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1.
Dogs with lower airway pathology that present in respiratory distress often receive oxygen therapy as the first line of treatment regardless of the underlying cause. Conventional “low-flow” systems deliver oxygen with a maximum flow rate of 15 L/minute. Traditionally, when an animal’s respiratory status does not improve with conventional oxygen therapy and treatments for underlying disease, options might be limited to either intubation and mechanical ventilation or humane euthanasia. High-flow oxygen therapy (HFOT) has been gaining popularity in veterinary medicine as an alternative route of oxygen supplementation for animals that require support beyond conventional therapy. High-flow oxygen therapy can supply a mixture of air and oxygen via a heated and humidified circuit. It is user friendly and can be used in an environment in which mechanical ventilation is unavailable.This review article is written for emergency doctors and general practitioners who lack access to mechanical ventilation. This article briefly reviews pertinent respiratory physiology, traditional oxygen supplementation techniques, the physiology of HFOT, and the limited evidence available in veterinary medicine regarding the use of HFOT, its applications, and limitations. Guidelines for the use of HFOT are suggested and HFOT is compared to conventional therapy.  相似文献   

2.
Objective: To review the pathophysiology, clinical signs, diagnosis, and current treatment modalities used in treating tetanus in small animals and humans. Etiology: Tetanus is caused by the activity of a toxin released from the bacterial organism, Clostridium tetani. The disease has an incubation period of 3 days to 3 weeks and usually follows a deep penetrating wound. Diagnosis: The diagnosis of tetanus is usually based on history and clinical signs. Therapy: Therapy of tetanus consists of direct and supportive care and includes toxin neutralization via human or equine derived immunoglobulin, antimicrobial therapy to eliminate C. tetani, and central and peripheral muscle relaxants to control hypertonicity. Adjunctive care may include positive pressure ventilation, anticonvulsant medication, drugs to treat autonomic dysfunction, and nutritional support. Prognosis: Prognosis varies based on severity of clinical signs at the time of diagnosis and the availability of appropriate care.  相似文献   

3.
Analysis of blood gases in equine neonatology is regarded as a diagnostic tool to study the neonatal adaptation period. Aim of this study therefore was to compare the diagnostic value of venous blood gas parameters to arterial parameters in newborn foals with pulmonary disorders. Venous as well as arterial blood samples were taken from 24 foals (1 to 6 days old) and the partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), pH, and oxygen parturition (S-O2) of these samples were investigated. In addition, the alveolar (A) to arterial (a) gradients (A-aDO2) were calculated. Due to changes in blood gas parameters during the first week postnatal the age was taken into consideration by using covariance analysis. All arterial parameters except paCO2 showed a significant difference among healthy foals (n = 15) and foals with respiratory disorders (n = 11) with A-aDO2 and paO2 being the most reliable arterial parameters. In venous blood there was a significant difference between healthy and sick foals only in S-O2 and pH.  相似文献   

4.
Endotracheal intubation is an essential component of general anaesthesia in horses to facilitate delivery of inhalation anaesthetic agent and oxygen, artificial ventilation, and prevent pulmonary aspiration of blood or gastric reflux. Experimental studies have identified a high incidence of tracheal mucosal injury after intubation resulting from direct trauma or local ischaemia from the pressure of the inflated cuff. Recommendations to minimise injury include gentle intubation, disconnection from the anaesthesia machine when moving the horse, and monitoring the endotracheal tube cuff pressure. New studies are needed to evaluate trachea and cuff pressure interactions under current practice conditions, including specialised ventilation modalities such as positive end‐expiratory pressure and continuous airway pressure.  相似文献   

