Respiratory Articles 2017-2019 Flashcards
Vet Journal 2017 What was the optimal cut offs for fluid responders in healthy dogs undergoing mechanical ventilation for aortic peak flow velocity, Systolic pressure variation, distensibility index of the caudal vena cava
Greater than were more likely to be fluid responders
9.4% aortic peak flow velocity
6.7% systolic pressure variation
24% Caudal vena cava distensibitliy index
Aortic peak flow velocity the best as less influcence of MV on arterial compliance
JVECC 2017 What was the prevelance and mortatily rate in a study of ARDS
Prevelance 3.2% dogs 1.3 % cats
Mortality 90%
JAVMA 2017 how did brachycelphalic or BCS effect respiratory thermoregulation
BCS greater determinate of body temp than breed.
Bracycephalics have decrease capacity of thermoregulation
BCS positively associated with body temp and negative association with tidal volume
JAVMA 2017 What was found in lung lobe torsions in juvienele dogs
Pugs- left cranial lung lob; Non pugs- right middle
No cartilidge change in pugs on histopath
Males overrepesented
Chylothorax assoicated with guarded prognosis
JAVMA 2017 Accuracy of POC lung ultrasound for cardiogenic pulmonary edema
Positive > 3 B-lines in a site; > 2 sites on each hemithorax
Misdiagnosis in diffuse interstitial disease, and alveolar disease
More likely CPE if 5/8 sites positive, and less likely if 2.8/8 sites
Less sens/spec than with people and cats due to primary differentials not having fluid
JAVMA 2017 How does neoplasia lead to chylothorax
direct compression of the thoracic duct or via the creation of venous hypertension
JAVMA 2017 When is mycopalsma felis assoicated with LRT disease
In non shelter cats.
Shelter cats may be carriers but not associated with disease
JAVMA 2017 What was the difference between small and large bore chest tubes in a cadaveric study
No difference in fluid recovery from pleural space
JVIM 2017 How does an obstructive fibrinous tracheal psueodomembrane occur
After intubation regardless of how easy it was to place.
NEJM 2017 How does chronic hypoxia lead to pulmonary hypertension
low PO2 leads to contraction of smooth muscle in small pulmonary arteries
NEJM 2017 How does HIF-alphachange with chronic hypoxia
promotes survival by switching from oxadative to glycolytic metabolism and promotes angiogensis
NEJM 2017 What are the Berline 2012 definition of ARDs
1) within 7 days of known insult- acute
2) bilateral opacities on radiograph/CT
3) P/F ratio: Mild 201-300 mmHg; Moderate 101-200, Severe<100
4) Min PEEP at 5 cmH20
CCM 2017 What improved mortality in mechanically ventilated pediatrics
Improvement in oxygenation but not respiratory mechanics associated with lower mortality
Goal of higher P/F ration vs Lower peak inspiratory pressure
CCM 2017 Define VILI
Ventilator induced lung injury
Mechanical strain due to exaggerated deformation at the cellular level through mechancotransduction response
JVIM 2017 How does C-reactive protein alter antibiotic therapy in pneumonia
When decrease then can deescalate therapy. Still gave 7 days post decrease for 21 days versus 35 days
JVIM 2017 what percentage of patients had resolution of alveolar infiltrated by day 10
69%. Recommended to doing radiographs; instead monitor with CRP
JVIM 2017 what was superior for deliver of drug to respiratory tract
neublizer was superior to meter dose inhaler
JVIM 2017 Respiratory antibiotic guidelines What were the indications for antibiotics in feline upper respiratory disease
Fever, lethargy, anorexia, +/- mucopurlent discharge.
