Hipertensão situacional em cães dóceis adultos / Situational hypertension in docile adult dogs

A hipertensão arterial sistêmica (HAS) é uma enfermidade silenciosa que pode afetar gatos e cães. Embora bastante descrita em felinos, a "Síndrome do Jaleco Branco", ou hipertensão situacional, é pouco relatada em cães. Assim, este trabalho tem como objetivo mostrar a importância do estresse na aferição da pressão arterial de cães adultos. O estudo foi realizado com 46 cães de ambos os sexos, dóceis, adultos, e aparentemente saudáveis. Após anamnese, exame físico, ambientação e manejo amigável dos animais, mensurou-se a pressão arterial sistólica (PAS) pelo método Doppler no membro torácico. Foram feitas várias aferições para obtenção de média aritmética. Animais com até 160mmHg de PAS, na primeira aferição, foram considerados normotensos (36 cães, correspondente a 78,26%). Para os que tiveram PAS maior ou igual a 160mmHg (dez cães, equivalente a 21,74%), realizou-se um segundo momento de aferição, após 15 a 30 minutos, com os animais em repouso. Assim, seis desses cães apresentaram PAS entre 154mmHg e 200mmHg, sendo, então, um considerado pré-hipertenso e cinco hipertensos, e outros quatro considerados normotensos. Para o animal com pré-hipertensão e para os hipertensos, realizaram-se exames complementares, pelos quais quatro cães foram diagnosticados com doença renal crônica e dois com dislipidemia familiar dos Schnauzers. Dessa forma, pode-se concluir que, dos 46 cães avaliados, 36 apresentaram-se normotensos (78,26%), um pré-hipertenso (2,17%), cinco hipertensos (10,87%) e quatro com hipertensão situacional (8,7%). Portanto, para cães em ambiente hospitalar, é importante realizar um manejo amigável e, quando necessário, mais de um momento de aferição de PAS para evitar diagnósticos errôneos de HAS.

Systemic arterial hypertension (SAH) is a silent disease that can affect cats and dogs. Although well described in felines, "white coat syndrome", or situational hypertension, is little reported in dogs. Thus, this paper aims to show the importance of stress in the measurement of blood pressure from adult dogs. The study was conducted with 46 dogs of both sexes, docile, adults, apparently healthy. After anamnesis, physical examination, ambiance, and friendly management of animals, systolic blood pressure (SBP) was measured by the doppler method in the thoracic limb. Several measurements were made to obtain an arithmetic average. Animals up to 160mmHg of SBP, in the first measurement, were considered normotensive (36 dogs, corresponding to 78.26%). For those with SBP higher than or equal to 160mmHg (10 dogs, equivalent to 21.74%), a second measurement was performed after 15 to 30 minutes, with the animals at rest. Therefore, six of these dogs presented SBP between 154mmHg and 200mmHg (one considered prehypertense and five hypertensives) and four normotensives. For the animal with prehypertension and the hypertensives, complementary examinations were performed, in which four dogs were diagnosed with chronic kidney disease and two with family dyslipidemia of the Schnauzers. Thus, it can be concluded that among the 46 dogs evaluated, there were 36 normotenses (78.26%), a one prehypertense (2.17%), five hypertensives (10.87%), and four with situational hypertension (8.7%). Therefore, regarding dogs in a hospital environment, it is important to perform friendly management and, when necessary, more than one moment of SBP measurement to avoid erroneous diagnoses of SAH.

Cardiovascular indicators and mitral valve disease in dogs with spontaneous hypercortisolism - prospective evaluation

Background: Canine hypercortisolism (HC) is the most prevalent endocrinopathy in dogs in southern Brazil. The prognosis depends on several factors including the general health status, owners´ commitment, and the development of disease complications and comorbidities occurrence, such as cardiovascular complications including mitral valve disease (MVD), systemic arterial hypertension, and left ventricular hypertrophy. The main objective of the present study was to assess cardiovascular parameters in canine HC, based on investigating survival-related variables. The study also aimed to evaluate the influence of concurrent preclinical (MVD) on dogs` survival and the impact of HC on MVD progression. Materials, Methods & Results: A total of 25 dogs with spontaneous HC were enrolled and divided into 2 subgroups accordingly to their echocardiographic findings: group HC (normal echocardiography at first evaluation, n = 16); and group HC + MVD (concurrent presence of stages B1 and B2 MVD diagnosed at the first evaluation, n = 9). The patients were evaluated at diagnosis (T0); 6 months after treatment begging (T1); and after 12 months of treatment (T2). The owners were further contacted by phone or e-mail for 1 more year after T2 regarding survival information. A control group (CG, n = 20) was also evaluated at T0 and T1. At each evaluation, dogs were submitted to a complete clinical evaluation and physical exam, associated with a minimum database (CBC, serum biochemistry, and urine analysis) and cardiovascular evaluation composed of systolic blood pressure determination, electrocardiogram (ECG), and echodopplercardiography. In the HC group, 11/16 dogs underwent the evaluation at T2, while 4/9 dogs from the HC + MVD group and 17/20 dogs from the CG underwent the evaluation at T2. Five dogs (31.25%) from the HC group and 4 dogs (44.44%) from the HC + MVD group died before the end of the follow-up period. In the control group, only 1 dog (5.26%) died before the end of the study. Despite the higher mortality in the HC + MVD group during the follow-up period, there was no significant difference (P = 0.632) in survival when compared with the HC group. The MVD of 4 dogs included in the HC + MVD group was classified as stage B1, while the other 5 dogs were classified as stage B2. Only 1 dog from the CG developed stage B1 MVD in the period studied; however, progression of the MVD stage was documented in 1/4 of dogs in the HC + MVD group and MVD development was documented in 3/11 of dogs from the HC group from T0 to T2. The odds ratio (OR) and respective 95% confidence interval (95%CI) for HC as a risk factor for MVD progression were 4.267 (0.4268 - 42.65; P = 0.342). Exercise intolerance (12/16 dogs) and dyspnea (6/16 dogs) were the cardiorespiratory clinical signs with the highest incidence in the HC group at T0. When compared to the control group, both exercise intolerance (P < 0.001) and dyspnea (P = 0.03) occurrence were significantly higher in the HC group. The age (P = 0.001) and the occurrence of dyspnea (P = 0.036) at diagnosis were significantly higher in dogs with HC that died during the follow-up than those that remained alive. Regarding the occurrence of cardiac arrhythmias verified by ECG, no statistically significant differences were observed among groups. Discussion: The study suggests that systemic hypertension and altered echocardiographic measurements did not interfere with dogs' survival; however, dyspnea was associated with a worse prognosis. Finally, it is possible to conclude that mitral valve degeneration is a common comorbidity in dogs with HC, however, it was not evidenced their interference in the survival of dogs with this endocrine disease or even a role of the HC in the progression of the MVD.

