Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture
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Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture. / Hopster, Klaus; Duffee, Lauren R.; Hopster-Iversen, Charlotte C.S.; Driessen, Bernd.
I: American Journal of Veterinary Research, Bind 79, Nr. 10, 2018, s. 1021-1027.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture
AU - Hopster, Klaus
AU - Duffee, Lauren R.
AU - Hopster-Iversen, Charlotte C.S.
AU - Driessen, Bernd
PY - 2018
Y1 - 2018
N2 - OBJECTIVE To evaluate efficacy of an alveolar recruitment maneuver (ARM) with positive end-expiratory pressures (PEEPs) in anesthetized horses ventilated with oxygen or heliox (70% helium and 30% oxygen). ANIMALS 6 healthy adult horses. PROCEDURES In a randomized crossover study, horses were anesthetized and positioned in dorsal recumbency. Volume-controlled ventilation was performed with heliox or oxygen (fraction of inspired oxygen [Fio2] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm H2O in steps of 5 cm H2O every 5 minutes, followed by incremental steps back to 0 cm H2O) was performed. Peak inspiratory pressure, dynamic lung compliance (Cdyn), and Pao2 were measured during each PEEP. Indices of pulmonary oxygen exchange and alveolar dead space were calculated. Variables were compared with baseline values (PEEP, 0 cm H2O) and between ventilation gases by use of repeated-measures ANOVAs. RESULTS For both ventilation gases, ARM significantly increased pulmonary oxygen exchange indices and Cdyn. Mean ± SD Cdyn (506 ± 35 mL/cm H2O) and Pao2-to-Fio2 ratio (439 ± 36) were significantly higher and alveolar-arterial difference in Pao2 (38 ± 11 mm Hg) was significantly lower for heliox, compared with values for oxygen (357 ± 50 mL/cm H2O, 380 ± 92, and 266 ± 88 mm Hg, respectively). CONCLUSIONS AND CLINICAL RELEVANCE An ARM in isoflurane-anesthetized horses ventilated with heliox significantly improved pulmonary oxygen exchange and respiratory mechanics by decreasing resistive properties of the respiratory system and reducing turbulent gas flow in small airways.
AB - OBJECTIVE To evaluate efficacy of an alveolar recruitment maneuver (ARM) with positive end-expiratory pressures (PEEPs) in anesthetized horses ventilated with oxygen or heliox (70% helium and 30% oxygen). ANIMALS 6 healthy adult horses. PROCEDURES In a randomized crossover study, horses were anesthetized and positioned in dorsal recumbency. Volume-controlled ventilation was performed with heliox or oxygen (fraction of inspired oxygen [Fio2] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm H2O in steps of 5 cm H2O every 5 minutes, followed by incremental steps back to 0 cm H2O) was performed. Peak inspiratory pressure, dynamic lung compliance (Cdyn), and Pao2 were measured during each PEEP. Indices of pulmonary oxygen exchange and alveolar dead space were calculated. Variables were compared with baseline values (PEEP, 0 cm H2O) and between ventilation gases by use of repeated-measures ANOVAs. RESULTS For both ventilation gases, ARM significantly increased pulmonary oxygen exchange indices and Cdyn. Mean ± SD Cdyn (506 ± 35 mL/cm H2O) and Pao2-to-Fio2 ratio (439 ± 36) were significantly higher and alveolar-arterial difference in Pao2 (38 ± 11 mm Hg) was significantly lower for heliox, compared with values for oxygen (357 ± 50 mL/cm H2O, 380 ± 92, and 266 ± 88 mm Hg, respectively). CONCLUSIONS AND CLINICAL RELEVANCE An ARM in isoflurane-anesthetized horses ventilated with heliox significantly improved pulmonary oxygen exchange and respiratory mechanics by decreasing resistive properties of the respiratory system and reducing turbulent gas flow in small airways.
U2 - 10.2460/ajvr.79.10.1021
DO - 10.2460/ajvr.79.10.1021
M3 - Journal article
C2 - 30256141
AN - SCOPUS:85054124636
VL - 79
SP - 1021
EP - 1027
JO - American Journal of Veterinary Research
JF - American Journal of Veterinary Research
SN - 0002-9645
IS - 10
ER -
ID: 239812989