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1.
Noninvasive monitoring of cardiopulmonary function through pulse oximetry and capnography provides immediate and important information for the clinician. These monitors are not a replacement for vigilant attention to the patient, however; they should be used in conjunction with arterial blood gas analysis and serial physical examinations to ensure that the continuous readings are accurate and make clinical sense.  相似文献   

2.
The objective of this prospective clinical study was to evaluate the accuracy of pulse oximetry and capnography in healthy and compromised horses during general anesthesia with spontaneous and controlled ventilation. Horses anesthetized in a dorsal recumbency position for arthroscopy (n = 20) or colic surgery (n = 16) were instrumented with an earlobe probe from the pulse oximeter positioned on the tip of the tongue and a sample line inserted at the Y-piece for capnography. The horses were allowed to breathe spontaneously (SV) for the first 20 min after induction, and thereafter ventilation was controlled (IPPV). Arterial blood, for blood gas analysis, was drawn 20 min after induction and 20 min after IPPV was started. Relationships between oxygen saturation as determined by pulse oximetry (SpO2), arterial oxygen saturation (SaO2), arterial carbon dioxide partial pressure (PaCO2), and end tidal carbon dioxide (P(et)CO2), several physiological variables, and the accuracy of pulse oximetry and capnography, were evaluated by Bland–Altman or regression analysis. In the present study, both SpO2 and P(et)CO2 provided a relatively poor indication of SaO2 and PaCO2, respectively, in both healthy and compromised horses, especially during SV. A difference in heart rate obtained by pulse oximetry, ECG, or palpation is significantly correlated with any pulse oximeter inaccuracy. If blood gas analysis is not available, ventilation to P(et)CO2 of 35 to 45 mmHg should maintain the PaCO2 within a normal range. However, especially in compromised horses, it should never substitute blood gas analysis.  相似文献   

3.
Laser surgery and laparoscopy are two relatively new surgical techniques gaining popularity in veterinary medicine, which require special consideration when being performed on the anesthetized patient. For laser surgery, consideration must be given to the possibility of atmospheric contamination, inappropriate energy transfer, eye injury, perforation of a vessel or anatomic structure, perforation of the endotracheal tube, and fire. The primary concern with laparoscopy and thoracoscopy is the creation of a pneumoperitoneum or pneumothorax, which can result in (1) hypercarbia and inadequate ventilation, (2) poor cardiac output and systemic blood pressure, and (3) gas embolism. To minimize complications, patients should be placed on positive pressure ventilation, be well hydrated before and during the procedure, and be thoroughly monitored (ECG, capnography, pulse oximetry.  相似文献   

4.
The use of pulse oximeters as a non-invasive, real time and online method for the continuous monitoring of oxygen saturation is discussed and compared to other methods like hemoreflectometry, and blood gas analysis. Analyses of linear regression show extraordinarily good correlations between all three monitoring systems. Pulse oximetry and hemoreflectometry on the one hand and blood gas analysis on the other hand sometimes show quite differing values of oxygen saturation. This phenomenon is due to the fact that the measuring methods are based on different working principles as well as it can be explained by the various hemoglobin-types. The pulse rate also measured by the pulse oximeter is nearly completely identical to the heart rate of the ECG. A slight temporal delay between the two acoustic signals is noticed and justified. Pulse oximetry seems to be superior to other oxygen monitoring systems because of its continuous noninvasive measuring technique.  相似文献   