Adenocarcinoma de la glándula suprarrenal en una perra / Adenocarcinoma of the adrenal gland in a female dog / Adenocarcinoma da glândula adrenal em uma cadela

El objetivo de este artículo es describir un caso de neoplasia adrenocortical con manifestación de hiperadrenocorticismo. Los tumores adrenocorticales se originan a partir de diferentes tipos de células y presentan una variada manifestación clínica, que puede ser funcionante o no funcionante. Los adenocarcinomas son autónomos y funcionales en la mayoría de los casos, lo que lleva a una secreción excesiva de glucocorticoides, independientemente del control pituitario. Corroboran la aparición de hiperadrenocorticismo (HAC) al interferir con la síntesis de cortisol. Los signos clínicos observados pueden ser poliuria, polidipsia compensatoria, polifagia, alteraciones de la presión arterial, disfunciones cardíacas, renales y endocrinas, entre otras, estas manifestaciones clínicas pueden presentarse de forma aislada o en asociación. El diagnóstico se puede obtener de varias maneras, como mediciones de cortisol urinario, estimulación con hormona adrenocorticotrópica, pruebas de supresión con dosis bajas de dexametasona y pruebas de imagen. Sin embargo, el diagnóstico definitivo se basa en el uso de la histopatología. Este artículo reporta el caso de una mujer mestiza de 13 años con signos de poliuria y polidipsia. Tras descartar los diagnósticos iniciales (diabetes mellitus y/o alteraciones renales), se sospechó HAC, realizándose nuevas pruebas. Los resultados de los exámenes mostraro

The aim of this article is to describe a case of adrenocortical neoplasm with manifestation of hyperadrenocorticism. Adrenocortical tumors originate from different types of cells and present varied clinical manifestations, which can be functional or non-functional. Adenocarcinomas are autonomous and functional in most cases, leading to excessive secretion of glucocorticoids, regardless of pituitary control. They corroborate the occurrence of hyperadrenocorticism (HAC) due to interference in the synthesis of cortisol. Clinical signs can be observed, as polyuria, compensatory polydipsia, polyphagia, blood pressure alterations, cardiac, renal and endocrine dysfunctions, among others. Diagnosis can be made in various ways, such as urinary cortisol measurements, adrenocorticotropic hormone stimulation, low-dose dexamethasone suppression tests, and imaging tests and histopathology. This article reports the case of a 13-year-old mixed-breed female dog with signs of polyuria and polydpsia. After discarding the initial diagnoses (diabetes mellitus and/or renal alterations), HAC was suspected, with further tests being performed. The test results showed an increase in the adrenal region, and adrenalectomy and hormone replacement with trilostane were recommended. The diagnosis of HAC was confirmed by histopathology as HAC secondary to adrenal gland adenocarcinoma. The patient also develope

O objetivo deste artigo é descrever um caso de neoplasia adrenocortical com manifestação de hiperadrenocorticismo. Tumores adrenocorticais são originados de diversos tipos de células e apresentam manifestação clínica variada, podendo ser funcionantes ou não funcionantes. Os adenocarcinomas são autônomos e funcionantes na maioria dos casos, levando a secreção excessiva de glicocorticóides, independente do controle da hipófise. Eles corroboram com a ocorrência de hiperadrenocorticismo (HAC) por interferência na síntese de cortisol. Os sinais clínicos observados podem ser poliúria, polidipsia compensatória, polifagia, alterações pressóricas, disfunções cardíacas, renais e endócrinas, entre outros, estas manifestações clínicas podem se apresentar de forma isolada ou associada. O diagnóstico pode ser obtido de diversas formas, como dosagens de cortisol urinário, estimulação de hormônio adrenocorticotrópico, testes de supressão com baixa dose de dexametasona e por testes de imagem. No entanto, o diagnóstico definitivo baseia-se no uso da histopatologia. Este artigo relata o caso de uma fêmea sem raça definida, de 13 anos de idade, com sinais de poliúria e polidpsia. Após o descarte dos diagnósticos iniciais (diabetes mellitus e/ou alterações renais), suspeitou-se de HAC, com a realização de novos exames. Os resultados dos exames evidenciaram aumento da região adrenal, sendo recomenda

Systolic blood pressure in anesthetized bitches measured with photoplethysmography

Background: Photoplethysmography is widely used in human medicine, with few studies on its use in veterinary medicine. Its sensor detects fluctuations in blood volume at the site, providing direct readings of cardiac pulse and peripheral oxygen saturation, as well as estimating cardiac output, respiratory rate and blood pressure. This study aimed to evaluate the use of photoplethysmography and compare it to vascular Doppler ultrasound as an indirect method of measuring systolic blood pressure in bitches undergoing elective ovariohysterectomy, using the invasive assessment of systolic blood pressure as a reference. Materials, Methods and Results: After clinical and laboratory evaluation, 34 healthy bitches were selected to undergo elective ovariohysterectomy. After food and water fasting, patients received pethidine hydrochloride intramuscularly as pre-anesthetic medication, followed by anesthetic induction with fentanyl citrate and propofol intravenously. General anesthesia was maintained by inhalation with isoflurane diluted in 100% oxygen. Intraoperative analgesia consisted of continuous infusion of fentanyl citrate intravenously. The animals were randomly divided into 2 groups, the thoracic limb group (TLG) and the pelvic limb group (PLG). In each patient, non-invasive blood pressure measurement was obtained simultaneously with Doppler (DOP) and photoplethysmography (PPG). The sensors of both devices were placed on the end of the same limb. The PPG sensor was positioned in the interdigital region. In patients belonging to the TLG, the Doppler sensor was placed in the ventral region of the thoracic limb, under the ulnar artery. In PLG patients, the Doppler sensor was placed in the dorsal region of the pelvic limb, over the dorsal artery of the foot. The sphygmomanometer was positioned close to the sensors. For systolic blood pressure (SBP) measurement, the cuff was inflated until the Doppler sound signal and the plethysmographic wave were lost. The cuff was then deflated until the Doppler pulse sound resumed and the photoplethysmography showed at least 2 continuous waves on a regular basis. The corresponding pressure value observed on the manometer consisted of the SBP. The same 2 evaluators performed all SBP measurements: 1 responsible for the DOP method and the other for the PPG method; both were blind to the other's findings, thus minimizing potential bias in the results. All animals underwent cannulation of the auricular artery for invasive measurement of systolic blood pressure, using a multiparameter monitor. All blood pressure measurements were performed at 5-min intervals, as well as obtaining additional parameters (heart and respiratory rate, esophageal temperature, partial tissue oxygen saturation, carbon dioxide concentration) and electrocardiographic monitoring. All parameters were documented for further statistical analysis. A strong correlation (r² = 0.95) was obtained between the DOP and PPG methods regardless of the limb on which the sensors were placed. There was a low correlation between the invasive method of measuring systolic blood pressure and the other methods. There was better agreement between the DOP and PPG methods (r2 = -0.0061; P = 0.85) when systolic blood pressure was measured in the TLG. Discussion: In the PLG, the values obtained with the DOP and PPG methods were significantly higher than those obtained with the invasive method, while the values obtained in the TLG differed slightly. It was found that the best measurement site by non-invasive methods was the thoracic limb. It was concluded that the non-invasive methods showed a low correlation with the invasive method; however, both methods had similar characteristics and photoplethysmography can be used to replace the vascular Doppler method.

