Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia.
Abstract: To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Methods: Prospective randomized clinical study. Methods: Twenty client-owned healthy horses aged 5 ± 2 years, weighing 456 ± 90 kg. Methods: In the control group (CG; n = 10) weaning was performed by a gradual decrease in respiratory rate (fR ) and in the PSV group (PSVG; n = 10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2 > 50 mmHg, arterial pH < 7.35 plus PaCO2 > 50 mmHg or PaO2 < 60 mmHg were observed at any time after disconnection from the ventilator until 30 minutes after the horse stood. Threshold values for each index were established and the predictive power of these values was tested. Results: Pressure support ventilation group (PSVG) had (mean ± SD) pH 7.36 ± 0.02 and PaCO2 41 ± 3 mmHg at weaning and the average lowest PaO2 69 ± 6 mmHg was observed 15 minutes post weaning. The CG had pH 7.32 ± 0.02 and PaCO2 57 ± 6 mmHg at weaning and the average lowest PaO2 48 ± 5 mmHg at 15 minutes post weaning. No accuracy in predicting weaning effect was observed for fR (p = 0.3474), minute volume (p = 0.1153), SaO2 (p = 0.1737) and PaO2 /PAO2 (p = 0.1529). A high accuracy in predicting an optimal effect of weaning was observed for VT > 10 L (p = 0.0001), fR /VT ratio ≤ 0.60 breaths minute(-1) L(-1) (p = 0.0001), VT /bodyweight > 18.5 mL kg(-1) (p = 0.0001) and PaO2 /FiO2 > 298 (p = 0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for VT < 10 L (p = 0.0001), fR /VT ratio ≥ 0.60 breaths minute(-1) L(-1) (p = 0.0001) and Pe'CO2 ≥ 38 mmHg (p = 0.0001) at weaning. Conclusions: Pressure support ventilation (PSV) weaning had a better respiratory outcome. A higher VT , VT /body weight, PaO2 /FiO2 ratio and a lower fR /VT ratio and Pe'CO2 were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia.
© 2013 The Authors. Veterinary Anaesthesia and Analgesia © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.
Publication Date: 2013-04-20 PubMed ID: 23601289DOI: 10.1111/vaa.12041Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Research Support
- Non-U.S. Gov't
Summary
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The study investigates the impact of pressure support ventilation (PSV) during weaning from general anesthesia on ventilation and oxygenation in horses. It found that PSV weaning improved respiratory outcomes and that several indices could accurately predict weaning effects.
Objective and Methodology
- The research aimed to understand the effect of pressure support ventilation (PSV) on horses as they are weaned off general anesthesia, specifically looking at potential impacts on ventilation and oxygenation.
- A group of twenty healthy horses were chosen for the prospective randomized clinical study. Their average age was five years and they weighed roughly 456 kg.
- They were divided into two groups: the control group (CG) and the PSV group (PSVG). In the former, weaning was done through a gradual decrease in their respiratory rate, and in the latter group, a similar decrease was employed but coupled with PSV support.
Findings and Results
- The PSV group had a better respiratory outcome overall. Their average pH was higher (7.36) and their PaCO2 was lower (41 mmHg) at weaning. Meanwhile, their average lowest PaO2 was 69 mmHg, which was observed 15 minutes post weaning.
- In contrast, the control group had lower pH (7.32) and higher PaCO2 (57 mmHg) at weaning. Moreover, their average lowest PaO2 was lower, at 48 mmHg, 15 minutes after weaning.
- No accuracy was observed in predicting weaning effect by using variables such as the respiratory rate (fR), minute volume, SaO2, and PaO2 /PAO2.
- However, some indices were found to accurately predict optimal weaning effects, such as VT (tidal volume) > 10 L, fR /VT ratio ≤ 0.60 breaths minute(-1) L(-1), VT /bodyweight > 18.5 mL kg(-1), and PaO2 /FiO2 > 298.
- Similarly, a few indices could predict suboptimal weaning effects. These include VT < 10 L, fR /VT ratio ≥ 0.60 breaths minute(-1) L(-1), and Pe'CO2 ≥ 38 mmHg at the time of weaning.
Conclusion
- The study concluded that using pressure support ventilation (PSV) during the weaning process from general anesthesia results in better respiratory outcomes for healthy horses.
- Furthermore, certain indicators such as a higher tidal volume, lower respiratory rate to tidal volume ratio, higher tidal volume to body weight ratio, higher PaO2 to FiO2 ratio, and a lower end-tidal CO2 could accurately predict the success of the weaning process.
Cite This Article
APA
Ida KK, Fantoni DT, Souto MT, Otsuki DA, Zoppa AL, Silva LC, Ambrósio AM.
(2013).
Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia.
Vet Anaesth Analg, 40(4), 339-350.
https://doi.org/10.1111/vaa.12041 Publication
Researcher Affiliations
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil. keilaida@usp.br
MeSH Terms
- Anesthesia Recovery Period
- Anesthesia, General / veterinary
- Animals
- Horses / physiology
- Oxygen / blood
- Respiration
- Respiration, Artificial / methods
- Respiration, Artificial / veterinary
Citations
This article has been cited 2 times.- Rodrigues RR, Ambrósio AM, Engbruch AM, Gonçalves LA, Villela PA, Sanchez AF, Fantoni DT. Intraoperative Protective Mechanical Ventilation in Dogs: A Randomized Clinical Trial. Front Vet Sci 2022;9:842613.
- Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
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