5.
This report documents the feasibility and clinical information provided by a new method for spirometric monitoring adapted for equine anaesthesia. Monitoring of ventilatory function was done with continuous spirometry during general anaesthesia of client‐owned horses presented for various diagnostic and surgical procedures. An anaesthetic monitor with a spirometry unit for human anaesthesia was used. To allow the measurement of large tidal volumes, a remodelled larger version of the pitot tube‐ based flow sensor was used. This technology provided reliable spirometric data even during prolonged anaesthesia when water condensation accumulated in the anaesthetic circuit and the sensor. In addition to flow and volume measurement and respiratory gas analysis, the continuous display of flow‐volume and pressure‐volume loops offered visually recognisable information about compliance, airway resistance and integrity of the circuit. Continuous spirometry with this monitoring system was helpful in evaluating the efficacy of spontaneous ventilation, in adjusting intermittent positive pressure ventilation and detecting technical faults in the anaesthetic apparatus and connection with the patient. This adapted spirometry method represents a practical and reliable measuring system for use during equine anaesthesia. The variety of information provides an opportunity to optimise anaesthetic management in this species.  相似文献   

6.
This case series is the first report of the use of CPAP (continuous positive airway pressure) ventilation in adult horses. Two horses and 3 ponies anesthetized for orthopedic procedures in lateral recumbency received 10 cm H2O CPAP. During anesthesia, arterial oxygen partial pressure tended to increase and arterial carbon dioxide pressure tended to increase despite increased minute ventilation index. The measured cardiovascular parameters were within physiologic limits.  相似文献   

7.
OBJECTIVE: To determine whether a laryngeal mask airway (LMA) provides a better airway than a facemask in spontaneously breathing anesthetized rabbits, and to test if it can be used for mechanically controlled ventilation. STUDY DESIGN: Randomized prospective experimental trial. ANIMALS: Sixteen young, healthy, specific pathogen-free Giant Flemish cross Chinchilla rabbits (10 females and 6 males) weighing 4.1 +/- 0.8 kg. METHODS: Rabbits were assigned randomly to one of three treatment groups: facemask with spontaneous ventilation (FM-SV; n = 5), LMA with spontaneous ventilation (LMA-SV; n = 5), and LMA with controlled ventilation (LMA-CV; n = 6). In dorsal recumbency, and at 2.3% end-tidal isoflurane concentration, Fé isoflurane, Fi isoflurane, partial pressure of expired isoflurane (PECO(2)), partial pressure of inspired carbon dioxide (PiCO(2)), heart rate, respiratory rate, minute volume, arterial oxygen tensions (PaO(2)), arterial carbon dioxide tensions (PaCO(2)), arterial pH (pH(a)), arterial standard base excess (SBE(a)) values were measured for 120 minutes. Results Two individuals in the FM-SV group had PaCO(2) > 100 mm Hg. One rabbit in the FM-SV had PaO(2) < 80 mm Hg. All FM-SV rabbits showed signs of airway obstruction, and two were withdrawn from the study at 45 and 90 minutes, respectively, because cyanosis was observed. No signs of airway obstruction were observed in either LMA group. Four rabbits in the LMA-CV group developed gastric tympanism, one of which refluxed gastric contents after 110 minutes. There were no differences between FM-SV and LMA-SV in any variable tested. PaCO(2) and PECO(2) were decreased, while PaO(2) and minute volume were increased in the LMA-CV group compared to the LMA-SV group. CONCLUSIONS: An LMA provided a better airway than a facemask during spontaneous breathing in rabbits, as the use of a facemask was associated with hypercapnia and low partial pressures of oxygen. Although an LMA can be used for intermittent positive pressure ventilation (IPPV), gastric tympanism may develop, especially at a peak inspiratory pressure of 14 cm H(2)O. CLINICAL RELEVANCE: The LMA can be used in rabbits but further work is needed before it is applied routinely.  相似文献   

8.
A 5-hour-old, premature alpaca cria was presented with failure to nurse, weakness, hypoglycemia, hypercapnia, and respiratory distress. The cria was treated with 3 doses of fresh, crude equine surfactant, positive pressure ventilation, and supplemental intranasal oxygen. Recovery to discharge was uneventful, and the cria regained apparently normal respiratory function. Three years after hospital discharge, the alpaca was a healthy adult.  相似文献   

9.
Anaesthesia requires maintenance of a patent airway. Nasotracheal intubation of a red kangaroo (Macropus rufus) was performed when the inability to open the animal’s mouth prevented orotracheal intubation. Nasotracheal intubation was easy to perform, secured the airway and permitted delivery of supplemental oxygen, isoflurane and intermittent positive pressure ventilation.  相似文献   