Effects of renal denervation on endogenous ouabain in spontaneously hypertensive rats

Purpose: To investigate the role of renal denervation (RDN) on endogenous ouabain (EO) secretion in spontaneously hypertensive rats (SHR). Methods: Sixteen 12-week-old male SHR were randomly separated into the renal denervation group (RDNX group) and sham operation group (sham group), and eight age-matched Wistar Kyoto rats (WKY) were served as control group. EO concentrations, the Na+- K+-ATPaseactivity, and the expression of Na+-K+-ATPase were assessed. Results: EO levels in serum, kidneys and hypothalamus of sham group were higher than in RDNX group (p < 0.05). Renal Na+-K+-ATPase activity subjected to denervation surgery showed significantly reduction when compared with the sham groups (p < 0.05). A positive correlation existed between norepinephrine (NE) content and Na+-K+-ATPase activity in the kidney (r2 = 0.579). Renal Na+-K+-ATPase α1 subunit mRNA expression was down-regulated in the RDNX group compared with the sham group (P < 0.05), while renal Na+-K+-ATPase α1 subunit mRNA expression was no statistical significance between the groups (P = 0.63). Immunohistochemical analysis showed that there were significant differences in the renal expression of Na+-K+-ATPasebetween the three groups (P < 0.05). Conclusions: These experiments demonstrate that RDN exerted an anti-hypertensive effect with reduction of EO levels and Na+-K+-ATPase activity and Na+-K+-ATPase α1 subunit expression of kidney in SHR.

Efeitos cardiorrespiratórios da dexmedetomidina isolada e associada à morfina na medicação pré-anestésica de cadelas submetidas à ovariohisterectomia eletiva / Cardiorespiratory effects of dexmedetomidine alone and associated to morphine as premedicants in healthy bitches undergoing ovariohisterectomy / Efectos cardiorespiratorios de la dexmedetomidina aislada y asociada con morfina sobre medicamentos pre-anestésicos de perras sometidas a ovariohisterectomía electiva

Objetivou-se avaliar os efeitos cardiorrespiratórios da dexmedetomidina isolada e associada à morfina em pacientes submetidas à anestesia geral inalatória com isoflurano e submetidas à ovariohisterectomia eletiva. Vinte cadelas saudáveis foram selecionadas a partir de exames físico e laboratoriais. Os animais foram distribuídos aleatoriamente em dois grupos: dexmedetomidina (10 µg/Kg) (GD) e dexmedetomidina (10 µg/Kg) associado com morfina 0,3 mg/Kg (GDM), administrados pela via intramuscular (IM). Ato contínuo, o paciente foi induzido com propofol (à efeito) e mantido com isoflurano diluído em oxigênio 100% e administrado através de vaporizador calibrado. Foram aferidos os parâmetros fisiológicos: frequências cardíaca (FC) e respiratória (f), temperatura corporal (T°C), pressões arteriais sistólica (PAS), diastólica (PAD) e média (PAM), saturação de oxigênio na hemoglobina (SpO2), pressão parcial de gás carbônico no final da expiração (ETCO2) e isoflurano expirado (ETISO). A hemogasometria arterial foi utilizada para a análise do potencial hidrogeniônico (pH), bicarbonato (HCO3-) e pressão parcial de dióxido de carbono (PaCO2). O procedimento cirúrgico teve duração máxima de 45 minutos. Os parâmetros demonstraram diferença estatística entre os tempos e grupos avaliados, de acordo com os testes de Tukey e Bonferroni (p<0,05). Observou-se bradicardia 30 minutos após a aplicação da medicação pré-anestésica e acidemia no período trans-anestésico. Apesar disto, tanto a dexmedetomidina isolada quanto associada, conferiram estabilidade hemodinâmica e respiratória, apesar da bradicardia e acidemia observada.(AU)

This study aimed to evaluate the cardiorespiratory effects of dexmedetomidine alone and associated with morphine. Twenty healthy dogs were selected from physical and laboratory exams. The animals were randomly distributed into two groups: 10 µg/Kg dexmedetomidine (DG) and 10 µg/Kg dexmedetomidine group associated with 0.3 mg/Kg morphine (GDM), administered intramuscularly (IM). The patients were induced with propofol (to effect) and maintained with isoflurane diluted in 100% oxygen and administered through a calibrated vaporizer. Physiological parameters were measured: heart rate (HR), respiratory rate (f), body temperature (T°C), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP), oxygen saturation of hemoglobin (SpO2), end-tidal carbon dioxide partial pressure (ETCO2) and end-tidal isoflurane concentration (ETISO). Arterial blood gas analysis was used to analyze hydrogen potential (pH), bicarbonate (HCO3-) and partial pressure of carbon dioxide (PaCO2). The surgical procedure lasted up to 45 minutes. The parameters showed a statistical difference between the times and groups evaluated, according to the Tukey and Bonferroni tests (p<0.05). Bradycardia was observed 30 minutes after the application of pre-anesthesic medication and acidemia in the trans-anesthetic period. Despite this, both dexmedetomidine alone and associated, provided good hemodynamic and respiratory stability, despite the bradycardia and acidemia observed.(AU)

