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Home / Equine Research Bank / J Vet Intern Med / Use of prototype bi-nasal prongs for noninvasive ventilation...
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.

References

This article includes 41 references
  1. Cohen ND. Causes of and farm management factors associated with diease and death in foals. J Am Vet Med Assoc 1994;204:1644‐1651.
    pubmed: 8050947
  2. Galvin NP, Corley KT. Causes of disease and death from birth to 12 months of age in the thoroughbred horse in Ireland. Irish Vet J 2010;63:37‐43.
    pmc: PMC3113843pubmed: 21851741
  3. Raidal SL, Hughes KJ, Eastwell B, Noble N, Lievaart J. Prevalence and performance effects of neonatal disease in thoroughbred and standardbred foals in south‐eastern Australia. Aust Vet J 2021;99:152‐162.
    pubmed: 33624285
  4. Kosch PC, Koterba AM, Coons TJ, Webb AI. Developments in management of the newborn foal in respiratory distress 1: evaluation. Equine Vet J 1984;16:312‐318.
    pubmed: 6383813
  5. Gough SL, Carrick J, Raidal SL. Chlamydia psittaci infection as a cause of respiratory disease in neonatal foals. Equine Vet J 2020;52:244‐249.
    pubmed: 31436332
  6. Lumb AB. Nunn's Applied Respiratory Physiology. Edinburgh: Butterworth‐Heinemann; 2003.
  7. Raidal SL, Catanchin CSM, Sacks M, Carstens A, Quinn CT, Mosing M. Effects of two modes of positive pressure ventilation on respiratory mechanics and gas exchange in foals. J Vet Int Med 2023;37:1233‐1242.
    pmc: PMC10229351pubmed: 37051768
  8. Raidal SL, Catanchin CSM, Burgmeestre L, Quinn CT. Bi‐level positive airway pressure for non‐invasive respiratory support of foals. Front Vet Sci 2021;8:741720.
    pmc: PMC8511517pubmed: 34660771
  9. Raidal SL, McKean R, Ellul PA, Nielsen SG, Quinn CT. Effects of continuous positive airway pressure on respiratory function in sedated foals. J Vet Emerg Crit Care 2019;29:269‐278.
    pubmed: 31044526
  10. Floyd E, Danks S, Comyn I, Mackenzie C, Marr CM. Nasal high flow oxygen therapy in hospitalised neonatal foals. Equine Vet J 2022;54:946‐951.
    pubmed: 34541699
  11. van Diggelen M, Quinn CT, Catanchin CSM, Lehmann HS, Raidal SL. Tolerance of bi‐nasal prongs for delivery of non‐invasive ventilation to foals. Animals 2024;14(6):865.
    pmc: PMC10967355pubmed: 38539963
  12. Jasani B, Ismail A, Rao S, Patole S. Effectiveness and safety of nasal mask versus bi‐nasal prongs for providing continuous positive airway pressure in preterm infants ‐ a systematic review and meta‐analysis. Pediatr Pulmonol 2018;53:987‐992.
    pubmed: 29687659
  13. Sweet DG, Carnielli V, Greisen G. European consensus guidelines on the management of respiratory distress syndrome ‐ 2019 update. Neonatology 2019;115:432‐450.
    pmc: PMC6604659pubmed: 30974433
  14. Chakkarapani AA, Adappa R, Mohammad Ali SK. Current concepts of mechanical ventilation in neonates ‐ part 1: basics. Int J Pediatr Adolesc Med 2020;7:13‐18.
    pmc: PMC7193068pubmed: 32373697
  15. Koterba AM, Wozniak JA, Kosch PC. Changes in breathing pattern in the normal horse at rest up to age one year. Equine Vet J 1995;27:265‐274.
    pubmed: 8536662
  16. Koterba AM, Wozniak JA, Kosch PC. Ventilatory and timing parameters in normal horses at rest up to age one year. Equine Vet J 1995;27:257‐264.
    pubmed: 8536661
  17. Luján M, Lalmolda C, Ergan B. Basic concepts for tidal volume and leakage estimation in non‐invasive ventilation. Turk Thorac J 2019;20:140‐146.
    pmc: PMC6453637pubmed: 30958988
  18. De Luca A, Sall FS, Khoury A. Leak compensation algorithms: the key remedy to noninvasive ventilation failure?. Resp Care 2017;62:135‐136.
    pubmed: 28003559
  19. Oto J, Chenelle CT, Marchese AD, Kacmarek RM. A comparison of leak compensation in acute care ventilators during noninvasive and invasive ventilation: a lung model study. Resp Care 2013;58:2027‐2037.
    pubmed: 23696688
  20. Racca F, Appendini L, Gregoretti C. Helmet ventilation and carbon dioxide rebreathing: effects of adding a leak at the helmet ports. Int Care Med 2008;34:1461‐1468.
    pubmed: 18458874
  21. Zhu K, Rabec C, Gonzalez‐Bermejo J. Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study. BMC Pulm Med 2017;17:145.