5.
The purpose of this study was to evaluate the cardio-respiratory effects of the combination of medetomidine and thiopentone followed by reversal with atipamezole as a combination for anaesthesia in 10 healthy German Shepherd dogs breathing spontaneously in a room at an altitude of 1486 m above sea level with an ambient air pressure of 651 mmHg. After the placement of intravenous and intra-arterial catheters, baseline samples were collected. Medetomidine (0.010 mg/kg) was administered intravenously and blood pressure and heart rate were recorded every minute for 5 minutes. Thiopentone was then slowly administered until intubation conditions were ideal. An endotracheal tube was placed and the dogs breathed room air spontaneously. Blood pressure, pulse oximetry, respiratory and heart rate, capnography, blood gas analysis and arterial lactate were performed or recorded every 10 minutes for the duration of the trial. Thiopentone was administered to maintain anaesthesia. After 60 minutes, atipamezole (0.025 mg/kg) was given intramuscularly. Data were recorded for the next 30 minutes. A dose of 8.7 mg/kg of thiopentone was required to anaesthetise the dogs after the administration of 0.010 mg/kg of medetomidine. Heart rate decreased from 96.7 at baseline to 38.5 5 minutes after the administration of medetomidine (P < 0.05). Heart rate then increased with the administration of thiopentone to 103.2 (P < 0.05). Blood pressure increased from 169.4/86.2 mmHg to 253.2/143.0 mmHg 5 minutes after the administration of medetomidine (P < 0.05). Blood pressure then slowly returned towards normal. Heart rate and blood pressure returned to baseline values after the administration of atipamezole. Arterial oxygen tension decreased from baseline levels (84.1 mmHg) to 57.8 mmHg after the administration of medetomidine and thiopentone (P < 0.05). This was accompanied by arterial desaturation from 94.7 to 79.7% (P < 0.05). A decrease in respiratory rate from 71.8 bpm to 12.2 bpm was seen during the same period. Respiratory rates slowly increased over the next hour to 27.0 bpm and a further increases 51.4 bpm after the administration of atipamezole was seen (P < 0.05). This was maintained until the end of the observation period. Arterial oxygen tension slowly returned towards normal over the observation period. No significant changes in blood lactate were seen. No correlation was found between arterial saturation as determined by blood gas analysis and pulse oximetry. Recovery after the administration of atipamezole was rapid (5.9 minutes). In healthy dogs, anaesthesia can be maintained with a combination of medetomidine and thiopentone, significant anaesthetic sparing effects have been noted and recovery from anaesthesia is not unduly delayed. Hypoxaemia may be problematic. Appropriate monitoring should be done and oxygen supplementation and ventilatory support should be available. A poor correlation between SpO2 and SaO2 and ETCO2 and PaCO2 was found.  相似文献   

6.
Blood gas analysis.   总被引:3,自引:0,他引:3  
Evaluation of both arterial and central venous blood can be valuable in monitoring the critically ill veterinary patient. The traditional approach, which concentrates on arterial blood analysis only, may miss important aspects of oxygen delivery to tissues, especially in patients with poor perfusion. The advances that have resulted in affordable bedside blood gas analyzers have created a clinical situation in which blood gas analysis should be an integral part of critical care monitoring. Following basic principles of interpretation, blood gas analysis, which has traditionally been viewed as a complex method of monitoring, should become more useful. Assessing both the arterial and central venous samples should result in more efficient and higher quality care for veterinary patients.  相似文献   

7.
To assess the clinical applicability of pulse oximetry in the intensive care setting, a comparison was made of arterial hemoglobin saturation values determined by in vitro oximetry (SaO2) and pulse oximetry (SpO2) in 21 critically ill dogs. Single SaO2 measurements were compared to simultaneously obtained SpO2 readings. The correlation between these two methods was statistically significant (r = 0.8944, p = 0.0001). In addition, heart rates read by the pulse oximeter were compared to simultaneously obtained electrocardiograms (ECG). The correlation between these two methods was statistically significant (r = 0.9966, p = 0.0001). The pulse oximeter was easy to use, and recorded trends in oxygenation virtually instantaneously. Pulse oximetry appears to be an accurate and practical technique for the continuous non-invasive monitoring of oxygenation in critically ill dogs in the intensive care unit.  相似文献   

8.
The use of pulse oximetry for on-line monitoring of oxygen saturation of arterial blood using a probe on the nasal septum is described in the horse. When compared to the results of blood gas analysis an excellent correlation between the two methods for measuring oxygen saturation is found. Nevertheless a discrepancy between the values for oxygen saturation provided by either method is found. This can lead to misinterpretation of oxygen saturation values generated by the pulse oximeter. The cause of this discrepancy is not clear but differences in measuring principle, presence of dyshemoglobins and differences in absorption characteristics of hemoglobin are to be ruled out as major contributors. Contrary to findings in several other animal species occasionally double counting of pulse frequency by the pulse oximeter is seen.  相似文献   

