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1.
Objective— To report the technique, complications, and effectiveness of thoracoscopic subphrenic pericardectomy (SPP) using double‐lumen endobronchial intubation for alternating 1‐lung (OLV) in healthy dogs. Study Design— Prospective cohort study. Animals— Mature purpose‐bred dogs (n=7). Methods— Bronchoscope‐assisted placement of a left‐sided double‐lumen endobronchial tube, immediately before surgery, allowed intraoperative alternation of ventilation between lung fields. A camera portal was established in a subxyphoid location. Two instrument portals were established at the 4th–6th intercostal spaces on the right and left sides. A vessel‐sealing device was used to create the subphrenic pericardectomy. After termination of the procedure, dogs were humanely euthanatized under anesthesia and necropsy performed. In each dog, the extent of pericardectomy and any complications were evaluated. Results— Technical difficulties with tube placement occurred in 4 dogs, but alternating OLV was achieved in all dogs and SPP completed successfully. Median surgical time was 87.5 minutes (range, 80–105 minutes). At necropsy, 0.5–2 cm of pericardial tissue remained ventral to the intact phrenic nerve in 6 dogs; in 1 dog, the phrenic nerve was transected on the left side only. Conclusions— Thoracoscopic subphrenic pericardectomy is a technically feasible procedure in healthy dogs. Double‐lumen endobronchial intubation allowed alternating OLV without intraoperative bronchoscopically guided tube manipulation in all but 1 dog. Clinical Relevance— Thoracoscopic subphrenic pericardectomy could potentially be used for management of conditions where relief of pericardial constriction or access to intrapericardial structures is desired.  相似文献   

2.
This case report describes the death of a yearling Thoroughbred colt due to segmental severe necrotising tracheitis with stenosis of the tracheal lumen, 19 days after endotracheal intubation for elective endoscopic surgery. The stenosis of the trachea leading to asphyxiation was caused by an inflammatory process accompanied by massive accumulation of necrotic material, fibrinous inflammatory exudate, oedema and granulation tissue. The cause of this inflammation was likely to be a bacterial infection secondary to traumatic damage of the tracheal mucosa. Given the clinical history and location of the lesion, the endotracheal tube used for general anaesthesia was hypothesised to be responsible for this damage. Delayed tracheal necrosis as a fatal complication of endotracheal intubation has not previously been described in the horse and should be considered as a potential catastrophic consequence following relatively innocuous clinical signs.  相似文献   

3.
A retrospective study was performed to identify positional changes of endotracheat tubes (ETT) during cervical spine radiography in 153 dogs. Three neck positions were identified: traction, hyperextension, and flexion. A properly placed ETT was defined as having the caudal tip of the tube located between the caudal half of the fourth cervical (C) vertebra (C4) and the caudal half of C7. In the traction position, before neck flexion and extension, the caudal tip of 13% of ETT were located caudal to C7, and one tube was in the endobronchial position at the seventh thoracic (T) vertebra (T7). In the hyperextended position, 60% of ETT moved cranially. The average distance moved was 0.6 vertebral spaces. In the flexed position, all ETT moved caudally. The average distance moved was 3.5 vertebral spaces, with 81.8% of ETT located caudal to C7 and seven tubes in endobronchial positions. Endotracheal tube occlusion caused by kinking at the atlanto-occipital joint was seen in four dogs during flexion of the neck. Based on this study, ETT position should be monitored during cervical manipulation.  相似文献   

4.
OBJECTIVE: To determine causes of tracheal rupture in cats and the mechanism of injury. DESIGN: A retrospective study was conducted to identify cats with tracheal rupture. A second study was conducted to establish mechanism of injury, and a third study was conducted to determine volume of air needed to obtain an airtight seal when inflating the cuff of an endotracheal tube in a cat. ANIMALS: 16 cats with clinical signs of tracheal rupture, 10 cat cadavers, and 20 clinically normal cats that were undergoing anesthesia. PROCEDURES: Details were extracted from medical records of 16 cats with tracheal rupture (9 treated surgically and 7 treated conservatively). For the cadaver study, the trachea of each cat cadaver was intubated and observed during overinflation of the endotracheal tube cuff. For clinically normal cats, volume of air needed to obtain an airtight seal for the endotracheal tube was recorded. RESULTS: Most ruptures were associated with cats anesthetized for dental procedures. Clinical signs associated with tracheal rupture included subcutaneous emphysema, coughing, gagging, dyspnea, anorexia, and fever. Tracheoscopy was the method of choice for documenting tracheal rupture. Surgical and conservative management were successfully used, unless the injury extended to the carina. In the cadaver study, overinflation of the endotracheal tube cuff with > 6 ml of air resulted in tracheal rupture in 7 of 10 cadavers. For clinically normal cats, the volume of air (mean +/- SD) needed to obtain an airtight seal was 1.6 +/- 0.7 ml. CLINICAL IMPLICATIONS: Overinflation of an endotracheal tube cuff may result in tracheal rupture in cats.  相似文献   

