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Comparison of mainstream (Capnostat 5) and two low-flow sidestream capnometers (VM-2500-S and Capnostream) in spontaneously breathing rabbits anesthetized with a Bain coaxial breathing system
Institution:1. Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada;2. Clinique équine de Provence, Haras de la Trévaresse, Saint Cannat, France;3. Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada;1. Department of Animal Medicine Production and Health, University of Padova, Padova, Italy;2. Department of Animal Sciences, Stellenbosch University, Stellenbosch, South Africa;3. Wildlife Pharmaceuticals (Pty) Ltd., White River, South Africa;4. School of Veterinary and Life Sciences, Murdoch University, Perth, Australia;5. Wildlifevets.com, Ngongoni Game Lodge, Karino, South Africa;6. Centre for Nutrition and Food Sciences, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, Australia
Abstract:ObjectiveTo evaluate agreement with PaCO2 of two low sampling rate sidestream capnometers and a mainstream capnometer in rabbits and the effect of using high fresh gas flow from a Bain coaxial breathing system.Study designProspective, crossover study.AnimalsA total of 10 New Zealand White rabbits weighing 3.4 ± 0.3 kg mean ± standard deviation (SD)].MethodsTwo sidestream analyzers (Viamed VM-2500-S and Capnostream 35) with a sampling rate of 50 mL minute–1 and a mainstream capnometer (Capnostat 5) were tested. All capnometers used infrared spectroscopy and advanced microprocessor technology. Rabbits were anesthetized and intubated with noncuffed endotracheal tubes of 3 mm internal diameter and adequate seal. A sidestream sampling adapter or the mainstream capnometer was attached to the endotracheal tube and connected to a Bain coaxial breathing system. Oxygen (1.5 L minute–1) delivered sevoflurane to maintain anesthesia. An auricular artery catheter allowed blood sampling for PaCO2 analysis corrected to rectal temperature. Inspired and end-tidal carbon dioxide (Pe′CO2) measurements were recorded during blood sample withdrawal. From each rabbit, 10 paired PaCO2/Pe′CO2 measurements were obtained. Each rabbit was recovered from anesthesia and was anesthetized again with an alternate capnometer after 1 week. Data were analyzed using Bland–Altman and two-way anova for repeated measures.ResultsAnalysis included 100 paired samples. Negative bias reflects underestimation of PaCO2. Bland–Altman mean (±1.95 SD) was –16.7 (–35.2 to 1.8) mmHg for Capnostat 5, –27.9 (–48.6 to –7.2) mmHg for Viamed, and –18.1 (–34.3 to –1.9) mmHg for Capnostream. Viamed PaCO2–Pe′CO2 gradient was greater than other two capnometers.ConclusionsAll three capnometers underestimated PaCO2. Capnostat 5 and Capnostream performed similarly.Clinical relevanceThese capnometers underestimated PaCO2 in spontaneously breathing rabbits anesthetized using a Bain coaxial breathing system with high fresh gas flows.
Keywords:anesthesia circuits  capnography  capnometry  carbon dioxide  monitoring  rabbit
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