10.
The structural and vascular anatomy of the healthy equine foot is compared with the pathologic changes in the foot of horses with acute and chronic laminitis. The structural and vascular abnormalities present in the foot of horses with laminitis are demonstrated in order to explain the abnormal manner in which their feet grow. The medical, surgical, dietary, and endocrine management of acute and chronic laminitis is discussed. Various forms of hoof trimming beneficial to the reestablishment of normal digital perfusion, normal hoof growth, and normal spatial orientation among the distal phalanx, hoof wall, and sole are described. Guidelines for the provision of frog support provided by adjustable heart-bar shoes are presented.  相似文献   

11.
Hyperbaric oxygen therapy appears to be a promising adjunctive treatment for a variety of equine disorders, including laminitis and other ischemic injuries. Hyperbaric oxygen (HBO) is a high-dose oxygen inhalation therapy that is achieved by having the patient breathe 100% oxygen inside a pressurized hyperbaric chamber. The delivery of oxygen to the tissues is through respiration because there is insufficient absorption of oxygen through the skin. The benefits of HBO are derived from both the physiologic and pharmacologic effects of high-dose oxygen. HBO is based on two physical factors related to the hyperbaric environment: mechanical effects of pressure and increased oxygenation of tissues. The use of HBO by veterinary medical hospitals is in its infancy. Our clinic has currently treated more than 250 patients in our HBO chamber. Patients included pregnant animals as well as neonatal foals, with no adverse effects noted. Patients have been pressurized from 1.5 to 3 ATA (ATM absolute) ranging from 60 to 90 minutes at treatment pressure (depth). Hagyard Equine Medical Institute has used HBO as adjunctive therapy for fungal disease (fungal pneumonia); thermal burns, carbon monoxide, smoke inhalation; closed head injuries; ileus; central nervous system edema/perinatal asphyxia; peripheral neuropathies; sports injuries (exertional rhabdomyolysis); cellulitis; compartment syndrome; and ischemic injuries (laminitis). In carefully selected patients, the addition of HBO therapy to standard measures may improve clinical outcomes. Further research is needed in the field of equine HBO medicine.  相似文献   

12.
Over the past several decades, recognition of acute respiratory failure as the cause of death in patients suffering from various clinical conditions has prompted aggressiv investigation into the area of respiratory physiology and supportive respiratory care. With the evolution of emergency medicine and critical care services in both human and veterinary medicine, many patients previously considered unsalvageable due to the severity of their underlying disease are now being resuscitated and successfully supported, creating a new population of critically ill patients. Where only a decade ago these patients would have succumbed to their underlying disease, they now survive long enough to manifest the complications of shock and tissue injury in the form of acute respiratory failure. Investigation into the pathophysiology and treatment of this acute respiratory distress syndrom (ARDS) has facilitated increased clinical application of respiratory theerapy and machanical ventilation.1 The purpose of this paper is to provide a basic review of respiratory mechanics and the pathophysiology of hypoxemia as they relate to airway pressure therapy in veterinary patients and to review the use of airway pressure therapy in veterinary patients This paper is divided into two parts; part I reviews respiratory mechanics and hypoxemia as they apply to respiratory therapy, while part II deals specifically with airway pressure therapy andits use in clinical cases.  相似文献   