5.
The aim was to develop an endobronchial infection procedure for the study of Mycobacterium bovis infection in badgers. The badgers were anaesthetised and a cannula was passed per os to the tracheal bifurcation. When in place 1 ml of M. bovis suspension was inoculated. Three concentrations of M. bovis suspension were used; <10 colony forming units (cfu), approximately 10(2) cfu and approximately 3 x 10(3) cfu. The badgers were examined at three weekly intervals for clinical signs of disease and a tracheal aspirate was collected at each examination. The badgers were euthanased 17 weeks post infection (pi) and at the post mortem examination a wide range of tissues were examined for gross and histopathological lesions of tuberculosis and cultured for M. bovis. A sample of bronchial alveolar lavage (BAL) fluid was collected at post mortem for culture. At post mortem examination 17 weeks after infection, gross and histopathological lesions of tuberculosis were observed in all badgers inoculated with the high and medium dose and 1/3 inoculated with the low dose. M. bovis was recovered from all inoculated badgers. Infection in the high dose group was more widely disseminated than in the other groups. The number of sites with gross and histopathological lesions increased with increasing dose of M. bovis. All tracheal aspirates were negative on culture and only one BAL, collected from a badger of the high dose group, was positive on culture. No clinical signs due to the experimental infection were observed. The endobronchial route of inoculation is an effective route for establishing experimental infection, and could be used for studies of tuberculosis pathogenesis, immunology of M. bovis infection in badgers and for challenging badgers in vaccine protection studies. Badgers appeared to be very susceptible to infection by this procedure even with a dose of < 10 cfu but appear to control and limit the resulting infection.  相似文献   

6.
One hundred dogs with clinical signs associated with tracheal collapse were examined over a four-year period. The symptomatic state of tracheal collapse was found to have a multifactorial aetiology. Factors linked with the onset of clinical signs included cardiomegaly, pulmonary oedema, respiratory infection, endotracheal intubation, the presence of a smoker in the household, allergic respiratory disease and obesity. Medical or conservative management resulted in long term resolution of signs (greater than 12 months) in 71 per cent of cases while a further 4 per cent were successfully managed by upper airway surgery. Tracheal reconstruction was performed for the minority of non-responsive cases (11 per cent) in which no other medical condition could be identified. Only half of these dogs (5 per cent) remained asymptomatic long term. The importance of identifying and eliminating the factors implicated in initiating the symptomatic state of tracheal collapse is emphasised. Suppression of these exciting causes should be considered as the therapeutic priority and surgery should be reserved only for those dogs which do not respond to conservative management.  相似文献   

7.
A 3-year-old Thoroughbred colt was presented to the University Veterinary Centre Camden for evaluation of ataxia. The horse was anaesthetised to facilitate cervical radiography and myelographic examination of the spinal cord. Recovery from anaesthesia was uneventful. Five days after general anaesthesia the horse re-presented with pleuropneumonia. It was euthanased 24 hours after presentation on humane grounds. Necropsy revealed severe tracheal erosion over the middle third of the ventral surface of the trachea, pleuropneumonia and narrowing of the cervical cord between C4 and C6. It is postulated that extension and flexion of the neck during myelography resulted in movement of the endotracheal tube cuff, causing the tracheal lesion and predisposing the colt to pleuropneumonia. Severe tracheal lesions and pleuropneumonia have not been reported as sequela of equine myelography, and should be considered as possible complications following repeated cervical manipulation during myelography in the horse.  相似文献   