Mucopurlent discharge alone does not warrent abx
JVIM 2017 Respiratory antibiotic guidelines what were the antibiotic recommendations for feline upper respiratory disease
doxycycline, amoxicillin PO
Based on culture
JVIM 2017 Respiratory antibiotic guidelines what were the recommendations for canine infectious disease complex
If bacterial suspected: Doxycycline or amoxi/clav PO
JVIM 2017 Respiratory antibiotic guidelines what were the antibiotic recommendations for pneumonia with contact with other dogs but no systemic signs
PO Doxycycline
Based on c/s when available
JVIM 2017 Respiratory antibiotic guidelines what were the antibiotic recommendations for pneumonia with or without sepsis
Parental: Fluorquinolone and penicillin/or/ clindamycin
JVIM 2017 Respiratory antibiotic guidelines what were the antibiotic recommendations for pyothorax dogs/cats
Parental: Fluorquinolone and penicillin/or/ clindamycin
Vet Journal 2018 What was the respiratory rates in healthy cats at home while sleeping vs. in clinic
Sleeping 20-40 breaths per minute
Single RR in clinic 28-176 breaths per minute
AJVR 2018 How did a tidal volume of 8 ml/kg alter CO2 in dogs with healthy lungs
Even at RR> 30 bpm had hypercapneia
AJVR 2018 at what tidal volume is PEEP necesary and why
> 15 ml/kg- Dogs have higher phisiolgical dead space. Higher volume will cause varying degrees of strain based on PEEP
JAVMA 2018 in cats with pleural effusion what was the findings that were different based on cause
Older CHF, Neoplasia
Younger, Trauma, FIP
CHF cats were hypothermic 98F
JAVMA 2018 What was the proposed mechanism for hypothermia in cats
hypoperfusion, increased AngII, cahexia
JVECC 2018 How did chest physiotherapy in dogs with pneumonia alter outcome compared to historical controls
Assisted cough and prolonged expiration
Tolerated but not survival benefit
JVIM 2018 How did a pheromon defuse alter clinical signs in cats with feline herpes
Reduced sneezing and had more sleeping
JVIM 2018 What were complications of stenting for tracheal collapse
Tracheitis (bacterial vs. inflammatory) stent fracture, stent migration, stent shortening
JVIM 2018 in evaluation of bile acids in BAL samples what was found with Westies
Even normal Westies had higher bile acids in BAL than healthy control Beagles
VetJournal 2018 In the PCR of BAL what was different between controls and eosinophilic bronchitis and chronic bronchitis
No difference in amount postivie for mycoplasma or bordetella
Eosinophic dogs with increase severity were more likely to be positive for bordetella
Inflammatory disease had higher loads of mycoplasma and bordetella
NEJM 2018 PRO ACT: How did procalcitonin guided antibiotic use differe in lower respiratory tract
No difference in precricption of or ABX days in either group
NEJM 2018 EOLIA What was the difference in mortality in ECMO vs. MV + rescue ECMO.
No 60 day mortality difference
AJVR 2019 How does negative pressure change intermittent suction with various syringe size
Increased pressure with increase volume of negative pull
Decreased pressure with larger syringe size and equal volume
Recommend >/= 20 ml syringe with only 1 ml negative
Red rubber had less negative pressure for equal size tube compared to others
JAVMA 2019 What were the complications and what percentage had them
Mucus secretions, cough aspiration, death
Mucus plug risk of obstruction 61%
Shorter survival for tracheal collapse overall 5 yrs
JAVMA 2019 For endoluminal stent was percentage were placed for tracheal collpase and what was the survial to discharge
~50% for TC
~90% survival to discharge 0-9 days
MST ~3 yrs
JVECC 2019 What was noted to interfere with SPO2 when used as at PaO2
Dysrrhythmias, hypothermia, poor perfusion, pigmentation
JVECC 2019 What is the SPO2 for a PaO2 < 80 mmHg
SPO2 93%
Do to the oxygen hemoglobin dissociate curve shifted to the right compared to people
JVECC 2019 Tissue oxygenation in canine shock How does this help predict in hemorrhagic shock
Lower tissue oxygenation in shocks us hemorrhagic shock.