13.
There are many causes of respiratory failure in veterinary patients. Assessment of oxygenation is imperative for the diagnosis and monitoring of these patients. Oxygen therapy should be instituted when hypoxemia is diagnosed to prevent tissue hypoxia, end-organ damage, and death. Methods of administering oxygen include commercial oxygen cages, mask oxygen, nasal cannulation (for dogs), and intubation. Mechanical ventilation is an option in many referral hospitals for patients who are severely hypoxemic and are not responding to inspired oxygen concentrations achieved with other methods of oxygen administration. One rule of thumb used to assess need for mechanical ventilation is a PaO2 of less than 50 mm Hg despite aggressive oxygen therapy, or a PaCO2 of greater than 50 mm Hg despite treatment for causes of hypoventilation. A mechanical ventilator has the ability to vary the FiO2 by increments of one, from 21% to 100% (0.21-1) oxygen in inspired gas. Positive end-expiratory pressure (PEEP) is also available on most ventilators. PEEP allows the alveoli to remain open on expiration, allowing gas exchange to occur in both inspiration and expiration. PEEP also helps diseased alveoli to inflate, increasing the available surface area for gas exchange and improving arterial blood oxygen tension. Because patients requiring mechanical ventilation have severe respiratory failure that did not respond to conventional oxygen therapy, the prognosis is guarded for most of these patients unless ventilation is instituted due to primary hypoventilation and lung parenchyma is normal. Hypoxemia caused by respiratory failure is a common problem in small animal veterinary patients. Assessment of blood oxygenation and continual monitoring of respiratory rate and effort are essential in management of these patients. Oxygen therapy should be instituted if hypoxemia is diagnosed. The prognosis depends on the underlying disease process and response to treatment with an enriched oxygen environment.  相似文献   

14.
Inhalant exposure to airborne irritants commonly encountered in horse stables is implicated in the pathogenesis of inflammatory airway disease (IAD) and recurrent airway obstruction (RAO), non‐infectious, inflammatory pulmonary disorders that impact the health and performance of horses across all equine disciplines. IAD and RAO have overlapping clinical, cytological, and functional manifestations of the pulmonary response to organic dust and noxious gases encountered in the barn environment. Study of these diseases has provided important but incomplete understanding of the effect of air quality upon the respiratory health of horses. In this review, the principles of particulate exposure assessment, including health‐related aerosol size fractions and size‐selective sampling, the factors influencing air quality in equine environments, and the effect of air quality on the equine respiratory tract are discussed. The objective of this review is to provide the reader with a summary of the most common chronic inflammatory airway diseases in the horse and the principles of air sampling that are essential to the planning, interpretation, and assessment of equine respiratory health‐related exposure studies.  相似文献   

15.
Objective— To describe anesthetic management of endoscopic electrosurgical removal of a bronchial carcinoma, partially blocking the right main stem bronchus in a Cocker Spaniel.
Study Design— Clinical case report.
Animals— Dog with a bronchial carcinoma.
Methods— To allow sufficient space for the endoscope and to avoid an oxygen-rich gas mixture in the trachea, which carries the risk of an airway fire when electrocautery is used, a 1 lumen endobronchial tube (EBT) was inserted into the left main stem bronchus. One-lung ventilation (OLV) started with a volume-controlled ventilator was switched to pressure-controlled ventilation in combination with positive end-expiratory pressure (PEEP).
Results— Resection of the bronchial carcinoma was successful. The dog was hypercapnic throughout the procedure and a high alveolar-arterial oxygen gradient was measured.
Conclusion— An EBT may be a feasible and safe option to provide OLV for bronchoscopic electrocautery with a closed thoracic cavity in dogs.
Clinical Relevance— EBT intubation for OLV should be considered as part of the anesthetic management of airway diseases treated with bronchoscopic electrocautery.  相似文献   

16.
This study investigated the reliability of measurements with a new equine ergospirometer (Quadflow). Heart rate and blood lactate responses during exercise in horses wearing the Quadflow and an open flow mask were also compared. The mean percentage error of the oxygen uptake measurements was 8.2% (range 2.1-12.5%). Percent error for peak expiratory flow rates ranged from 6.1% to 9.4 %, and for minute ventilation from 2.5% to 7.4%. The coefficients of variation of the means of four measurements in two horses exercising continuously at 9.0 m/s were <5% for variables related to pulmonary ventilation, and was 7.7% for oxygen uptake. The Quadflow mask resulted in small increases in blood lactate concentration and relative heart rate during submaximal exercise. It was concluded that between- and within-test reliability statistics for important measurements in equine clinical exercise testing were acceptable for routine use in a veterinary practice or research laboratory.  相似文献   