8.
ObjectiveTo compare ultrasonography with computed tomography (CT) for assessment of tracheal diameter as a feasibility study for endotracheal tube selection.Study designProspective study.AnimalsA total of nine Beagle dogs with a median (interquartile range) weight of 7.4 (7.2–7.7) kg.MethodsTracheal diameter measurements were obtained at two locations: 1 cm proximal to caudal border of the cricoid cartilage (sublaryngeal; SL) and dorsal to above cranial border of the manubrium (thoracic inlet; TI). For CT, dogs were anesthetized with propofol and sevoflurane, in sternal recumbency, and measurements obtained after controlled ventilation–induced apnea and the endotracheal tube cuff was deflated. Transverse diameter, right and left 45° oblique diameters were measured. For ultrasonography, unsedated dogs were standing with slight neck extension, and images obtained in ventrodorsal, 45° right and left oblique ways after expiration. Diameters between the tracheal lumen mucosal borders were measured. The degree of agreement between the tracheal diameters measured at SL and TI locations with CT (TDCT-SL and TDCT-TI) and ultrasonography (TDUS-SL and TDUS-TI) was verified using the Bland-Altman method.ResultsThe agreement between the measurements obtained with CT and ultrasonography was revealed by Bland-Altman analyses, although ultrasonography tended to slightly underestimate the tracheal diameter.Conclusions and clinical relevanceUltrasonography can be applied for tracheal diameter measurement. Although further studies are required, an endotracheal tube selection method, using ultrasonography, could be proposed.  相似文献   

9.
A FOUR-year-old spayed miniature poodle was presented for evaluation because of a chronic cough which had been present from eight weeks of age. The condition had gradually worsened until exercise intolerance, inappetence and abdominal breathing occurred. The dog was thin and weighed only 1.5 kg. Auscultation revealed tachycardia, a normal respiratory rate and wheezing noises - more prominent on inspiration and localised to the cervical portion of the trachea. There was marked inspiratory and expiratory effort. Tracheal sensitivity was moderate and palpation induced a dry hacking cough. Radiography demonstrated mild thickening of the bronchial wall and pulmonary hyperinflation. Expiratory/inspiratory radiographs failed to demonstrate dynamic tracheal collapse. On fluroscopy, substantial changes in tracheal calibre were not apparent. Bronchoscopy was performed and the tracheal lumen was normal up to 12.5 cm from the incisors. At this point, there was lateral tracheal collapse to about 30 per cent. There was dynamic collapse with respiratory effort. The bronchoscope could be passed beyond the narrowing (consisting of five tracheal rings) to a trachea of normal size. No pathogens were found on tracheal lavage. Surgery was undertaken through a midline, ventral approach. Six specially made tracheal ring prostheses were individually inserted around the trachea and inside the recurrent laryngeal nerve. Each prosthesis was sutured in four places to the tracheal ring, to give external support. The dog improved clinically and 11 months after surgery, bronchoscopy was again performed. The trachea was narrowed to approximately 60 per cent but there was no dynamic collapse of the airway. Twenty-seven months after surgery the dog continued to lead a healthy active life.  相似文献   

10.
No published reports on the occurrence of Mendelson's syndrome (pneumonitis caused by aspiration during anaesthesia) in horses were found in the literature. Although the peculiar anatomy of the equine stomach makes horses less prone than other species to regurgitate, gastric reflux may still occur in horses with colic under certain circumstances. The colic horses in this report had in common stomach impaction, abdominal distention and preanaesthetic placement of a nasogastric tube, which was not withdrawn prior to induction. In both cases, a significant volume of gastric reflux was noted pouring from the endotracheal tube during general anaesthesia for exploratory laparotomy. It was hypothesised that the cause of gastric reflux was the combination of increased intra-abdominal pressure and patency of the cardia, and that inhalation of gastric content occurred at induction, before tracheal intubation. Treatment, which failed to improve oxygenation, consisted of repositioning of the horses to facilitate passive drainage of gastric content from the airways, active suction through the endotracheal tubes, ventilation strategies, improvement of haemodynamics to increase the pulmonary perfusion, and administration of bronchodilators. One horse was subjected to euthanasia owing to poor prognosis. Aspiration pneumonitis should be regarded as a life-threatening, although rare, perianaesthetic complication in equine colic cases. Patency of the cardia and increased intra-abdominal pressure are possible predisposing factors. Partial or even total withdrawal of the nasogastric tube prior to anaesthetic induction and tracheal intubation performed with the horse positioned in sternal recumbency may be undertaken as preventive measures in patients at high risk of developing Mendelson's syndrome.  相似文献   

11.
Steers and calves were experimentally infected with bovine leukosis virus. The virus was isolated from the blood and from the tracheal and bronchoalveolar washings before antibodies could be detected in the serum. Bovine leukosis virus was not detected during any period in the blood plasma.  相似文献   