    pmc: PMC5697337pubmed: 29157220
  22. Rabec C, Georges M, Kabeya NK. Evaluating noninvasive ventilation using a monitoring system coupled to a ventilator: a bench‐to‐bedside study. Eur Respir J 2009;34:902‐913.
    pubmed: 19324951
  23. Fischer HS, Roehr CC, Proquitte H, Hammer H, Wauer RR, Schmalisch G. Is volume and leak monitoring feasible during nasopharyngeal continuous positive airway pressure in neonates?. Intensive Care Med 2009;35:1934‐1941.
    pubmed: 19771409
  24. Falk M, Gunnarsdottir K, Baldursdottir S, Donaldsson S, Jonsson B, Drevhammar T. Interface leakage during neonatal CPAP treatment: a randomised, cross‐over trial. Arch Dis Child Fetal Neonatal Ed 2021;106:663‐667.
    pmc: PMC8543197pubmed: 33963004
  25. Fischer HS, Roehr CC, Proquitte H, Wauer RR, Schmalisch G. Assessment of volume and leak measurements during CPAP using a neonatal lung model. Physiol Measurement 2008;29:95‐107.
    pubmed: 18175862
  26. Iyer NP, Chatburn R. Evaluation of a nasal cannula in noninvasive ventilation using a lung simulator. Respir Care 2015;60:508‐512.
    pubmed: 25492958
  27. Lebret M, Fresnel E, Prouvez N. Responses of bilevel ventilators to unintentional leak: a bench study. Healthcare 2022;10(12):2416.
    doi: 10.3390/healthcare10122416pmc: PMC9777664pubmed: 36553941google scholar: lookup
  28. Itagaki T, Chenelle CT, Bennett DJ, Fisher DF, Kacmarek RM. Effects of leak compensation on patient‐ventilator synchrony during premature/neonatal invasive and noninvasive ventilation: a lung model study. Respir Care 2017;62:22‐33.
    pubmed: 27651525
  29. Dexter AM, Clark K. Ventilator graphics: scalars, loops and secondary measures. Respir Care 2020;65:739‐759.
    pubmed: 32457168
  30. Morgenroth S, Thomas J, Cannizzaro V, Weiss M, Schmidt AR. Accuracy of near‐patient vs. inbuilt spirometry for monitoring tidal volumes in an in‐vitro paediatric lung model. Anaesthesia 2018;73:972‐979.
    pubmed: 29492954
  31. Ergan B, Nasiłowski J, Winck JC. How should we monitor patients with acute respiratory failure treated with noninvasive ventilation?. Eur Respir Rev 2018;27:170101.
    pmc: PMC9489094pubmed: 29653949
  32. Georges M, Rabec C, Monin E. Monitoring of noninvasive ventilation: comparative analysis of different strategies. Respir Res 2020;21:324.
    pmc: PMC7725884pubmed: 33302961
  33. Carroll CL, Napolitano N, Pons‐Òdena M, Iyer NP, Korang SK, Essouri S. Noninvasive respiratory support for pediatric acute respiratory distress syndrome: from the second pediatric acute lung injury consensus conference. Ped Crit Care Med 2023;24:S135‐S147.
    pubmed: 36661442
  34. Rauseo M, Spinelli E, Sella N. Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond”. J Anesth Analg Crit Care 2022;2:28.
    pmc: PMC9210063pubmed: 37386674
  35. Longhini F, Bruni A, Garofalo E. Monitoring the patient‐ventilator asynchrony during non‐invasive ventilation. Front Med 2022;9:1119924.
    pmc: PMC9893016pubmed: 36743668
  36. Mellema MS. Ventilator waveforms. Top Companion Anim Med 2013;28:112‐123.
    pubmed: 24183000
  37. Rabec C, Rodenstein D, Leger P, Rouault S, Perrin C, Gonzalez‐Bermejo J. Ventilator modes and settings during non‐invasive ventilation: effects on respiratory events and implications for their identification. Thorax 2011;66:170‐178.
    pubmed: 20947891
  38. MacFarlane PD, Mosing M. Early experience with continuous positive airway pressure (CPAP) in five horses ‐ a case series. Can Vet J 2012;53:426‐429.
    pmc: PMC3299518pubmed: 23024393
  39. Priyadarshi A, Hinder M, Badawi N, Luig M, Tracy M. Continuous positive airway pressure belly syndrome: challenges of a changing paradigm. Int J Clin Ped 2020;9:9‐15.
  40. Fischer C, Bertelle V, Forcada‐Guex M, Stadelmann‐Diaw C, Hohlfeld J, Tolsa JF. Incidence and severity of nasal trauma due to continuous positive airway pressure in neonates: a prospective study. Swiss Med Week 2020;139:8S.
    pubmed: 20584802
  41. Fischer C, Bertelle V, Hohlfeld J, Forcada‐Guex M, Stadelmann‐Diaw C, Tolsa JF. Nasal trauma due to continuous positive airway pressure in neonates. Arch Dis Child‐Fetal Neonatal Ed 2010;95:F447‐F451.
    pubmed: 20584802

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