Este estudio tuvo como objetivo evaluar los efectos cardiorrespiratorios de la dexmedetomidina sola y asociada con la morfina en pacientes sometidas a anestesia general por inhalación con isoflurano y sometidas a ovariohisterectomía electiva. Se seleccionaron veinte perras sanas a partir de exámenes físicos y de laboratorio. Los animales se dividieron aleatoriamente en dos grupos: dexmedetomidina (10 µg/kg) (GD) y dexmedetomidina (10 µg/kg) asociada con 0,3 mg/kg de morfina (GDM), administrada por vía intramuscular (IM). Posteriormente, el paciente fue inducido con propofol (en efecto) y mantenido con isoflurano diluido en oxígeno al 100% y administrado mediante de un vaporizador calibrado. Se midieron parámetros fisiológicos: frecuencia cardíaca (FC) y respiratoria (f), temperatura corporal (T°C), presión arterial sistólica (PAS), diastólica (PAD) y media (PAM), saturación de oxígeno de hemoglobina (SpO2), presión parcial de carbono dióxido al final de la expiración (ETCO2) e isoflurano expirado (ETISO). Se utilizó gasometría arterial para analizar el potencial de hidrógeno (pH), el bicarbonato (HCO3-) y la presión parcial de dióxido de carbono (PaCO2). El procedimiento quirúrgico tuvo una duración máxima de 45 minutos. Los parámetros mostraron diferencia estadística entre los tiempos y grupos evaluados, según las pruebas de Tukey y Bonferroni (p <0.05). Se observó bradicardia 30 minutos después de la aplicación de medicación preanestésica y acidemia en el período transnestésico. A pesar de esto, tanto la dexmedetomidina aislada como la asociada proporcionaron estabilidad hemodinámica y respiratoria, a pesar de la bradicardia y acidemia observadas.(AU)

Bezold-Jarisch reflex induced by dopamine during isoflurane anesthesia in small dogs

Background: Unlike other major reflexes contributing to hemodynamic homeostasis, the Bezold-Jarisch reflex (BJR)paradoxically decreases heart rate (HR) and mean arterial pressure (MAP) despite hypotension. In the veterinary field,there are few reported cases of BJR induced by dopamine, which is often used to manage hypotension. Herein, 2 casesinvolving small dogs exhibiting BJR due to dopamine infusion during general anesthesia are described.Cases: Case 1: A 7-year-old, 7 kg, mongrel was referred for external skeletal fixator removal. The patient was premedicatedwith 0.3 mg/kg midazolam and 0.2 mg/kg butorphanol intravenously (IV). General anesthesia was induced with 6 mg/kgpropofol and maintained with 1.6% isoflurane in oxygen. The patient was given 5 mL/kg/h of Hartmann’s solution IV. Therespiratory rate (RR) was set to 9 breaths/min with a ventilator. The HR and MAP values were initially 120 bpm and 76mmHg and gradually decreased to 70 bpm and 40 mmHg, respectively. The end-tidal CO2 partial pressure (ETCO2) was 39mmHg, and the patient was administered 2.5 μg/kg glycopyrrolate IV. Then, 5 μg/kg/min dopamine was administered IVsince the MAP did not improve. The HR, MAP, and ETCO2 increased to 113 bpm, 72 mmHg, and 47 mmHg, respectively.Subsequently, HR and MAP dramatically decreased to 50 bpm and 43 mmHg, respectively. A second-degree atrioventricularblock was detected, prompting dopamine infusion discontinuation, and 2.5 μg/kg glycopyrrolate was again administeredIV. Within 5 min, HR and MAP values normalized, and postoperative patient recovery was typical. Case 2: A 2-year-old,8.6 kg, mongrel underwent surgery to correct a medial luxating patella of the right leg. The patient was premedicated with0.3 mg/kg midazolam and 0.2 mg/kg butorphanol IV. Anesthesia was induced with 4 mg/kg propofol IV and maintained...

Bezold-Jarisch reflex induced by dopamine during isoflurane anesthesia in small dogs

Background: Unlike other major reflexes contributing to hemodynamic homeostasis, the Bezold-Jarisch reflex (BJR)paradoxically decreases heart rate (HR) and mean arterial pressure (MAP) despite hypotension. In the veterinary field,there are few reported cases of BJR induced by dopamine, which is often used to manage hypotension. Herein, 2 casesinvolving small dogs exhibiting BJR due to dopamine infusion during general anesthesia are described.Cases: Case 1: A 7-year-old, 7 kg, mongrel was referred for external skeletal fixator removal. The patient was premedicatedwith 0.3 mg/kg midazolam and 0.2 mg/kg butorphanol intravenously (IV). General anesthesia was induced with 6 mg/kgpropofol and maintained with 1.6% isoflurane in oxygen. The patient was given 5 mL/kg/h of Hartmanns solution IV. Therespiratory rate (RR) was set to 9 breaths/min with a ventilator. The HR and MAP values were initially 120 bpm and 76mmHg and gradually decreased to 70 bpm and 40 mmHg, respectively. The end-tidal CO2 partial pressure (ETCO2) was 39mmHg, and the patient was administered 2.5 μg/kg glycopyrrolate IV. Then, 5 μg/kg/min dopamine was administered IVsince the MAP did not improve. The HR, MAP, and ETCO2 increased to 113 bpm, 72 mmHg, and 47 mmHg, respectively.Subsequently, HR and MAP dramatically decreased to 50 bpm and 43 mmHg, respectively. A second-degree atrioventricularblock was detected, prompting dopamine infusion discontinuation, and 2.5 μg/kg glycopyrrolate was again administeredIV. Within 5 min, HR and MAP values normalized, and postoperative patient recovery was typical. Case 2: A 2-year-old,8.6 kg, mongrel underwent surgery to correct a medial luxating patella of the right leg. The patient was premedicated with0.3 mg/kg midazolam and 0.2 mg/kg butorphanol IV. Anesthesia was induced with 4 mg/kg propofol IV and maintained...(AU)

Use of aerobic treadmill exercises on nerve regeneration after sciatic nerve injury in spontaneously hypertensive rats

Purpose: Various postoperative protocols have been proposed to improve outcomes and accelerate nerve regeneration. Recently, the use of physical exercise in a post-surgical neurorraphy procedure has shown good results when started early. We experimentally investigated the hypothesis that post-operative exercise speeds up results and improves clinical and morphologic parameters. Methods: Isogenic rats were randomly divided into four groups: 1 SHAM; 2 SHAM submitted to the exercise protocol (EP); 3 Grafting of the sciatic nerve; and 4 Grafting of the sciatic nerve associated with the EP. The EP was based on aerobic activities with a treadmill, with a progressive increase in time and intensity during 6 weeks. The results were evaluated by the sciatic functional index (SFI), morphometric and morphologic analysis of nerve distal to the lesion, and the number of spinal cord motor neurons, positive to the marker Fluoro-Gold (FG), captured retrogradely through neurorraphy. Results: Functional analysis (SFI) did not show a statistical difference between the group grafted with (­50.94) and without exercise (-65.79) after 90 days. The motoneurons count (Spinal cord histology) also showed no diference between these groups (834.5 × 833 respectively). Although functionally there is no difference between these groups, morphometric study showed a greater density (53.62) and larger fibers (7.762) in GRAFT group. When comparing both operated groups with both SHAM groups, all values were much lower. Conclusions: The experimental model that this aerobic treadmill exercises protocol did not modify nerve regeneration after sciatic nerve injury and repair with nerve graft.