17.
Bronchial hyper-responsiveness (BHR) describes a lung abnormality in which airways are easily triggered to constrict in response to normally harmless inhaled stimuli, and is a key element of human asthma pathophysiology. BHR contributes to equine respiratory diseases including inflammatory airway disease and recurrent airway obstruction. Collectively these diseases account for over 80% of poor performance in equine athletes, and at least 10% of veterinary admissions. BHR is also a contributing factor in ‘exercise induced pulmonary hemorrhage’. Increased sensitivity to airway constriction that characterizes BHR is a documented sequel to viral respiratory infections in several species, including horses and humans. Five respiratory viruses known to circulate extensively in equine populations place the horse at risk for BHR. Despite adverse effects of BHR on equine health, there remains a gap in our fundamental understanding of how gene products coordinate in the lung to cause BHR. Leveraging the equine genome sequence, we employ systems biology including proteomics and RNA sequencing to model the complex biology of BHR in the lungs of horses with pasture asthma. Using a self controlled experimental design, gene products that segregate with seasonal asthma exacerbation in diseased horses are being identified and their relevant physiology identified to address the need for better recognition and management of BHR in equine disease.  相似文献   

18.
Controlled mechanical ventilation (CMV) is routinely used in equine anaesthesia, with many different options available to mechanically deliver breaths. The complexity of respiratory pathophysiology in anaesthetised horses and the wide range of devices available is described in this scoping review. The first part of the review outlines basic equine respiratory physiology and pathophysiology during anaesthesia to illustrate what makes horses prone to inefficient gas exchange and ventilation when they are recumbent. The difference between spontaneous ventilation and CMV is reviewed and basic considerations of CMV are explored in more detail.  相似文献   

19.
High-frequency ventilation (HFV) is a form of artificial ventilation that uses higher rates and smaller tidal volumes than those used with conventional mechanical ventilation (intermittent positive pressure ventilation [1PPV]). HFV is divided into three categories based on the rate and type of equipment used: 1) high-frequency positive pressure ventilation administered through a system with low internal compliance having an expiratory valve to maintain positive airway pressure during expiration and rates of 60 to 120/minute; 2) high-frequency jet ventilation delivered through an open system or a system with an expiratory valve at rates of 120 to 400/minute; and 3) high-frequency oscillation using open systems and rates of 400 to 2400/minute. All forms of HFV provide adequate ventilation in normal animals at lower peak and mean airway pressures, resulting in less cardiovascular depression than that associated with 1PPV. HFV provides adequate ventilation with less cardiovascular depression and risk of barotrauma than 1PPV in the presence of pulmonary disease. The exact mechanism of gas exchange during HFV is not clearly understood, but enhanced diffusion as a result of turbulent gas flow appears to be a major factor.  相似文献   

20.
OBJECTIVE: To test the hypothesis that isoflurane-anesthetized horses during controlled ventilation and spontaneous ventilation exhibit temporal changes in cerebral hemodynamics, as measured by intracranial pressure and cerebral perfusion pressure, that reflect temporal changes in systemic arterial pressure. ANIMALS: 6 healthy adult horses. PROCEDURE: Horses were anesthetized in left lateral recumbency with 1.57% isoflurane in O2 for 5 hours in 2 experiments by use of either controlled ventilation (with normocapnia) or spontaneous ventilation (with hypercapnia) in a randomized crossover design. Intracranial pressure was measured with a subarachnoid strain-gauge transducer. Carotid artery pressure, central venous pressure, airway pressures, blood gases, and minute ventilation also were measured. RESULTS: Intracranial pressure during controlled ventilation significantly increased during constant dose isoflurane anesthesia and thus contributed to decreasing cerebral perfusion pressure. Intracranial pressure was initially higher during spontaneous ventilation than during controlled ventilation, but this difference disappeared over time; no significant differences in cerebral perfusion pressures were observed between horses that had spontaneous or controlled ventilation. CONCLUSIONS AND CLINICAL RELEVANCE: Cerebral hemodynamics and their association with ventilation mode are altered over time in isoflurane-anesthetized horses and could contribute to decreased cerebral perfusion during prolonged anesthesia.  相似文献   

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