12.
Computed tomography (CT) is used to document upper airway lesions in dogs with brachycephalic obstructive airway syndrome. The presence of an endotracheal tube during CT scanning is often required for general anesthesia. We hypothesized that the endotracheal tube placement would change the soft tissue dimensions of the upper airway. The aims of this prospective, method comparison study were to evaluate the reliability of the previously reported upper airway CT measurements with endotracheal tube placement, and to propose measurements that are minimally affected by the endotracheal tube. Twenty brachycephalic dogs were included in this study. Each dog underwent head/neck CT with an endotracheal tube, followed by a second scan without the endotracheal tube. Ten measurements of the soft palate, nasopharynx, and trachea were performed. Tracheal dimension was significantly larger with the endotracheal tube compared to without, whereas the soft palate cross‐sectional area was significantly smaller with the endotracheal tube than without the endotracheal tube. The influence of the endotracheal tube on the caudal nasopharynx cross‐sectional (transverse‐sectional) area varied with a mean proportional absolute difference of 35%. Rostral soft palate thickness, tracheal perimeter, and cross‐sectional area of the rostral nasopharynx were the measurements least affected by the endotracheal tube (intraclass correlation coefficient = 0.964, 0.967, and 0.951, respectively). Therefore, we proposed that these three measurements may be most useful for future brachycephalic obstructive airway syndrome studies that require CT scanning of intubated animals. However, with endotracheal tube placement, measurements of soft palate length, caudal nasopharyngeal cross‐sectional area, and trachea height and width may not be reliable.  相似文献   

13.
Two suture techniques for tracheal anastomosis after large-segment tracheal resection were compared. Eight cartilages were resected from the trachea of each of 12 dogs; anastomoses with 4-0 polydioxanone suture were created using a simple continuous suture technique in six dogs and a simple interrupted suture technique in six dogs. Surgical time was shorter but apposition of tracheal segments at the time of surgery was less precise with the simple continuous suture technique. The dogs were evaluated for 150 days after surgery. Clinical abnormalities after tracheal resection and anastomosis were not observed. Percent dorsoventral luminal stenosis was calculated by measuring the tracheal lumen diameter on lateral cervical radiographs. Percent luminal stenosis was calculated planimetrically using a computerized digitizing tablet. Anastomotic stenosis was mild in all dogs; however, the mean percent luminal stenosis determined planimetrically was significantly greater for dogs that had the simple continuous suture technique. Planimetric measurements of cross-sectional area made before and after formalin fixation were not significantly different. Radiographic determination of percent dorsoventral luminal stenosis was a poor predictor of diminution of cross-sectional area determined planimetrically.  相似文献   

14.
Endotracheal intubation is commonly performed in horses undergoing general anaesthesia to avoid fluid aspiration and provide mechanical ventilation and inhalational anaesthetic agents. Secondary laryngeal and tracheal trauma following intubation is not rare. This case report describes the successful treatment of a horse with laryngeal and tracheal trauma secondary to intubation during myelography. Based on other clinical reports and clinical experience, movement of the endotracheal tube during myelography was considered the most likely cause of the damage. This case underscores the importance of monitoring horses for development of respiratory signs after general anaesthesia for computerised tomography and myelography.  相似文献   

15.
Objective: To describe the surgical technique, complications, and outcome after use of extraluminal prostheses in 2 ponies with severe tracheal collapse. Study Design: Clinical report. Animals: Ponies (n=2) with severe tracheal collapse. Methods: A ventral median approach was used to expose the trachea from the larynx to the manubrium. Extraluminal, high‐density polyethylene, C‐shaped prostheses were sutured to the dorsal tracheal membrane and tracheal rings to provide external tracheal support. Results: The surgical approach provided good tracheal access and placement of the rings was uncomplicated. Initial estimates of the tracheal diameter from preoperative radiographs resulted in prostheses that were too small at surgery requiring a 2nd surgical procedure in 1 pony. Postoperative complications were coughing, right laryngeal hemiplegia, seroma formation, and antimicrobial induced colitis. Both ponies had marked resolution of clinical abnormalities after surgery. Recurrent esophageal obstruction resulted in euthanasia of 1 pony 3.5 years after surgery. The other pony was doing well 1 year after surgery. Conclusions: Extraluminal support of the trachea resulted in rapid resolution of clinical signs in 2 ponies with tracheal collapse. Clinical Relevance: Extraluminal tracheal prostheses can resolve clinical abnormalities in ponies with severe tracheal collapse.  相似文献   