Adenocarcinoma of the adrenal gland in a female dog / Adenocarcinoma da glândula adrenal em uma cadela / Adenocarcinoma de la glándula suprarrenal en una perra

The aim of this article is to describe a case of adrenocortical neoplasm with manifestation of hyperadrenocorticism. Adrenocortical tumors originate from different types of cells and present varied clinical manifestations, which can be functional or non-functional. Adenocarcinomas are autonomous and functional in most cases, leading to excessive secretion of glucocorticoids, regardless of pituitary control. They corroborate the occurrence of hyperadrenocorticism (HAC) due to interference in the synthesis of cortisol. Clinical signs can be observed, as polyuria, compensatory polydipsia, polyphagia, blood pressure alterations, cardiac, renal and endocrine dysfunctions, among others. Diagnosis can be made in various ways, such as urinary cortisol measurements, adrenocorticotropic hormone stimulation, low-dose dexamethasone suppression tests, and imaging tests and histopathology. This article reports the case of a 13-year-old mixed-breed female dog with signs of polyuria and polydpsia. After discarding the initial diagnoses (diabetes mellitus and/or renal alterations), HAC was suspected, with further tests being performed. The test results showed an increase in the adrenal region, and adrenalectomy and hormone replacement with trilostane were recommended. The diagnosis of HAC was confirmed by histopathology as HAC secondary to adrenal gland adenocarcinoma. The patient also developed diabetes mellitus during postoperative treatment with prednisone, which made it necessary to discontinue the medication.

O objetivo deste artigo é descrever um caso de neoplasia adrenocortical com manifestação de hiperadrenocorticismo. Tumores adrenocorticais são originados de diversos tipos de células e apresentam manifestação clínica variada, podendo ser funcionais ou não funcionais. Os adenocarcinomas são autônomos e funciona na maioria dos casos, levando a secreção excessiva de glicocorticóides, independente do controle da hipófise. Eles corroboram com a ocorrência de hiperadrenocorticismo (HAC) por interferência na síntese de cortisol. Os sinais clínicos observados podem ser poliúria, polidipsia compensatória, polifagia, alterações pressóricas, disfunções cardíacas, renais e endócrinas, entre outros. Estas manifestações clínicas podem se apresentar de forma isolada ou associada. O diagnóstico pode ser obtido de diversas formas, como dosagens de cortisol urinário, estimulação de hormônio adrenocorticotrópico, testes de supressão com baixa dose de dexametasona e por testes de imagem. No entanto, o diagnóstico definitivo baseia-se no uso da histopatologia. Este artigo relata o caso de uma fêmea sem raça definida, de 13 anos de idade, com sinais de poliúria e polidpsia. Após o descarte dos diagnósticos iniciais (diabetes mellitus e/ou alterações renais). suspeitou-se de HAC, com a realização de novos exames. Os resultados dos exames evidenciaram aumento da região adrenal, sendo recomendada a adrenalectomia e reposição hormonal com trilostano. O diagnóstico de HAC foi confirmado pela histopatologia como sendo HAC secundário a adenocarcinoma de glândula adrenal. A paciente desenvolveu ainda um quadro de diabetes mellitus durante o tratamento com prednisona no pós-operatório, sendo necessário interromper a medicação.

El objetivo de este artículo es describir un caso de neoplasia adrenocortical con manifestación de hiperadrenocorticismo. Los tumores adrenocorticales se originan a partir de diferentes tipos de células y presentan una variada manifestación clínica, que puede ser funcionante o no funcionante. Los adenocarcinomas son autónomos y funcionales en la mayoría de los casos, lo que lleva a una secreción excesiva de glucocorticoides, independientemente del control pituitario. Corroboran la aparición de hiperadrenocorticismo (HAC) al interferir con la síntesis de cortisol. Los signos clínicos observados pueden ser poliuria, polidipsia compensatoria, polifagia, alteraciones de la presión arterial, disfunciones cardíacas, renales y endocrinas, entre otras. Estas manifestaciones clínicas pueden presentarse de forma aislada o en asociación. El diagnóstico se puede obtener de varias maneras, como mediciones de cortisol urinario, estimulación con hormona adrenocorticotrópica, pruebas de supresión con dosis bajas de dexametasona y pruebas de imagen. Sin embargo, el diagnóstico definitivo se basa en el uso de la histopatología. Este artículo reporta el caso de una perra mestiza de 13 años con signos de poliuria y polidipsia. Tras descartar los diagnósticos iniciales (diabetes mellitus y/o alteraciones renales), se sospechó HAC, realizándose nuevas pruebas. Los resultados de los exámenes mostraron un aumento en la región suprarrenal, por lo que se recomendó adrenalectomía y reemplazo hormonal con trilostano. El diagnóstico de CAH se confirmó por histopatología como CAH secundaria a adenocarcinoma de la glándula suprarrenal. La paciente también desarrolló diabetes mellitus durante el tratamiento con prednisona en el postoperatorio, siendo necesario suspender la medicación.

Hipertensão arterial sistêmica em gatos / Systemic arterial hypertension in cats

A hipertensão arterial sistólica é frequentemente reconhecida na prática clínica da medicina interna felina, sendo um problema comum em gatos mais velhos. Esta enfermidade é, costumeiramente, secundária a outras doenças, tais como, doença renal crônica e hipertireoidismo. No entanto, em alguns pacientes a causa subjacente não é identificada, portanto denominada de hipertensão idiopática. Elevações na pressão arterial, de forma sustentada ou não, podem levar a danos em diversos órgãos como, cérebro, olhos, coração e rins. Essas injúrias são denominadas de lesão de órgãos-alvo. Pressão arterial sistêmica acima de 160mmHg possue risco moderado a grave de dano aos órgãos-alvo. Desta maneira, o tratamento procura idealmente atingir riscos de dano mínimos. Alguns fármacos podem ser utilizados como terapia anti-hipertensiva, dentre elas, a amlodipina, um bloqueador de canal de cálcio, que é o medicamento de primeira escolha para tratamento em gatos. Além disso, é de extrema importância o diagnóstico de doenças que possam gerar o quadro hipertensivo ou estar em associação para que desta forma seja possível um controle adequado da pressão arterial. O diagnóstico precoce da doença é fundamental pois auxilia reduzir as chances de lesão nos órgãos-alvo, e consequentemente, reduz a mortalidade e melhora a qualidade de vida dos pacientes.

