Ventilation Flashcards
Problems in equine ventilation
- hypercapnia
- hypoxaemia
- hypotension
Hypercapnia definition
high arterial CO2 levels due to respiratory depression
What causes hypoventilation?
- sedatives
- opioids
- IV anaesthetics
- muscle relaxants
- positioning (horse on side for a long time)
How do you asses hypercapnia?
- take multiple blood samples
- monitor end tidal CO2 alveolar gas analysis (machine): less accaurate but less invasive
Benefits and adverse effects of hypercapnia
Benefits:
-improved sympathetic stimulation leads to increased myocardial contractility and improved tissue blood flow.
disadvantages:
- increased incidence of cardiac arrhythmia’s
- acidaemia (leads to enzyme dysfunction and reduced myocardial contractility)
- narcosis
- hypoxaemia
What is normal blood pH?
7.35-7.45
PaCO2 of 80mmHg will decrease it to less than 7.2
Treatment of hypercapnia
- reduce anaesthetic depth
- IPPV
Hypoxaemia definition
low blood oxygen
SpO2 vs PaO2
SpO2: haemoglobin oxygen saturation as measured by a pulse oximeter
PaO2 partial pressure of oxygen in arterial blood
as PaO2 decreases, SpO2 will decrease.
at SpO2 of 90% an animal will have PaO2 of 60mmHg (below this they are hypoxaemic!)
Causes of hypoaxaemia?
- low inspired O2 (check equipment!)
- hypoventilation*
- VQ mismatch*
- diffusion impairment (e.g. pulmonary oedema thickens barrier)
- shunt
*most common
What is a closing capacity and what does it have to do with hypoaemia?
when you breath out maximally and approach your residual volume and the small airways in lower part of lungs begin to close.
collapse of airways causes ventilation perfusion mismatching and may lead to hypoxaemia
Why do alveoli collapse in the horse?
-dorsal recumbency is not a natural position for the horse
the added weight of viscera causes FRC causing atelectasis and approaches closing capacity
it is a big problem in the horse as the have a large dorsal lung area due to them being athletes (this is where perfusion occurs and if these areas collapse O2 can not cross over the barrier)
why does perfusion (Q) change?
- gravity influences
- reduced cardiac output due to decreased contractility /HR
- vasodialtion (due to anaesthesia)
How to avoid VQ mismatch?
- positioning
- IPPV
- give O2 AND air (N2 and O2) will prevent absorption atelectasis
Treatment of VQ mismatch
IPPV improves V
drugs can help with Q