9.
ObjectiveEvaluation of the accuracy of Masimo signal extraction technology (SET) pulse oximetry in anaesthetized late gestational pregnant sheep.Study designProspective experimental study.AnimalsSeventeen pregnant Merino ewes.MethodsAnimals included in study were late gestation ewes undergoing general anaesthesia for Caesarean delivery or foetal surgery in a medical research laboratory. Masimo Radical-7 pulse oximetry (SpO2) measurements were compared to co-oximetry (SaO2) measurements from arterial blood gas analyses. The failure rate of the pulse oximeter was calculated. Accuracy was assessed by Bland &; Altman's (2007) limits of agreement method. The effect of mean arterial blood pressure (MAP), perfusion index (PI) and haemoglobin (Hb) concentration on accuracy were assessed by regression analysis.ResultsForty arterial blood samples paired with SpO2 and blood pressure measurements were obtained. SpO2 ranged from 42 to 99% and SaO2 from 43.7 to 99.9%. MAP ranged from 24 to 82 mmHg, PI from 0.1 to 1.56 and Hb concentration from 71 to 114 g L?1. Masimo pulse oximetry measurements tended to underestimate oxyhaemoglobin saturation compared to co-oximetry with a bias (mean difference) of ?2% and precision (standard deviation of the differences) of 6%. Accuracy appeared to decrease when SpO2 was <75%, however numbers were too small for statistical comparisons. Hb concentration and PI had no significant effect on accuracy, whereas MAP was negatively correlated with SpO2 bias.Conclusions and clinical relevanceMasimo SET pulse oximetry can provide reliable and continuous monitoring of arterial oxyhaemoglobin saturation in anaesthetized pregnant sheep during clinically relevant levels of cardiopulmonary dysfunction. Further work is needed to assess pulse oximeter function during extreme hypotension and hypoxaemia.  相似文献   

10.
Objective To assess the cardiovascular effects (arterial blood pressure, heart rate, and metabolic acid–base status) of three doses (MAC multiples) of isoflurane alone and combined with butorphanol in the green iguana (Iguana iguana). Study design Prospective randomized double‐blind, two‐period cross‐over trial. Animals Six mature healthy green iguanas (Iguana iguana). Methods The iguanas received each of two treatments, saline 0.1 mL kg?1 (SAL) and butorphanol 1.0 mg kg?1 (BUT) during isoflurane anesthesia. Treatments were separated by at least 1 week. The iguanas were exposed to each of the three minimum alveolar concentration (MAC) multiples (1.0, 1.5, and 2.0) in random order. Anesthesia was induced with isoflurane and maintained using controlled ventilation. Instrumentation included use of an ECG, airway gas monitor, cloacal thermometer, esophageal pulse oximeter, and the placement of a femoral arterial catheter. Body temperature was stabilized and maintained at 32 °C. The treatment was administered, and the animals were equilibrated for 20 minutes at each MAC multiple. At each concentration, the heart rate, blood pressure (systolic, mean, diastolic), end‐tidal CO2, and SpO2 were measured. At 1.0 and 2.0 MAC, simultaneous blood samples were drawn from the tail vein/artery complex and femoral catheter for blood gas analysis. Data were analyzed using a two‐way analysis of variance for repeated measures looking for differences between treatments and among MAC multiples. Results There were no significant differences in any of the cardiovascular variables between the treatments. Significant differences among isoflurane MAC multiples were observed for HR, mean, diastolic, and systolic blood pressures. Blood pressure and heart rate decreased with an increasing dose of anesthetic. There were no significant differences between treatments or MAC multiples for any of the blood gas variables. The blood pH, PCO2, HCO3?, and hemoglobin saturation differed significantly between sites. Pulse oximetry values measured from the carotid complex did not correlate with and were significantly different from the calculated hemoglobin saturation values determined using the gas analyzer. Conclusion and clinical relevance Cardiovascular depression associated with isoflurane anesthesia in the green iguana is dose dependent. The degree of cardiovascular depression was not significantly different when isoflurane was combined with butorphanol. This finding suggests that the pre‐emptive or intraoperative use of butorphanol is unlikely to be detrimental to cardiovascular function. Butorphanol may be a useful anesthetic adjunct to isoflurane anesthesia in the green iguana.  相似文献   

