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1.
Capnographic documentation of nasoesophageal and nasogastric feeding tube placement in dogs 总被引：1，自引：0，他引：1
Paula A. Johnson DVM F. A. Mann DVM MS DACVS DACVECC John Dodam DVM MS PhD DACVA Keith Branson DVM MS DACVA Colette Wagner-Mann DVM PhD Mark A. Brady DVM Elizabeth Dunphy DVM 《Journal of Veterinary Emergency and Critical Care》2002,12(4):227-233
Objective: To evaluate the ability of capnography to document proper placement of nasoesophageal (NE) and nasogastric (NG) feeding tubes. This study was conducted in 3 phases. Phase I of this study was designed in order to test the efficacy of capnography to distinguish placement of a feeding tube in the alimentary tract versus the respiratory tract. Phase II was designed in order to document that carbon dioxide (CO2) could be measured through a polyvinyl chloride (PVC) feeding tube. Phase III was performed in order to evaluate the technique of continuous monitoring during insertion of the feeding tube into the esophagus and stomach as would be performed during a clinical‐tube placement. Design: Prospective study. Setting: Research laboratory. Animals: 24 adult dogs. Interventions: In Phase I, sedated dogs were instrumented with an intratracheal catheter and an 8 French feeding tube placed nasally into the distal esophagus and later advanced into the stomach. In Phase II, dogs were anesthetized and an 8 French feeding tube was placed down the endotracheal tube, then into the esophagus and later advanced into the stomach. In Phase III, sedated dogs were instrumented with an 8 French feeding tube inserted intranasally and then advanced to the level of the nasopharynx, distal esophagus and, lastly, the stomach. Fluoroscopy was used in order to determine location of the feeding tube. Measurements and main results: Phase I measurements included respiratory rate and CO2 from the trachea, esophagus, and stomach and pH of gastric fluid sample. Phase II measurements included respiratory rate and CO2 from the endotracheal tube, feeding tube in the endotracheal tube, feeding tube in the distal esophagus, and feeding tube in the stomach. Phase III data collection included respiratory rate and CO2 as the tube was passed through the nasal cavity, nasopharynx, esophagus and stomach. Phase I fluid samples were collected from 5 of the 9 dogs and had pH values from 1.68 to 4.20. In both phases, values for the respiratory rate and CO2 from the esophagus and stomach were 0 ± 0, significantly lower (P < 0.001) than the values from the trachea. In Phase II, there was no significant difference between the respiratory rates (P = 0.886) and CO2 (P = 0.705) readings obtained from the endotracheal tube compared to readings from the feeding tube in the endotracheal tube. In Phase III, there was a significant difference (P < 0.001) between the respiratory rates and CO2 readings obtained from the nasal cavity and the nasopharynx when compared to those readings obtained from the esophagus and stomach. Measurement of CO2 and respiratory rate resulted in a reading of 0 every time the feeding tube was in the esophagus or stomach. Conclusions: Capnography may be used in order to detect airway placement of NE and NG tubes. 相似文献
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Deborah C. Silverstein DVM DACVECC Janet Aldrich DVM Steve C. Haskins DVM MS DACVECC DACVA Kenneth J. Drobatz DVM MSCE DACVECC DACVIM Larry D. Cowgill DVM PhD DACVIM 《Journal of Veterinary Emergency and Critical Care》2005,15(3):185-192
Objective: To determine the continuous changes in blood volume in response to fluid administration using an in‐line hematocrit monitor. Design: Prospective study. Setting: Research laboratory. Animals: Four healthy dogs. Interventions: Each dog received intravenous boluses of 80 mL/kg of 0.9% saline (S), 4 mL/kg of 7.5% saline (HS), 20 mL/kg of dextran 70 (D), 20 mL/kg of hetastarch (HES), or no fluids (control, C) on separate occasions. Fluids were administered at 150 mL/min in the S, D, and HES groups, and at 1 mL/kg/min in the HS group. Measurements and main results: Blood volume changes were measured every 20 seconds for 240 minutes using an in‐line hematocrit monitor. There was a rapid rise in blood volume during all infusions. Immediately after the administration of crystalloid fluids, the rapid rise in blood volume ceased. Subsequently, there was a steep decline in blood volume for 10 minutes, and a slower decline thereafter. In contrast, the rise in blood volume continued for at least 10 minutes after the infusion of the colloids was complete, and a plateau was observed for the remainder of the experiment. The blood volume effect, as measured by area under the curve, was significantly greater in the saline group than the other groups during the infusion time and for the 0–240 minutes time period. The areas under the curve for the two colloid solutions were not significantly different from each other during any time periods. The percent increase in blood volume immediately following the infusions was 76.4±10.0 in the S group, 17.1±3.2 in the HS group, 23.0±10.5 in the D group, and 27.2±6.4 in the HES group. At 30 minutes from the start of the infusion, the mean percent increases in blood