Journals Flashcards
What were the main points of a case report by Lynch et al detailing acute tracheal compression in a large breed dog due to a dorsal tracheal membrane abscess?
Lynch et al. Acute tracheal compression in a large breed dog due to a dorsal tracheal membrane abscess. JVECC 2015 25 (6)
Tracheal collapse/obstruction was identified on radiographs in this patient, determined to be static on tracheoscopy
Suppurative inflammation was found from an FNA of a fluid filled structure dorsal to the trachea identified with ultrasound
Surgical exploration revealed an abscess in the dorsal tracheal membrane
Post-operatively the dog developed a pneumothorax and pneumomediastinum, likely secondary to surgical approach worsened by PPV.
Culture revealed Streptococcus. Dog recovered uneventfully.
What were the primary points from a case report by Garber et al detailing the development of pneumothorax in a dog following heat stroke?
Garber et al. Pneumothorax in a dog caused by necrotizing pneumonia secondary to heatstroke. JVECC 2015 25 (6)
Dog presented for respiratory distress 12 days after an episode of exertional heat stroke
CT showed bilateral pneumothorax and consolidation of lung lobes; sternotomy showed multifocal consolidation at the periphery of multiple lung lobes which was resected
Histopath confirmed necrotizing pneumonitis, grew Pseudomonas
Necrotizing myopathy was found on a pectoral muscle biopsy;
Multifocal necrotizing pneumonia with/without pneuothorax should be considered as a differential in dogs that develop respiratory distress following severe systemic illness.
What were the major findings of a review by Stillion and Letendre regarding canine pneumothorax?
(Not any of the pathophysiology necessarily…)
Stillion, Letendre. A clinical review of the pathophysiology, diagnosis and treatment of pyothorax in dogs and cats. JVECC 2014 35 (1)
Optimal treatment to ensure successful short and long-term outcome, including the avoidance of recurrence, is unknown
Prognosis can be good
83% survival in dogs, 62% in cats
What were the primary points from a case series by Pigott et al regarding H1N1 in cats?
Pigott et al. Acute bronchointerstitial pneumonia in two indoor cats exposed to the H1N1 influenza virus. JVECC 2014 24(6)
Two indoor DSH from the same household were presented for severe respiratory signs; managed aggressively with one requiring mechanical ventilation
Both were ultimately euthanized.
Histopath revealed severe diffuse bronchointerstitial pneumonia; 2009 influenza AH1N1 testing by real time PCR was positive in one cat.
Domestic felids are susceptible to this strain; should be considered in the ddx list. Seems possible that human-to-cat transmission can occur.
What were the major findings of a study by Holowaychuk et al evaluating a transcutaneous blood gas monitoring system in critically ill dogs?
Holowaychuk et al Evaluation of a transcutaneous blood gas monitoring system in critically ill dogs. JVECC 2014 24(5)
Agreement between transcutaneous and arterial PO2 and PCO2 measurements in the dogs studied were inferior to those reported in the human literature
The cutaneous monitor consistently overestimated both PO2 and PCO2 and should not be used to replace arterial blood gas monitoring
What were the major points of a retrospective study of feline secondary spontaneous pneumothorax by Liu et al?
Liu and Silverstein. Feline secondary spontaneous pneumothorx: a retrospective study of 16 cases. JVECC 2014 24 (3)
Secondary causes include asthma, heartworm, neoplasia, PTE, abscesses…
Asthma was the most common cause of SSP in this study (25%); had a good prognosis for survival to discharge with medical management only
Clinical assessment, imaging and invasive diagnostics were required to differentiate AASSP from NAASSP
What were the major conclusions from a case series evaluating the use of autologous blood patch treatment for persistent pneumothorax in dogs?
Oppenheimer et al. Retrospective evalution of the use of autologous blood patch treatment for persistent pneumothorax in 8 dogs. JVECC 2014 24 (2)
62.5% success after 1 round, 87% after 1-2 additional times
Success rate of thoracotomy/lobectomy for persistent pneumo is 88% in dogs; suggests that blood patch pleurodesis may be a viable alternative in dogs that are poor surgical candidates or for whom surgery is declined
MOA suggested–>eiter a true pleurodesis resulting in pleural adhesions (blood generates an inflammatory reaction that may contribute to adhesion between parietal and visceral pleura) versus sealing the site of the leakge with blood clots
Most common complication in people is empyema; documented in 2/8 dogs in this study, resolved in one and other was euthanized.