11.
BACKGROUND: Carbon dioxide (CO2) embolism is a possible complication of capnoperitoneum during laparoscopic surgery. Experimentally induced venous CO2 embolism has been studied in pigs. In this paper we report a case of spontaneous CO2 embolism. OBSERVATIONS: A 4-month-old Large White pig weighing 20 kg underwent experimental laparoscopic surgery under general anaesthesia. Monitoring consisted of pulse oximetry, capnography, airway pressure, electrocardiography, invasive arterial and central venous blood pressures, and arterial blood-gas analysis. Shortly after the start of laparoscopy and onset of CO2 insufflation, sudden decreases in end-tidal CO2 (Pe'CO2), haemoglobin saturation of oxygen (SpO2), systolic arterial blood pressure and heart rate were observed. Airway pressure increased and pulmonary compliance decreased simultaneously. Insufflation was immediately discontinued and epinephrine (2 mg IV), atropine (0.5 mg IV) and a 50 mL bolus of a polygeline solution were administered without effect. At this time arterial blood-gas analysis revealed a pH of 7.29 and a PaCO2 of 6.8 kPa (51.2 mmHg); PaO2 was 26.6 kPa (199.5 mmHg). After 4 minutes asystole occurred. CONCLUSIONS: The sudden decrease of Pe'CO2 and lung compliance combined with the sudden decrease in systolic blood pressure, heart rate and a poor response to resuscitation suggest a case of fatal gaseous venous embolism.  相似文献   

12.
Respiratory distress is a very common presenting complaint in emergency practice. It is essential that the clinician rapidly determine the underlying cause of the clinical signs using physical examination findings and nonstressful diagnostic tests. Oxygen therapy will often stabilize a patient, allowing for a more complete physical examination and diagnostics, including thoracocentesis, thoracic radiographs, and blood collection for laboratory analysis. The disease processes that cause respiratory distress can be grouped according to anatomic location: the airways, pulmonary parenchyma, pleural space, or thoracic wall. The choice of diagnostic and therapeutic techniques will be dependent on the suspected anatomic origin of disease. Techniques useful in diagnosing airway disorders include oral examination, cervical and thoracic radiographs, fluoroscopy, and bronchoscopy. Therapeutic techniques include intubation and tracheostomy. For parenchymal disease, thoracic radiographs, echocardiography, ultrasound of the thorax, and transtracheal or endotracheal wash can be useful. When the disease process is in the pleural space, thoracocentesis can be both diagnostic and therapeutic. Chest tube placement may be necessary for continuous removal of air or fluid from the pleural space. Monitoring of the respiratory patient can involve serial physical examination, pulse oximetry, and arterial blood gas analysis. It is essential to minimize stress on patients with respiratory distress because decompensation can occur easily, leading to respiratory arrest.  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.
A foal born 3 weeks prematurely was treated for respiratory distress, using a combination of oxygen therapy and mechanical ventilatory assistance. Clinical response and arterial blood gas tensions were monitored regularly. Continuous positive-airway pressure and intermittent positive-pressure ventilation administered via a nasotracheal tube were effective in improving arterial oxygenation and ventilatory function.  相似文献   

15.
OBJECTIVES: To determine whether small intestinal ischemia and reperfusion affects intestinal intramucosal pH (pHi), arterial and portal venous blood gas values, and intestinal blood flow (IBF) and to investigate relationships between regional intestinal tissue oxygenation and systemic variables in dogs. ANIMALS: 15 healthy adult Beagles. PROCEDURE: Occlusion of superior mesenteric artery (SMA) for 0, 30, or 60 minutes, followed by reperfusion for 180 minutes, was performed; IBF, pHi, arterial and portal venous blood gas values, arterial pressure, and heart rate were measured at various time points; and intestinal mucosal injury was histologically graded. RESULTS: Occlusion of the SMA induced significant decreases in pHi and IBF. After the release of the occlusion, IBF returned rapidly to baseline values, but improvement in pHi was slow. Arterial and portal venous blood gas analyses were less sensitive than tonometric measurements of pHi, and there was no correlation between results of blood gas analyses and tonometric measurements. Histologic score for intestinal mucosal injury increased significantly, depending on duration of ischemia, and there was a correlation between tonometric results and the histologic score. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that it is difficult to accurately evaluate local oxygenation disorders by monitoring at the systemic level, whereas clinically pHi is the only reliable indicator of inadequate regional intestinal tissue oxygenation in dogs.  相似文献   