Systolic arterial hypertension is often recognized in the clinical practice of feline internal medicine and is a common problem in older cats. This disease is usually secondary to other diseases, such as chronic kidney disease and hyperthyroidism. However, in some patients the underlying cause is not identified, therefore called idiopathic hypertension. Elevations in blood pressure, whether sustained or not, can cause damage to various organs such as the brain, eyes, heart and kidneys. These injuries are called target organ damage. Systemic blood pressure above 160mmHg has a moderate to severe risk of damage to target organs. In this way, the treatment ideally seeks to achieve risks of cognitive damage. Pharmacological substances can be used as antihypertensive therapy, among them, an amlodipine, a calcium channel blocker, which is the drug of choice for treatment in cats. In addition, it is extremely important to diagnose diseases that cause hypertension or to be associated with it, so that this form of blood pressure is adequate. Early diagnosis of the disease is essential because it helps to reduce the chances of target organ damage, and consequently, reduce mortality and improve patients' quality of life.

Pressão arterial sistólica em cães anestesiados: concordância entre mensurações por dois métodos não invasivos / Systolic blood pressure in anesthetized dogs: agreement between measurements by two noninvasive monitors

The oscillometric monitor is a noninvasive method used for measuring blood pressure in dogs and cats. Despite widely used, there is a large variability in the accuracy of oscillometric monitors, which may also be influenced by the location of the blood pressure cuff. The Doppler ultrasound is another non-invasive method that was shown to measure blood pressure with good accuracy and precision in small animals. The present study aimed to determine the agreement between systolic arterial pressure (SAP) measured by the Prolife P12 oscillometric monitor with 2 cuff locations and the Doppler ultrasound in anesthetized dogs. Dogs scheduled for routine anesthetic procedures were included in the study, which was carried out in 2 phases. In Phase 1, SAP values measured by the Doppler were compared with those measured by the Prolife P12 monitor with the cuff placed at the thoracic limb for both methods. In Phase 2, SAP values measured by the Doppler were compared with those measured by the Prolife P12 monitor, with the cuff placed at the thoracic limb for the Doppler and at the base of the tail for the P12. The cuff width corresponded to approximately 40% of limb or tail circumference. On all occasions, 3 consecutive measurements of SAP were recorded, followed by a single measurement of SAP by the P12, and then other 3 measurements were performed with the Doppler. The arithmetic mean of the 6 SAP measurements with the Doppler was compared with the SAP value measured by the P12 monitor (paired measurements). Agreement between SAP values measured by the Doppler and the P12 monitor was analyzed by the Bland Altman method for calculation of the bias (Doppler - P12) and standard deviation (SD) of the bias. The percentages of differences between the methods with an error ≤ 10 mmHg and ≤ 20 mmHg and Pearson's correlation coefficients were also calculated. Results were compared with the criteria from the American College of Veterinary Internal Medicine (ACVIM) for validation of noninvasive blood pressure methods. A total of 33 dogs were included in Phase 1 and 15 were included in Phase 2. During Phases 1 and 2, 179 and 87 paired measurements were recorded, respectively. Most of the measurements were recorded during normotension (SAP = 90-130 mmHg): 113/179 in Phase 1 and 52/87 in Phase 2. The bias (± SD) for Phases 1 and 2 were -2.7 ± 14.1 mmHg and 7.2 ± 25.8 mmHg. The percentages of differences ≤ 10 mmHg and ≤ 20 mmHg were: Phase 1, 61% and 83%; Phase 2, 41% and 70%. Correlation coefficients were 0.81 and 0.67 for Phases 1 and 2, respectively. According to the ACVIM criteria, maximum values accepted for bias are 10 ± 15 mmHg, the percentages of differences ≤ 10 mmHg and ≤ 20 mmHg should be ≥ 50% and ≥ 80%, respectively, and the correlation coefficient should be ≥ 0.9. When the blood pressure cuff was placed at the thoracic limb, SAP values measured by the P12 monitor met most of the ACVIM criteria, demonstrating good agreement with SAP values measured by the Doppler. The only requirement not met was the correlation coefficient which was 0.81 whereas the recommended is ≥ 0.9. Conversely, when the cuff was placed at the base of the tail, SAP values measured by the P12 monitor did not meet most of the ACVIM criteria indicating that, in anesthetized dogs, SAP measurements with the P12 monitor should be performed with the cuff placed at the thoracic limb. One limitation of this study was that most measurements fell in the normotensive range and the results should not be extrapolated for hypotensive and hypertensive conditions. In conclusion, the Prolife P12 oscillometric monitor demonstrated good agreement with SAP values measured by the Doppler and provides acceptable values in normotensive anesthetized dogs.(AU)

Hipertensão em idosos: revisão de literatura de artigos nacionais / Hypertension in the elderly: brazilian review

Buscou-se, no presente trabalho, analisar os dados na literatura científica referentes à incidência da Hipertensão Arterial em idosos e suas possíveis associações. Trata-se de um artigo de revisão de publicações nacionais originais, dos anos 2008 a 2019, que abordam as palavraschave hipertensão arterial em idosos, doença cardiovascular e envelhecimento, disponíveis na base de dados SciELO e na plataforma de pesquisa Google Acadêmico. Foram excluídos artigos internacionais, estudos de revisão e os que não perfazem o público alvo dessa revisão. No total, foram selecionados 9 artigos, sendo 8 estudos transversais e 1 ensaio clínico não randomizado. Todos os estudos registraram maior prevalência da doença nas mulheres quando se comparado aos homens e em idades superiores a 60 anos, o que pode estar relacionado às alterações hormonais da menopausa. Outros fatores de risco foram confirmados pelos estudos, como o peso, o nível de escolaridade e a renda familiar. Através desta revisão foi concluído que há uma maior prevalência da doença em indivíduos com 60 anos ou mais. Sabendo disso, nota-se a importância de manter a prática de atividade física regular e bons hábitos alimentares, além de fazerem exames preventivos periodicamente para um eventual um diagnóstico precoce.(AU)