volumes were 35.2±9.3 in the S group, 12.3±0.9 in the HS group, 35.9±7.3 in the D group, and 36.8±6.5 in the HES group. At 240 h post‐infusion, the mean percent increases in blood volume were 18.0±9.7 in the S group, 2.9±6.1 in the HS group, 25.6±16.1 in the D group, and 26.6±8.6 in the HES group. The C group had a mean percent change in blood volume of ?3.7±3.4 at the end of the experiment. Conclusions: This study indicates that the rapid administration of saline at clinically relevant doses leads to the largest immediate increase in blood volume, although this change is transient because of rapid redistribution of the fluid. Despite a brief increase in blood volume that was almost 3 times the volume administered, hypertonic saline led to the smallest increase in blood volume post‐infusion. The synthetic colloid solutions increased the blood volume by an amount greater than that infused and the effect was sustained for a longer period of time than seen following crystalloid administration, but the maximum increase in blood volume was significantly less than saline. The measurement of continuous changes in blood volume, using an in‐line hematocrit monitor, was a useful means of assessing the dynamic effects of fluid administration in dogs in a research setting. 相似文献
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Alexander Valverde DVM DVSc DACVA Cornelia I. Gunkel Dr. med. vet. MRCVS 《Journal of Veterinary Emergency and Critical Care》2005,15(4):295-307
Objective: This review discusses the different analgesic drugs and routes of administration used in large animals for acute pain management. General guidelines and doses are given to assist in choosing techniques that provide effective analgesia. Etiology: Noxious stimuli are perceived, recognized, and localized by specialized sensory systems located at spinal and supraspinal levels. Diagnosis: Localizing the source of the noxious stimulus as well as understanding the behavioral aspects and physiological changes that result from such insult is important to adequately diagnose and treat pain. Pain assessment is far from being definite and objective; not only are there species differences, but also individual variation. In addition, the behavioral and physiological manifestations vary with the acute or chronic nature of pain. Therapy: Pain management should include (1) selecting drugs that better control the type of pain elicited by the insult; (2) selecting techniques of analgesic drug administration that act on pathways or anatomical locations where the nociceptive information is being processed or originating from; (3) combining analgesic drugs that act on different pain pathways; and (4) provide the best possible comfort for the animal. Prognosis: Providing pain relief improves the animal's well being and outcome; however, interpreting and diagnosing pain remains difficult. Continuing research in pain management will contribute to the evaluation of the pathophysiology of pain, pain assessment, and newer analgesic drugs and techniques. 相似文献
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Thomas K. Day DVM MS DACVA DACVECC Carolyn R. Boyle PhD Merrilee Holland DVM DACVR 《Journal of Veterinary Emergency and Critical Care》2007,17(1):22-31
Objective and hypothesis: To determine whether or not there is agreement between the thermodilution and echocardiographic measurement of cardiac output (CO) during normovolemia and acute hemorrhage. The hypothesis was that there will be agreement between echocardiographic measurement of CO (ECO) and thermodilution measurement of CO (TDCO) during normovolemia and acute hemorrhage. Design: CO was measured by both thermodilution and echocardiography during α‐chloralose anesthesia in dogs before and 15 and 30 minutes following acute arterial hemorrhage. Setting: Laboratory investigation. Animals: Eighteen clinically healthy dogs, weighing 20–25 kg, anesthetized with α‐chloralose. Interventions: Acute arterial hemorrhage of approximately 50% of the total blood volume. CO was measured by thermodilution and echocardiography before and 15 and 30 minutes following hemorrhage. Measurements and main results: Acute hemorrhage resulted in a significant decrease in CO. There was a lack of agreement between the 2 methods to measure CO at each time and at all anatomic points of measurement in the aorta and pulmonary artery. Conclusion: There is a lack of agreement between the 2 methods; thus, determination of CO by echocardiography may not be a clinically useful tool following hemorrhage in dogs. 相似文献
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D. Pang BVSc J. Hethey N. A. Caulkett DVM MVetSc DACVA T. Duke BVetMed DVA DACVA DECVA 《Journal of Veterinary Emergency and Critical Care》2007,17(2):143-148
