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Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses.
Portela, Diego A; Di Franco, Chiara; Chiavaccini, Ludovica; Araos, Joaquin; Romano, Marta; Otero, Pablo E; Biedrzycki, Adam H; Schramel, Johannes P.
Afiliação
  • Portela DA; Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA. Electronic address: dportela@ufl.edu.
  • Di Franco C; Department of Veterinary Sciences, University of Pisa, Pisa, Italy.
  • Chiavaccini L; Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
  • Araos J; Department of Clinical Sciences, College of Veterinary Medicine, Ithaca, NY, USA.
  • Romano M; Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
  • Otero PE; Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.
  • Biedrzycki AH; Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
  • Schramel JP; Department of Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine Vienna, Vienna, Austria.
Vet Anaesth Analg ; 50(4): 363-371, 2023 Jul.
Article em En | MEDLINE | ID: mdl-37055259
OBJECTIVE: To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (VTalv), airway (VDaw) and physiological (VDphys) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO2) elimination per breath (Vco2br-1), PaCO2, and the ratio of PaO2-to-fractional inspired oxygen (PaO2:FiO2). STUDY DESIGN: Prospective research study. ANIMALS: A group of eight healthy research horses undergoing laparotomy. METHODS: Anesthetized horses were mechanically ventilated as follows: 6 breaths minute-1, tidal volume (VT) 13 mL kg-1, inspiratory-to-expiratory time ratio 1:2, positive end-expiratory pressure 5 cmH2O and EIP 0%. Vco2br-1 and expired tidal volume (VTE) of 10 consecutive breaths were recorded 30 minutes after induction, after adding 30% EIP and upon EIP removal to construct volumetric capnograms. A stabilization period of 15 minutes was allowed between phases. Data were analyzed using a mixed-effect linear model. Significance was set at p < 0.05. RESULTS: The EIP decreased VDaw from 6.6 (6.1-6.7) to 5.5 (5.3-6.1) mL kg-1 (p < 0.001) and increased VTalv from 7.7 ± 0.7 to 8.6 ± 0.6 mL kg-1 (p = 0.002) without changing the VTE. The VDphys to VTE ratio decreased from 51.0% to 45.5% (p < 0.001) with EIP. The EIP also increased PaO2:FiO2 from 393.3 ± 160.7 to 450.5 ± 182.5 mmHg (52.5 ± 21.4 to 60.0 ± 24.3 kPa; p < 0.001) and Vco2br-1 from 0.49 (0.45-0.50) to 0.59 (0.45-0.61) mL kg-1 (p = 0.008) without reducing PaCO2. CONCLUSIONS AND CLINICAL RELEVANCE: The EIP improved oxygenation and reduced VDaw and VDphys, without reductions in PaCO2. Future studies should evaluate the impact of different EIP in healthy and pathological equine populations under anesthesia.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Respiração com Pressão Positiva / Pulmão Tipo de estudo: Observational_studies Limite: Animals Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Respiração com Pressão Positiva / Pulmão Tipo de estudo: Observational_studies Limite: Animals Idioma: En Ano de publicação: 2023 Tipo de documento: Article