Apple Full scores better predictor
JVECC 2019 In animals with ARDS what was the most common risk factor and mortatlity in this group
Dogs- pneumonia
Cats SIRS
80%
AVG 51 hrs of MV, 1 survived with medical management
JVECC 2019 in a study of animals with ARDS what was a unique necropsy finding
11/54 dogs, ARDS was diagnosis at necropsy. Either did not look or did not have signs)
JVECC 2019 Percutaneous dilation tracheostomy how may attempts to become proficent
6 practice attempts. Students were able to complete both in the same amount of time
JVECC 2019 What rate did it take high flow to acheive CPAP
1 L/kg/min, more at 2, but not as significant
JVECC 2019 in normal oxygen flow (not high flow) what FiO2 was achieved with 0.4 L/kg/min
72%
JVECC 2019 How did high flow affect PaCO2
increased form baseline
JVIM 2019 in dogs with tracheal stents what was the complication rate and what led to shorter suvival
50%
Stent fracture 600 days vs. 1200 days
Larger max tracheal diameter assoicated with fracture
JVIM 2019 How did helium O2 mixture alter flow rates
Increased airway flow during tidal breathing in both brachycephalic and mesocephalic breeds
Helium reduces resistance due to increased density
JVIM 2019 Which mycoplasma species assoicated with Lower respiratory tract disease in dogs
M. Cynos- pathogenic
JVIM 2019 What was found in irish wolfhounds with recurrent bacterial pneumonia
AVG age 5 yrs
respiratory signs only with bacterial pneumonia
Underlying dz possible LarPar, decreased esophageal motility
JVIM 2019 what are characteristics of periphreal eosinophils and underlying eitologies for eosinophilic bronchitis in dogs
Less peripheral eosinophils than in granulamatous and pneumonia
Parastic, fungal, neoplastic, inflammatory
JVIM2019 How did liposome toll like receptos work for FHV-1
Single dose resulted in less conjuctivitis and DNA sheding
NEJM 2019 PETAL ROSE Trial: Neuromuscular blockade in ARDS what was the mortatlity difference
No difference in 90 day mortality with or without blockade
Used higher PEEP in control group than in previous studies
NEJM 2019 C-reactive protien to guide abx for COPD
How did it alter abx use
lower abx use than usual care with same patient reported improvement
THe alien study 2011 what was the mortatlity difference in lung protective strategies
42% vsl 47 %
CCM 2011 Pediatrics mechanical ventilation daily test w/ spontaenous breathing what was found
Less ventilatory days (1) , despite shock being higher in the treatment group
NEJM 2010 ACURASYS How did neuromuscular blockade with cisicurium alter mortaltity
Lower 28 and 90 day mortatlity
also allowed for lower title volume and higher PEEP
AJVR 2016 quantification/ characterization of pleural fluid in healthy dogs with chest tubes
Pyothorax developed on day 4
Tubes produced 0.48 ml/kg over the 7 day peroid
< 2 ml/kg/day that has been previous reproted
6/8 dogs had positive cultures
JVECC 2007 Can ETCO2 substitue for PaCO2
ETCO2 via a nasal catheter is acceptable correlation
NEJM 2015 FLORALI ; High flow O2 through nasal cannula How did it alter care
Did not change intubation; however did decrease 90 day mortality
P/F <200 mmHg not as likely to be intubed with hiflow
JSAP 2011 What good are CT findings vs surgery in pyothorax
May be useful diagnostic tool for evaluating the nature and extent of the intra thoracic pathology
JVECC 2015 Biomarkers for differentiation of causes of respiratory disease: Is cTnI useful for cardiac vs. respiratory
Cats no
Dogs- one did not and one did studies used different analyzers
JVECC 2015 Biomarkers for differentiation of causes of respiratory disease: What breeds have increased cTnI
grehounds and boxers
JVECC 2015 Biomarkers for differentiation of causes of respiratory disease: what process besides respiratory/cardiac can increase cTnI
Blunt trauma, GDV, high intensity exercise, CKD
JVECC 2015 Biomarkers for differentiation of causes of respiratory disease: In cats how is NT-proBNP used
Cats with CKD have higher baseline (5x with ckd, up to 25x with hypertension)
pimobendan decreases
Useful in cats with respiratory distress with pleural effusion- higher with cardiac disease
JVECC 2015 Biomarkers for differentiation of causes of respiratory disease: What has endothelin-1 increased in
heart disease, arrythmias, icshemia/reprofusion , pulmonary hypertension, mmvd, and increased with pulmonary fibrosis
JVECC 2015 Biomarkers for differentiation of causes of respiratory disease: what can be used as exhaled markers
Nitric Oxide - not yet useful
Hyperbilirubinemia increases CO exhalation
H2O2 in exhaled gas marker for feline asthma