In the present study, we sought to analyze the data in the scientific literature regarding the incidence of arterial hypertension in the elderly and its possible associations. This is a review article of original national publications, from the years 2008 to 2019, which address the keywords arterial hypertension in the elderly, cardiovascular disease and aging, available in the SciELO database and in the Google Academic research platform. International articles, review studies and those that are not the target audience of this review were excluded. In total, 9 articles were selected, 8 cross-sectional studies and 1 nonrandomized clinical trial. All studies recorded a higher prevalence of the disease in women When compared to men and at ages over 60 years, which may be related to hormonal changes in menopause. Other risk factors were confirmed by the studies, such as weight, education level and family income. Through this review it was concluded that there is a higher prevalence of the disease in individuals aged 60 years or older. Knowing this, we note the importance of maintaining regular physical activity and good eating habits, in addition to periodically doing preventive exams for an eventual Early diagnosis.(AU)

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep / Efeitos da mielografia lombar na pressão subaracnoidea e nos parâmetros cardiorrespiratórios em ovelhas saudáveis

The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.(AU)

O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.(AU)

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep / Efeitos da mielografia lombar na pressão subaracnoidea e nos parâmetros cardiorrespiratórios em ovelhas saudáveis

The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.(AU)

O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.(AU)

Hipertensão em idosos: Revisão de literatura de artigos nacionais / Hypertension in the elderly: brazilian review

Buscou-se, no presente trabalho, analisar os dados na literatura científica referentes à incidência da Hipertensão Arterial em idosos e suas possíveis associações. Trata-se de um artigo de revisão de publicações nacionais originais, dos anos 2008 a 2019, que abordam as palavras-chave hipertensão arterial em idosos, doença cardiovascular e envelhecimento, disponíveis na base de dados SciELO e na plataforma de pesquisa Google Acadêmico. Foram excluídos artigos internacionais, estudos de revisão e os que não perfazem o público alvo dessa revisão. No total, foram selecionados 9 artigos, sendo 8 estudos transversais e 1 ensaio clínico não randomizado. Todos os estudos registraram maior prevalência da doença nas mulheres quando se comparado aos homens e em idades superiores a 60 anos, o que pode estar relacionado às alterações hormonais da menopausa. Outros fatores de risco foram confirmados pelos estudos, como o peso, o nível de escolaridade e a renda familiar. Através desta revisão foi concluído que há uma maior prevalência da doença em indivíduos com 60 anos ou mais. Sabendo disso, nota-se a importância de manter a prática de atividade física regular e bons hábitos alimentares, além de fazerem exames preventivos periodicamente para um eventual um diagnóstico precoce.(AU)

In the present study, we sought to analyze the data in the scientific literature regarding the incidence of arterial hypertension in the elderly and its possible associations. This is a review article of original national publications, from the years 2008 to 2019, which address the keywords arterial hypertension in the elderly, cardiovascular disease and aging, available in the SciELO database and in the Google Academic research platform. International articles, review studies and those that are not the target audience of this review were excluded. In total, 9 articles were selected, 8 cross-sectional studies and 1 nonrandomized clinical trial. All studies recorded a higher prevalence of the disease in women When compared to men and at ages over 60 years, which may be related to hormonal changes in menopause. Other risk factors were confirmed by the studies, such as weight, education level and family income. Through this review it was concluded that there is a higher prevalence of the disease in individuals aged 60 years or older. Knowing this, we note the importance of maintaining regular physical activity and good eating habits, in addition to periodically doing preventive exams for an eventual Early diagnosis.(AU)

Determinação da acurácia do monitor oscilométrico Delta Life DL 1000 na mensuração da pressão arterial em cães anestesiados de diferentes faixas de peso / Evaluation of the accuracy of the Delta Life DL 1000 oscillometric monitor for blood pressure measurement in anesthetized dogs of different weight ranges

Background: Arterial blood pressure is one of the most commonly variables monitored during anesthetic procedures in veterinary patients. The most reliable method for measuring arterial blood pressure in dogs and cats is the direct (invasive) method. However, the oscillometric method is less complex and more practical for clinical routine in small animals. Nevertheless, oscillometric monitors present great variability in accuracy. The present study aimed to determine the accuracy of the Delta Life DL 1000 oscillometric monitor for measurement of systolic, mean and diastolic blood pressures (SAP, MAP and DAP, respectively) in anesthetized dogs of different weight ranges. Materials, Methods & Results: This study was approved by the Institutional Ethics Committee of Animal Use. Fifteen female dogs of different breeds, weighing 11.6 ± 10.0 kg and with a mean age of 48 ± 51 months were used. All animals were scheduled for elective surgery under general anesthesia in the Institution Veterinary Hospital. Dogs were anesthetized with morphine, propofol and isoflurane and had a 20 or 22 gauge catheter introduced into the dorsal pedal artery for continuous, invasive monitoring of SAP, MAP and DAP. A blood pressure cuff was positioned over the middle third of the radius and connected to Delta Life DL 1000 monitor. Oscillometric readings of SAP, MAP and DAP were registered every 5 minutes, and invasive values were simultaneously recorded. Values obtained with both methods were compared (invasive versus oscillometric) by use of the Bland Altman method to determine the bias, standard deviation of bias and 95% limits of agreement. The percentages of errors between the methods within 10 mmHg and within...

Anestesia para nefrectomia em cão com Dioctophyma renale: relato de caso / Anesthesia for nephrectomy in a dog with Dioctophyma renale: case report

A dioctofimose em cães é uma doença parasitária registrada em vários estados do Brasil, incluindo o Rio Grande do Sul que afeta, principalmente, animais errantes que habitam áreas alagadas. A resolução do caso quando atinge apenas um rim é cirúrgica, sendo assim necessária à realização de anestesia geral para o procedimento de nefrectomia unilateral. Dessa forma, a busca por protocolos mais seguros que mantém a integridade renal é fundamental. O objetivo desse trabalho é relatar a anestesia para o procedimento de nefrectomia como tratamento de dioctofimose em um cão errante da cidade de Pelotas-RS. No presente caso, foi realizada medicação pré-anestésica, com acepromazina, cetamina associados amorfina, e indução com propofol. A manutenção do plano anestésico com isoflurano diluído em oxigênio a 100%, e foi ainda realizado o bloqueio epidural com bupivacaína e morfina para dessensibilização regional. Após o término do procedimento cirúrgico o paciente recebeu analgesia pós-operatória com meloxicam, tramadol e dipirona, e permaneceu na internação por 10 dias para monitoração da função renal e tratamento de doença dermatológica concomitante. O protocolo anestésico foi efetivo e sem maiores complicações, após alta médica foi levado para o canil da prefeitura, onde aguarda adoção.

