Chapter 28 - Brachycephalic syndrome

Question 1

5 congenital abnormalities seen with BOAS?

Answer 1

Elongated soft palate
Stenotic nares
Hypoplastic trachea
Prominent nasopharyngeal turbinates
Thickened tongue

Question 2

Can tracheal hypoplasia be reversible growing up ?

Answer 2

Yes

Question 3

Mechanism of sleep apnea-hypopnea syndrome (SAHS)?

Answer 3

Increased resistance to inspiratory flow: complete episodes of airway obstruction and hemoglobin desaturation, leading to chronic intermittent hypoxia (CIH)

Question 4

Patients with BOAS generate pleural pressures lower than those without upper airway obstruction. Whare are the consequences on the respiratory and the digestive systems?

Answer 4

• Strain on thoracic viscera, leads to inflammation and fibrosis
• Upper gastrointestinal tract disease: esophagitis, gastritis, duodenitis (=>regurgitation or vomiting), hiatal herniae

Question 5

3 cardiovacsular and hematologic consequences of Chronic Intermittent Hypoxia secondary to sleep apnea-hypopnea syndrome?

Answer 5

• Systemic hypertension
• Higher packed cell volumes
• Prothrombotic state

Question 6

2 mechanisms for obstructive crisis upon extubation?

Answer 6

• Larynx/pharynx edema secondary to ET-tube
• During anesthesia, decrease of the upper airway dilator muscle tone. Upon anesthesia recovery, patients may be to awake to tolerate the orotracheal tube while not having sufficient muscle tone to maintain upper airway patency

Question 7

Discharge rate for brachycephalic dogs undergoing mechanical ventilation compared to the general population ?

Answer 7

Same as the general population - temporary tracheostomy recommended 24 hours prior weaning from mechanical ventilation