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Journal of veterinary internal medicine2024; 38(6); 3327-3336; doi: 10.1111/jvim.17170

Use of prototype bi-nasal prongs for noninvasive ventilation in foals.

Abstract: Noninvasive ventilation (NIV) provides effective respiratory support in foals, but face masks are poorly tolerated and associated with hypercapnia. Bi-nasal prongs might be a more effective device interface in foals. Objective: To compare bi-nasal prongs and masks for NIV in foals with pharmacologically induced respiratory insufficiency. Methods: Six healthy foals. Methods: In a randomized cross-over study, sedated foals received NIV delivered by mask or bi-nasal prongs, with the treatment repeated using the alternative device interface after a 3-day rest period. After periods of spontaneous ventilation through the allocated interface, with and without supplementary O (T2-T3), foals were subject to 10-minute treatment periods of NIV at different pressure support (5 or 10 cmHO) and end-expiratory pressure settings (5 or 10 cmHO), with and without supplementary O (T4-T7). Vital signs, arterial blood gases, spirometry, and gas exchange data were measured in the final 2 minutes of each treatment window. Results: Bi-nasal prongs were well tolerated and required less manual positioning or monitoring compared to the mask. Partial pressure of carbon dioxide did not increase during NIV with bi-nasal prongs and was lower than observed with masks (mean difference, 8.2 mmHg [95% confidence interval, 4.1-12.2 mmHg] at T6). Oxygenation and respiratory mechanics were improved in all foals and not different between device interfaces. Conclusions: Nasal prongs were well tolerated, had similar effects on respiratory function, and appeared to ameliorate hypercapnia observed previously during NIV in foals.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-10-07 PubMed ID: 39375942PubMed Central: PMC11586562DOI: 10.1111/jvim.17170Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study compared the effectiveness of prototype bi-nasal prongs versus traditional face masks for delivering noninvasive ventilation (NIV) in foals experiencing respiratory insufficiency.
  • Researchers assessed tolerance, blood carbon dioxide levels, oxygenation, and respiratory mechanics to determine which interface was better suited for respiratory support in foals.

Introduction and Objective

  • Noninvasive ventilation (NIV) is a method used to support breathing without intubation, often necessary in foals with respiratory issues.
  • Face masks, the usual interface for NIV, can be poorly tolerated by foals and tend to cause elevated carbon dioxide (hypercapnia), which is problematic.
  • The researchers hypothesized that bi-nasal prongs might offer a more effective and better-tolerated interface for NIV in foals.
  • The objective was to compare bi-nasal prongs with face masks in delivering NIV to foals with pharmacologically induced respiratory insufficiency.

Methods

  • Subjects: Six healthy foals participated in the study, with respiratory insufficiency induced pharmacologically to simulate clinical conditions.
  • Study design: Randomized cross-over study, meaning each foal received both interventions in random order with a 3-day rest period between treatments.
  • Interventions: NIV was delivered either through:
    • A face mask (traditional method)
    • Prototype bi-nasal prongs (new interface)
  • Procedure:
    • Foals were sedated and underwent spontaneous ventilation through the assigned interface with and without supplemental oxygen.
    • Multiple 10-minute NIV treatment periods were given with varying settings:
      • Pressure support at either 5 cmH2O or 10 cmH2O
      • End-expiratory pressure at 5 cmH2O or 10 cmH2O
      • With and without supplemental oxygen
  • Measurements: Vital signs, arterial blood gases (to assess oxygen and carbon dioxide levels), spirometry (lung function measures), and data on gas exchange were recorded during the last 2 minutes of each NIV setting period.

Results

  • Tolerance:
    • Bi-nasal prongs were well tolerated by all foals.
    • They required less manual adjustment and monitoring compared to face masks.
  • Carbon dioxide levels:
    • Unlike face masks, bi-nasal prongs did not cause an increase in the partial pressure of carbon dioxide (hypercapnia) during NIV.
    • At one measured time point (T6), carbon dioxide levels were significantly lower with bi-nasal prongs — mean difference of 8.2 mmHg compared to masks.
  • Oxygenation and respiratory mechanics:
    • NIV improved oxygenation and respiratory mechanics in all foals.
    • There was no significant difference between bi-nasal prongs and face masks in these parameters.

Conclusions

  • Prototype bi-nasal prongs are a viable and effective interface for delivering NIV to foals.
  • They were better tolerated and required fewer adjustments than face masks.
  • Importantly, bi-nasal prongs appeared to mitigate hypercapnia commonly seen with face mask NIV in foals.
  • The study suggests that bi-nasal prongs could improve respiratory support in foals by combining comfort with effective ventilation.

Cite This Article

APA
Raidal SL, van Diggelen M, Catanchin CSM, Lehmann HS, Quinn CT. (2024). Use of prototype bi-nasal prongs for noninvasive ventilation in foals. J Vet Intern Med, 38(6), 3327-3336. https://doi.org/10.1111/jvim.17170

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 38
Issue: 6
Pages: 3327-3336

Researcher Affiliations

Raidal, Sharanne L
  • Veterinary Clinical Centre, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
van Diggelen, Michael
  • Veterinary Clinical Centre, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
Catanchin, Chee Sum M
  • Veterinary Clinical Centre, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
Lehmann, Heidi S
  • Veterinary Clinical Centre, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
Quinn, Chris T
  • Veterinary Clinical Centre, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.

MeSH Terms

  • Animals
  • Horses
  • Cross-Over Studies
  • Noninvasive Ventilation / veterinary
  • Noninvasive Ventilation / instrumentation
  • Noninvasive Ventilation / methods
  • Female
  • Respiratory Insufficiency / veterinary
  • Respiratory Insufficiency / therapy
  • Male
  • Masks / veterinary
  • Animals, Newborn
  • Carbon Dioxide / blood
  • Blood Gas Analysis / veterinary

Conflict of Interest Statement

Authors declare no conflict of interest.

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