Objective: To demonstrate correlation and clinical usefulness of the partial pressure of end‐tidal CO2 (ETCO2) measurement by nasal catheter placement in sedated dogs with and without concurrent nasal oxygen administration as a substitute for partial pressure of arterial CO2 (PaCO2). Design: Prospective, cross‐over trial. Setting: University of Saskatchewan veterinary research laboratory. Animals: Six cross‐breed dogs with a mean (±SD) weight of 29.1±4.03 kg. Interventions: All dogs were sedated with 5 μg/kg medetomidine intravenously (IV) and an arterial catheter was placed in a dorsal pedal artery for removal of blood for gas analysis. A nasal catheter was placed in the ventral meatus and connected to a capnometer for ETCO2 measurements in all dogs. Dogs receiving supplemental nasal oxygen had a second nasal catheter placed in the contralateral naris. Measurements and main results: In the group without nasal oxygen supplementation, the ETCO2 measurement underestimated (negative bias) the PaCO2 by ?2.20 mmHg with limits of agreement (95% confidence interval) of ?5.79, 1.39 mmHg. In the group receiving oxygen supplementation, ETCO2 measurement underestimated (negative bias) the PaCO2 by ?2.46 mmHg with limits of agreement (95% confidence interval) of ?8.42, 3.50 mmHg. Conclusions: The results of this study demonstrate that ETCO2 monitoring via a nasal catheter provides a clinically acceptable substitute to arterial blood gas analysis as a means of monitoring ventilation in healthy, sedated dogs. The limits of agreement were within acceptable limits with and without concurrent insufflation of oxygen. 相似文献
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Catriona M. MacPhail DVM DACVS Eric Monnet DVM PhD DACVS DECVS Davyd H. Pelsue DVM DACVS James S. Gaynor DVM MS DACVA 《Journal of Veterinary Emergency and Critical Care》2006,16(3):192-198
Objective: To determine changes in hemodynamic and cardiac energetic parameters in dogs after induction of portal hypertension and gastric ischemia. These blood flow alterations are similar to changes seen in splanchnic blood flow in dogs with gastric dilatation volvulus syndrome (GDV). Design: Original experimental study. Setting: Veterinary teaching hospital. Animals: Seven purpose‐bred, intact male dogs. Interventions: Standard midline laparotomy and median sternotomy were performed under general anesthesia. Dogs were instrumented to obtain arterial blood pressure, aortic flow, cardiac chamber pressures, central venous pressure, portal flow, and portal pressure. Colored microsphere technology was used for the determination of myocardial blood flow. Measurements and samples were obtained at baseline, following induction of portal hypertension, and after induction of portal hypertension and gastric ischemia. Measurements and main results: Left ventricular myocardial blood flow was increased from 81.8±20.1 mL/100 g/min at baseline to 127.7±57.2 mL/100 g/min (P=0.02) after induction of portal hypertension and gastric ischemia. Myocardial oxygen consumption increased from 142.2±27.4 J/min/100 g at baseline to 219.1±33.4 J/min/100 g (P=0.003) after induction of portal hypertension and gastric ischemia, but cardiac external work remained unchanged (13.67±6.2 to 13.27±9.6 J/min; P=0.78; power=0.79). Cardiac efficiency decreased from 11.6±6.1% at baseline to 7.6±5.1% (P=0.017) after induction of portal hypertension and gastric ischemia. Conclusions: Transfer of energy within the myocardium was less efficient after induction of portal hypertension and ischemia of the stomach wall. On the basis of these results, alterations in cardiac function associated with GDV may result from deterioration of cardiac efficiency. 相似文献
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Alexander Valverde DVM DVSc DACVA Giacomo Gianotti DVM Eva Rioja DVM PhD DVSc DACVA Amanda Hathway RVT 《Journal of Veterinary Emergency and Critical Care》2011,21(4):328-334
Objective – To compare the determination of cardiac output (CO) via arterial pulse pressure waveform analysis (FloTrac/Vigileo) versus lithium dilution method. Design – Prospective study. Setting – University teaching hospital. Animals – Six adult dogs. Interventions – Dogs were instrumented for CO determinations using lithium dilution (LiDCO) and FloTrac/Vigileo methods. Direct blood pressure, heart rate, arterial blood gases, and end‐tidal isoflurane (ETIso) and CO2 concentrations were measured throughout the study while CO was manipulated with different depth of anesthesia and rapid administration of isotonic crystalloids at 60 mL/kg/h. Measurements and Main Results – Baseline CO measurements were obtained at 1.3% ETIso and were lowered by 3% ETIso. Measurements were obtained in duplicate or triplicate with LiDCO and averaged for comparison with corresponding values measured continuously with the FloTrac/Vigileo method. For 30 comparisons between methods, a mean bias of ?100 mL/kg/min and 95% limits of agreement between ?311 and +112 mL/kg/min (212 mL/kg/min) was determined. The mean (mL/kg/min) of the differences of LiDCO?Vigileo=62.0402+?0.8383 × Vigileo, and the correlation coefficient (r) between the 2 methods 0.70 for all CO determinations. The repeatability coefficients for the individual LiDCO and FloTrac/Vigileo methods were 187 and 400 mL/kg/min, respectively. Mean LiDCO and FloTrac/Vigileo values from all measurements were 145 ± 68 mL/kg/min (range, 64–354) and 244 ± 144 mL/kg/min (range, 89–624), respectively. The overall mean relative error was 48 ± 14%. Conclusion – The FloTrac/Vigileo overestimated CO values compared with LiDCO and the relative error was high, which makes this method unreliable for use in dogs. 相似文献
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