Respiratory articles Flashcards
Postoperative regurgitation and respiratory complications in brachycephalic dogs undergoing airway surgery before and after implementation of a standardized perianesthetic protocol
Renata S. Costa et al, javma 2020
Protocol:
- pre-op famotidine 1 mg/kg and reglan 0.5 mg/kg
- avoid peri-op opioids, admin 0.15 mg/kg IV dexSP before airway sx
- post-op recovery in ICU, delay extubation until fully alert, nasotracheal/HFNC to aid recovery, sedation PRN, monitor temp/c+/nasal d/c
Implementation reduced post-op regurgitation (35–>9%)
Hx of R+ pre-op was associated w/ development of post-op R+
Anesthetic risk during subsequent anesthetic events in brachycephalic dogs that have undergone corrective airway surgery: 45 cases (2007–2019)
Crystal R. Doyle, et al javma 2020
Having BOAS sx decreased post-ax complication by 79%
Intraop bradycardia increased risk of post-op complication
Every 15 minute increased in ax time increased odds of having intra-oax complication and post-ax complication
Effect of ultraviolet germicidal irradiation of the air on the incidence of upper respiratory tract infections in kittens in a nursery
Robyn A. Jaynes, et al javma 2020
UV irradiation - 1 within heating/ventilation/AC system and 1 within ceiling
Incidence of URI decreased by 87.1%
Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse
Chick Weisse et al javma 2019
93% survived to discharge, MST almost 3 years
Majority had improved goose-honking and dyspnea
Younger male dogs had longer MST
Mainstem bronchi collapse didn’t affect MST
Tracheal infection/pneumonia, stent fx and tissue ingrowth are most common complications
Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies
Janet A. Grimes et al javma 2019
- 35% revised; brachy more likely
- 61% had major complications: aspiration pneumonia, skinfold occlusion, stoma stenosis
- MST shorter if received steroids before trach, had tracheal collapse or older
usually for LC or LarPar
Lung ultrasonography findings in dogs with various underlying causes of cough
Jessica L. Ward et al javma 2019
- Bacterial pneumonia -> subpleural shred signs
- Neoplasia -> subpleural nodule signs
- Dogs with CPE had higher total B-line scores and higher numbers of LUS sites strongly positive for B lines (> 3 B lines/site) than other dogs
- B lines >10 and >2 sites strongly +ve for B-lines was 92% Sn and 94% Sp for cardiogenic PE
Distribution of alveolar-interstitial syndrome in dogs and cats with respiratory distress as assessed by lung ultrasound versus thoracic radiographs
Jessica L. Ward et al jvecc 2018
LUS and TXR were both useful
-LUS more useful in cranial and TXR more useful in caudal quadrant
LUS detected high incidence of AIS compared to TXR
CPE = diffuse AIS Pneumonia = Unilateral Airway/neuro = absence of AIS in all quadrants
Risk factors, characteristics, and outcomes of acute respiratory distress syndrome in dogs and cats: 54 cases.
Ludivine Boiron, et al jvecc 2019
Dogs= more pulmonary causes, main risk factor pneumonia Cats= mixed direct/indirect causes, main risk SIRS
49% vented
Mortality: 84% in dogs 100% in cats
Comparison of high flow nasal cannula oxygen administration to traditional nasal cannula oxygen therapy in healthy dogs.
Tiffany A Jagodich, et al jvecc 2019
CPAP achieved at 1-2 L/kg/min (recommended)
FiO2 at all HF rate > 1L/kg/min achieved 95%
Complication =aerophagia
**Nasal cannula at 100 ml/kg/min only achieve FiO2 0.27 (SACCM reports 0.37) –> need at least 100+ ml/kg/min
Evaluation of pulse oximetry as a surrogate for PaO2 in awake dogs breathing room air and anesthetized dogs on mechanical ventilation.
Kate S Farrell, et al jvecc 2019
SpO2 is not a surrogate for PaO2 though better with ventilated patient
Cutoff of PaO2 <80 mmHg for hypoxemia correlated to SpO2 of 95% with 77% sp and 89.5 Sn
–7% of the time SpO2 can’t detect hypoxemia and false +Ve for SpO2
Continuous positive airway pressure (CPAP) provision with a pediatric helmet for treatment of hypoxemic acute respiratory failure in dogs
Gianila Ceccherini, et al jvecc 2020
Able to deliver CPAP for those w/ hypoxemic resp failure
PaO2, A-a gradient, PF ratio, %SO2 improved 1h post helmet
Development of a tension pneumomediastinum during mechanical ventilation of a young Irish Wolfhound
Kristin M. Zersen et al jvecc 2020
In people 2dry pneumomediastinum most commonly caused by blunt force trauma or MV
Progressive CVS collapse despite -ve pressure obtained through chest tube
Suspect 2ry to overdistension + alveoli rupture –> dissection of air into perivascular space and tracking of air to the pulmonary hilum and mediastinum (Mackin effect)
High-flow nasal cannula oxygen therapy in acute hypoxemic respiratory failure in 22 dogs requiring oxygen support escalation
Tiffany A. Jagodich et al jvecc 2020
High flow decreased RR at 1h and dyspnea score, and increased SpO2.
60% of dogs responded to HFNC by 30 mins. 45% of responder survived.
Successful tracheoscopy-assisted reconstruction of traumatic tracheal avulsion in a cat
Michelle R. Joffe et al jvecc 2020
Intrathaoracic tracheal avulsion after HBC –> tracheoscopic assisted tracheal anastomosis –> did well
Preliminary evaluation of the use of high-flow nasal cannula oxygen therapy during recovery from general anesthesia in dogs with obstructive upper airway breathing
Tiffany A. Jagodich, et al jvecc 2020
HFNC reduced dyspnea score and stertor post-ax –> IMPROVED AIRFLOW
Can cause aerophagia and hypercapnia
Hypercapnia? Increased sedation/opioid OR increased resistance to exhalation during high gas flow.
Usually normocapnia maintained in BAS dog from improved airflow + nasopharyngeal washout by HF
Evaluation of the effects of helmet continuous positive airway pressure on laryngeal size in dogs anesthetized with propofol and fentanyl using computed tomography
Vincenzo Rondelli DVM et al jvecc 2020
CPAP 5 cmH2O
Laryngeal volume and cross-sectional area increased during CPAP
Helmet CPAP may be helpful to maintain upper airway patency in non-intubated dogs