Dioctophymosis in dogs is a parasitic disease registered in several states of Brazil, including Rio Grande do Sul, mainly wandering animals that live in flooded areas. The resolution of the case is only a surgical measure, so it is necessary to perform general anesthesia for the unilateral nephrectomy procedure. In this way, a search for other data that maintains the ri is fundamental. The purpose of this work is to report anesthesia for the nephrectomy procedure as a treatment of dioctosis in a wandering dog in the city of Pelotas, RS. In the present case, premedication with acepromazine, ketamine associated with morphine, and induction with propofol were performed. The maintenance of the anesthetic plan with isoflurane was diluted in 100% oxygen, and it was also performed with epidural block with bupivacaine and morphine for regional desensitization. After the end of the clinical procedure, the patient received postoperative analgesia with meloxicam, tramadol and dipyrone and remained in the hospital for 10 days to monitor renal function and the concomitant dermatology process. The anesthetic protocol was effective and without major complications, after being discharged to the health service, where it was installed.

Parâmetros hemodinâmicos e ventilatórios em coelhos anestesiados com isoflurano, submetidos à ventilação controlada à pressão com ou sem PEEP / Hemodynamic and ventilatory parameters in rabbits anesthetized with isoflurane submitted to pressure controlled ventilation with or without PEEP

Foi comparada a ventilação controlada à pressão com ou sem pressão positiva expiratória final (PEEP), em coelhos, distribuídos em três grupos, denominados GP (grupo ventilação ciclada à pressão), GPP (grupo ventilação ciclada à pressão com PEEP) e GE (grupo ventilação espontânea - grupo controle). Os animais foram anestesiados com isoflurano, em circuito com reinalação de gases, durante duas horas. As médias de pressão arterial média (PAM) e pressão arterial sistólica (PAS) permaneceram discretamente abaixo dos valores normais em todos os grupos. Houve diminuição significativa da PAM e da PAS no grupo submetido à PEEP (GPP) ao longo do tempo. A pressão parcial de dióxido de carbono arterial (PaCO2) foi maior no GPP quando comparado aos outros grupos no último momento, gerando acidemia respiratória após uma hora de procedimento. A concentração de dióxido de carbono ao final da expiração (ETCO2) apresentou médias discretamente elevadas no grupo não tratado com PEEP (GP) e no grupo controle, enquanto o GPP apresentou maiores médias, possivelmente, relacionadas à diminuição do volume corrente neste grupo. Com base nesses resultados, foi possível concluir que a utilização da PEEP levou à acidemia, que se agravou ao longo do tempo anestésico. Ademais, a anestesia prolongada com isoflurano promove depressão cardiorrespiratória, independentemente do modo ventilatório empregado.(AU)

Pressure controlled ventilation with or without positive end-expiratory pressure (PEEP) was compared in rabbits, which were divided into three groups denominated GP (pressure cycled ventilation group), GPP (pressure cycled ventilation with PEEP group) and GE (spontaneous ventilation group - control group). The animals were anesthetized with isoflurane in a gas rebreathing circuit for two hours. The means of mean arterial pressure (MAP) and systolic blood pressure (SBP) remained slightly below normal values ​​in all groups. There was a significant decrease in MAP and SBP in the group submitted to PEEP (GPP) over time. The partial pressure of arterial carbon dioxide (PaCO2) was higher in GPP when compared to the other groups, inducing respiratory acidosis after one hour. The end-expired carbon dioxide concentration (ETCO2) presented slightly elevated means in the GP, while the GPP presented higher means, possibly related to the decrease in tidal volume in this group. Based on these results it was concluded that the use of PEEP led to acidemia that worsened over anesthetic time. In addition, prolonged isoflurane anesthesia promotes cardiorespiratory depression, regardless the ventilatory mode employed.(AU)

Parâmetros hemodinâmicos e ventilatórios em coelhos anestesiados com isoflurano, submetidos à ventilação controlada à pressão com ou sem PEEP / Hemodynamic and ventilatory parameters in rabbits anesthetized with isoflurane submitted to pressure controlled ventilation with or without PEEP

Foi comparada a ventilação controlada à pressão com ou sem pressão positiva expiratória final (PEEP), em coelhos, distribuídos em três grupos, denominados GP (grupo ventilação ciclada à pressão), GPP (grupo ventilação ciclada à pressão com PEEP) e GE (grupo ventilação espontânea - grupo controle). Os animais foram anestesiados com isoflurano, em circuito com reinalação de gases, durante duas horas. As médias de pressão arterial média (PAM) e pressão arterial sistólica (PAS) permaneceram discretamente abaixo dos valores normais em todos os grupos. Houve diminuição significativa da PAM e da PAS no grupo submetido à PEEP (GPP) ao longo do tempo. A pressão parcial de dióxido de carbono arterial (PaCO2) foi maior no GPP quando comparado aos outros grupos no último momento, gerando acidemia respiratória após uma hora de procedimento. A concentração de dióxido de carbono ao final da expiração (ETCO2) apresentou médias discretamente elevadas no grupo não tratado com PEEP (GP) e no grupo controle, enquanto o GPP apresentou maiores médias, possivelmente, relacionadas à diminuição do volume corrente neste grupo. Com base nesses resultados, foi possível concluir que a utilização da PEEP levou à acidemia, que se agravou ao longo do tempo anestésico. Ademais, a anestesia prolongada com isoflurano promove depressão cardiorrespiratória, independentemente do modo ventilatório empregado.(AU)

Pressure controlled ventilation with or without positive end-expiratory pressure (PEEP) was compared in rabbits, which were divided into three groups denominated GP (pressure cycled ventilation group), GPP (pressure cycled ventilation with PEEP group) and GE (spontaneous ventilation group - control group). The animals were anesthetized with isoflurane in a gas rebreathing circuit for two hours. The means of mean arterial pressure (MAP) and systolic blood pressure (SBP) remained slightly below normal values ​​in all groups. There was a significant decrease in MAP and SBP in the group submitted to PEEP (GPP) over time. The partial pressure of arterial carbon dioxide (PaCO2) was higher in GPP when compared to the other groups, inducing respiratory acidosis after one hour. The end-expired carbon dioxide concentration (ETCO2) presented slightly elevated means in the GP, while the GPP presented higher means, possibly related to the decrease in tidal volume in this group. Based on these results it was concluded that the use of PEEP led to acidemia that worsened over anesthetic time. In addition, prolonged isoflurane anesthesia promotes cardiorespiratory depression, regardless the ventilatory mode employed.(AU)