16.
Difficulty in airway management during anesthesia was noted in a 10-year-old, castrated, male Pekingese dog and a 13-year-old male French Bulldog. They showed strong resistance during tracheal tube insertion through the subglottic lumen. Therefore, the airway was secured by using a small endotracheal tube or supraglottic airway device. Computed tomography scan revealed a markedly narrower vertical dimension of the cricoid cartilage compared to that seen in common brachycephalic breeds. Posterior glottis was relatively more accessible for translaryngeal intubation in the present cases. Our findings showed that brachycephalic airway syndrome may be associated with narrow cricoid cartilage. To the best of our knowledge, this is the first clinical case report of airway management during anesthesia in dogs with narrow cricoid cartilage.  相似文献   

17.
Instead of a conventional double lumen tube, an Arndt wire-guided endobronchial blocker was used to achieve one-lung ventilation in a dog undergoing thoracoscopic pericardiectomy. Overall, lung separation was easy to perform and surgical conditions for the creation of a pericardial window were adequate. Special ventilation strategies were applied.  相似文献   

18.
This study evaluated two methods of endotracheal tube selection using 28 fresh canine carcasses of various ages, weights, and genders. The two selection methods were 1) nasal septal width pairing with outer diameter of an endotracheal tube, and 2) digital palpation of the tracheal outer diameter to determine the endotracheal tube size. All dogs were dolichocephalic breeds. Results of this study showed that the canine nasal septal width method of endotracheal tube selection was correlated with the size of the tracheal internal (r=0.72) and outer (r=0.73) diameters. However, evidence shows that the digital palpation method is slightly more effective than the nasal width method in selecting the best-fitting endotracheal tube. The percentage of the best-fit tube selection for the nasal septal width method was 21%, while the digital palpation method was 46%. With these two methods, selecting an endotracheal tube that is too small is possible, especially when the tube internal diameter is > or =7 mm.  相似文献   

19.
Barometric plethysmography has become an increasingly used method to indirectly measure respiratory function in unrestrained freely-moving animals. This technique has been criticized because of physiological uncertainty of its major index, the enhanced pause (Penh). Moreover, a recent study raises concerns that during histamine challenges part of the Penh response could be produced by upper airways (nasal) responses. In this study we compared airway responsiveness measured by barometric plethysmography and total lung resistance (RL) in guinea pigs, and evaluated the role of upper airways during Penh measurement. Our results showed that intravenous acetylcholine or histamine caused a dose-dependent increase of the Penh values in non-anesthetized guinea pigs, which were correlated with RL values obtained in separate groups of anesthetized animals. In anesthetized but spontaneously breathing guinea pigs intravenous acetylcholine or histamine also produced a dose-dependent increment of Penh, which was similar regardless if guinea pigs breathed through the nose or through a tracheal tube. Our results suggest that, independently of the physiological meaning of Penh, this index seems to be a useful indirect measurement for evaluating airway responsiveness to intravenous agonists in guinea pigs, and that nasal passage seems not to be involved in this measurement.  相似文献   

20.
OBJECTIVE: To describe the surgical technique, complications, and outcome of thyroidectomy in 6 horses. STUDY DESIGN: Retrospective study. ANIMALS: Six horses, 10 to 22 years of age, with unilateral, rapidly enlarging thyroid masses. METHODS: Medical records between 1985 and 2000 were reviewed for horses that had unilateral thyroidectomy. Retrieved data included signalment, physical, clinical, and ultrasonographic examination findings, surgical technique, complications, and outcome. A minimum of 6 months follow-up was obtained. RESULTS: Six horses were identified. Three horses had tracheal compression and 2 of these also had exercise intolerance. On ultrasonography (5 horses), the enlarged thyroid ranged from 125 to 990 cm(3), and had either a heterogeneous (1 horse), cystic (2), or homogeneous (2) appearance. En bloc, unilateral thyroidectomy under general anesthesia was performed in all horses. After surgery, 3 horses had ipsilateral laryngeal hemiplegia, but tracheal compression was resolved. Thyroid masses were adenoma (3), C-cell compact carcinoma (1), and adenocarcinoma (1). No tumor recurrence or metastatic disease was reported 6 to 14 months after surgery. CONCLUSIONS: Unilateral thyroidectomy can be successfully performed in horses with large thyroid tumors, but laryngeal hemiplegia can be an important surgical complication. Ultrasonographic examination is useful to define thyroid enlargement and location but is seemingly not useful to characterize tumor type. CLINICAL RELEVANCE: Thyroidectomy is an uncommon surgical procedure and has an attendant risk for recurrent laryngeal nerve damage. Laryngoscopic examination before and after surgery and careful isolation of the recurrent laryngeal nerve during surgery is recommended.  相似文献   

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