameter of the pulmonary trunk (PT), pulmonary trunk-to-aorta ratio (PT/Ao), and right ventricle-to-left ventricle ratio (RV/LV) are CTA parameters commonly used to assess the presence of PH. Pulmonary vein-to-right pulmonary artery ratio (PV/PA) is a new echocardiographic parameter that can be used in dogs to diagnose PH. The primary aim of this study was to evaluate the use of various CTA parameters to diagnose PH. An additional aim was to evaluate the correlation of RV/LV measurements between different CTA planes. CTA and echocardiography were prospectively performed on a total of 47 WHWTs; 22 affected with CIPF and 25 presumed healthy control dogs. Dogs were considered to have PH if pulmonary vein-to-right pulmonary artery ratio (PV/PA) measured on 2D-mode echocardiography was less than to 0.7. WHWTs affected with CIPF had higher PT/Ao compared with control patients. In WHWTs affected with CIPF, PT size was larger in dogs with PH (15.4 mm) compared with dogs without PH (13 mm, p = 0.003). A cutoff value of 13.8 mm predicted PH in WHWTs affected with CIPF with a sensitivity of 90% and a specificity of 87% (AUC = 0.93). High correlations were observed between the different CTA planes of RV/LV. Results suggest that diameter of the PT measured by CTA can be used to diagnose PH in WHWTs with CIPF.

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“…On a modern mechanical ventilator, PEEP is a basic setting that applies pressure at the end of expiration. Otherwise, commercial PEEP valves or handmade water column can be adapted onto the expiratory limb of the circuit or the scavenge tubing of the anaesthesia machine (Allison et al 2017). In this case, suitable PEEP valves were not available, and use of a water column was inappropriate because of the risk of water being funnelled into the circuit.…”

Section: Discussionmentioning

confidence: 99%

A simple method to provide positive end expiratory pressure to treat hypoxaemia in an anaesthetised Asian Elephant (Elephas maximus)

Leung

Beths

Lynch

et al. 2021

J. S. Afr. Vet. Assoc.

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Hypoxaemia is a common complication in anaesthetised or immobilised elephants. It is presumably because of hypoventilation and ventilation-perfusion mismatch. To prevent hypoxaemia, orotracheal intubation and positive pressure ventilation are recommended. This case report describes a hypoxaemic period despite positive pressure ventilation in a 46-year-old female Asian elephant (Elephas maximus) anaesthetised with azaperone-etorphine, medetomidine and an etorphine constant rate infusion in lateral recumbency for a dental procedure. The hypoxaemia was corrected utilising positive end-expiratory pressure (PEEP) of 5 cm – 10 cm H2O, a technique that has not previously been reported in the management of anaesthetised elephants. PEEP decreases atelectasis, shunt fraction, and increases lung compliance. Positive end-expiratory pressure was achieved by partial occlusion of the tailpiece of a manually triggered demand valve ventilator during expiration. This is a simple effective method of generating PEEP and correcting hypoxaemia without the need for any additional specialised equipment. However, PEEP decreased arterial blood pressure and should be implemented with caution if arterial blood pressure is not monitored.

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Effect of fixed value positive end expiratory pressure valves on canine thoracic volume and atelectasis

Abstract: A fixed-value positive end-expiratory pressure valve provides a simple, cost-effective technique for improving expiratory thoracic CT studies by increasing lung volume and decreasing atelectasis formation.

Cited by 7 publications

References 38 publications

Minimal atelectasis and poorly aerated lung on thoracic CT images of normal dogs acquired under sedation

Minimal atelectasis and poorly aerated lung on thoracic CT images of normal dogs acquired under sedation

Utility of Computed Tomographic Angiography for Pulmonary Hypertension Assessment in a Cohort of West Highland White Terriers With or Without Canine Idiopathic Pulmonary Fibrosis

A simple method to provide positive end expiratory pressure to treat hypoxaemia in an anaesthetised Asian Elephant (Elephas maximus)

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