What were the major conclusions of a retrospective study by Wormser at al regarding TAPS for partial/complete lung lobectomy in dogs and cats?
Wormser et al. Thoracoscopic-associated pulmonary surgery for partial and complete lung lobectomy in dogs and cats: 11 cases (2008-2013). JAVMA 2014 245
11 animals underwent successful TAPs for lung lobectomy without observed intraoperative complication.
TAPS may offer a more technically feasible approach as compared to thoracotomy because it provides the benefits of minimally invasive thoracic surgery without the necessity of 1 lung ventilation.
What were the major conclusions of a study by Woods et al comparing the fluid obtained by manual aspiration with a syringe versus via a suction device during BAL?
Woods et al. Comparison of BAL fluid obtained by manual aspiration with a handheld syringe with that obtained by automated suction pump aspiration from health dogs. JAVMA 2014 75.
BAL by SPA resulted in a significantly higher percentage of fluid retrieval and samples with higher TNCC than did MA.
What were the primary findings of a study by Rubin et al examining dynamic pharyngeal collapse in dogs?
Rubin et al. Signalment, clinical presentation, concurrent diseases and diagnostic findings in 28 dogs with dynamic pharyngeal collapse. JVIM 2015 29.
Pharyngeal collapse is a complex disease process that is likely secondry to long-term negative pressure gradients and anatomic/functional abnormalities.
The most common concurrent disease processes in these dogs were mainstem bronchi collapse, tracheal collapse, and brachycephalic airway syndrome.
Pharyngeal fluoroscopy may be a useful diagnostic test.
What were the major findings of a study by Viitanen et al examining co-infections with respiratory viruses in dogs with bacterial pneumonia?
Viitanen et al. Co-infections with respiratory viruses in dogs with bacterial pneumonia. JVIM 2015.
Canine parainfluenza virus and canine respiratory coroonavirus were identified in 8/20 dogs with bacterial pneumonia.
In dogs with bordatella tracheobronchitis, no respiratory viruses were dectected.
Clinical variables and disease severity did not differ in dogs with BP with and without viral coinfection.
What was the major conclusion of a study by Viitanen et al evaluating serum CRP as a biomarker in dogs with bacterial respiratory disease?
Viitanen et al. Serum CrP as a diagnostic biomarker in dogs with bacterial respiratory distress. JVIM 2014 28.
Dogs with bacterial pneumonia had significantly higher CRP concentrations (121) as compared to dogs with bacterial tracheobronchiis (23), chronic bronchitis, eosinophilic bronchopneumoathy, cardiogenic pulmonary edema or healthy controls.
CRP is a major acute phase protein in dogs and has potential use as an additional biomarker when diagnosing BP.
What were the major conclusions of a study by Papazian et al evaluating the use of NMB in early ARDS?
Papazian et al. Neuromuscular blockers in early acute respiratory distress syndrome. NEJM 2010. 363 (12)
*supplemental article list
- Treatment with the NMB cisatricurium for 48 hours early in the course of severe ARDS improved the adjusted 90-day survival rate, increased the numbers of ventilator free days and days outside the ICU and decreased the incidence of barotruama during the first 90 days.
- It did not significantly improve the overall 90 day mortality.
What were the major findings of a study by Pang et al evaluating the ETCO2 sampled via a nasal catheter in comparison to PaCO2 in dogs?
Pang et al. Partial pressure of EtCO2 sampled via an intranasal catheter as a substitute for partial pressure of arterial CO2 in dogs. JVECC 2007 17.
*Supplemental article
- The results of this study demonstrate that EtCO2 monitoring via a nasal catheter is a clinically acceptable substitute to arterial blood gas analysis as a means of monitoring ventilation in healthy, sedated dogs.
- In both the group receiving nasal O2 supplementation and the group not receiving nasal O2 supplementation, the EtCO2 measurement underestimated for the PaCO2, however, the limits of agreement were found to be within acceptable limits.
What were the major findings of the ALIEN study?
Villar et al. The ALIEN study: incidence and outcome of ARDS in the era of lung protective ventilation. Intensive Care Med 2011. 37.
*Supplemental article
- The incidence of ARDS was identified to be 7.2/100,000 population/year
- Pneumonia and sepsis were the most common causes of ARDS
- Overall ARDS ICU and hospital mortality were 43% and 48% respectively (despite the use of lung protective ventilation)