16.
OBJECTIVE: To determine whether end-tidal partial pressure of carbon dioxide (PETCO2) correlated with PaCO2 in isoflurane-anesthetized African grey parrots receiving intermittent positive pressure ventilation (IPPV). DESIGN: Prospective study. ANIMALS: 14 healthy mature African grey parrots (Psittacus erithacus timnus). PROCEDURE: Each bird was anesthetized via mask with isoflurane, intubated, and connected to a pressure-limited intermittent-flow ventilator. Respiratory rate was altered while holding peak inspiratory pressure constant (5 cm H2O) to achieve a PETCO2 in 1 of 3 ranges: < 30 mm Hg, 30 to 40 mm Hg, and > 40 mm Hg. Blood was collected from the superficial ulnar artery of each bird at least once during each of the 3 ranges. Arterial blood samples were collected for blood gas analysis while PETCO2 was recorded simultaneously. RESULTS: A strong correlation between PETCO2 and PaCO2 was detected over a wide range of partial pressures, although PETCO2 consistently overestimated PaCO2 by approximately 5 mm Hg. End-tidal partial pressure of CO2 and PaCO2 also correlated well with arterial blood pH, and the acute response of the bicarbonate buffer system to changes in ventilation was similar to that of mammals. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that PETCO2 reliably estimates PaCO2 in isoflurane-anesthetized African grey parrots receiving IPPV and suggest that IPPV combined with capnography is a viable option for anesthetic maintenance in avian anesthesia.  相似文献   

17.
In human medicine, pulse oximetry is widely used to measure non-invasively and accurately the percentage of oxygen saturation of arterial haemoglobin (SpO(2)). Recently, pulse oximetry has been used in calves, but its accuracy has not been evaluated in newborn calves. The purpose of this study was to evaluate the accuracy of a pulse oximeter in newborn calves by comparing SpO(2) with arterial oxyhaemoglobin saturation (SaO(2)) obtained by use of a blood gas analyser. Fifty-five newborn calves were investigated from birth to 20 days old. Pulse oximetry readings and arterial blood samples were performed 5, 15, 30, 45, 60 min, 2, 3, 6, 12, 24 h and 1 and 3 weeks after birth. The transmission-type sensors of the pulse oximeter were fixed at the recommended site in the bovine species (at the base of the calf tail, where the skin had been shaved and was not pigmented) and arterial blood samples were withdrawn from the subclavian artery and analysed for SaO(2). Five-hundred paired data of SaO(2) and mean SpO(2)(mSpO(2)) were collected. Linear regression of the pooled data indicated a highly significant correlation of mSpO(2) with SaO(2) (r = 0.87;P< 0.001; mSpO(2) = 15.8 + 0.84 SaO(2)). The overall data bias value was positive (+2.1%), which indicated that the pulse oximeter tended to overestimate the SaO(2). The bias value for each SaO(2) category tended to become higher for lower ranges of SaO(2). Precision was also lower when SaO(2) values were low. The lower the SaO(2) value, the higher the positive bias (overestimation) and the lower the precision. These results suggest that pulse oximetry provides a relatively accurate non-invasive, immediate and portable method to monitor SaO(2) and to evaluate objectively the pulmonary function effectiveness in newborn calves during their adaptation to extra-uterine life.  相似文献   

18.
Chemical immobilization of wildlife often includes opioids or cyclohexamines. These substances are problematic as a result of their required storage, handling, and record-keeping protocols. A potentially useful alternative sedation protocol includes a combination of butorphanol, azaperone, and medetomidine (BAM: 0.43 mg/kg butorphanol, 0.36 mg/kg azaperone, 0.14 mg/kg medetomidine). One risk of wildlife immobilization with any drug combination is hypoxemia. This may be of particular importance when using an alpha 2 agonist such as medetomidine because of its powerful vasoconstrictive effect. In this prospective study, the BAM combination was evaluated for chemical immobilization of white-tailed deer. Additionally, selected physiologic parameters associated with BAM immobilization, including oxygen saturation via pulse oximetry and arterial blood gas measurement, with and without nasal insufflation of oxygen at a relatively low flow of 3 L/min, were evaluated. The BAM combination resulted in a predictable onset of sedation, with a mean induction time to lateral recumbency of 9.8 +/- 3.6 min. All deer recovered smoothly within a range of 5-20 min after reversal with intramuscular administration of naltrexone, atipamazole, and tolazoline (NAT). Clinically relevant decreases in arterial partial pressure of oxygen (PaO2) and oxygen saturation (SpO2) were observed in animals not receiving supplemental oxygen, while both parameters significantly improved for oxygen-supplemented deer. Pulse oximetry with this protocol was an unreliable indicator of oxygen saturation. In this study, altitude, recumbency, hypoventilation, butorphanol- and medetomidine-specific effects, as well as the potential for alpha 2 agonist-induced pulmonary changes all may have contributed to the development of hypoxemia. Overall, capture of white-tailed deer with the BAM/NAT protocol resulted in excellent chemical immobilization and reversal. Because the BAM combination caused significant hypoxemia that is unreliably detected by pulse oximetry but that may be resolved with nasal oxygen insufflation, routine use of oxygen supplementation is recommended.  相似文献   

19.
Pulse oximetry holds the promise of wide application for monitoring and assessing pulmonary function in small animal patients. Although the saturation as read by pulse oximetry (SpO2) has previously been shown to be accurate in healthy dogs, its accuracy and usefulness have not been demonstrated in critical small animal patients. The present study assessed the accuracy and usefulness of a pulse oximeter (Ohmeda Biox 3740, Ohmeda, Louisville, CO) in a small animal intensive care unit. The instrument yielded readings in 48 of 51 attempts in 33 animals (25 dogs, 8 cats). Criteria were developed to reject spurious readings; when these criteria were applied, the actual calculated SaO2 differed from the SpO2 by O.26 +2.2%, with a correlation of 0.87 (p<0.0001). The 95% confidence interval was +4.4%, comparable to the accepted level in humans. No ill effects from SpO2 were apparent in the patients, and the instrument was useful in monitoring the progress of critical animals. However, uncritical use of the oximeter could have led to gross patient mismanagement, as SpO2 readings as much as 29% different from SaO2 were sometimes obtained.  相似文献   

20.
At present there is no alternative to the use of a demand valve and pressurised oxygen for emergency ventilation in large animal field anaesthesia, therefore we aimed at providing a proof‐of‐principle of a small (2.5 l) commercial foot pump to provide emergency intermittent positive pressure ventilation (IPPV) in large animals. The study was performed during elective field anaesthesia for castration of 5 Haflinger stallions. Horses were premedicated with acepromazine i.m. after catheterisation of the jugular vein, further sedation was obtained with detomidine and butorphanol i.v. Anaesthesia was induced with ketamine and midazolam i.v. and maintained with a constant rate infusion of midazolam, ketamine and xylazine. After endotracheal intubation the foot pump, modified with a manually operated expiratory valve, was connected to the endotracheal tube and oxygen (6 l/min) was supplied. Anaesthesia was monitored using spirometry, respiratory gas analysis, pulse oximetry and arterial blood gas analysis. When arterial partial pressure of carbon dioxide (PaCO2) exceeded 6.65 kPa, IPPV was provided by 2–4 consecutive compressions of the pump aiming at a tidal volume of 10 ml/kg bwt. The PaCO2 was maintained at 6.18 ± 3.06 kPa (mean ± s.d.) with a respiratory rate of 4–10 breaths/min. The tidal volume was 2678–8300 ml with a peak inspiratory pressure of 24 ± 6.6 cmH2O and a mean minute volume of 68.5 ± 13 l/min. Inspired oxygen concentration ranged from 26–46% (36 ± 7%) and arterial partial pressure of oxygen from 8.38–11.03 kPa (10.1 ± 0.93 kPa). The modified foot pump enables the practitioner to provide IPPV to large animals in emergency situations.  相似文献   

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