Virginia García-Sanz, Susana Canfrán, Ignacio A. Gómez de Segura, Delia Aguado
{"title":"吸气末暂停持续时间对肺部健康的机械通气狗呼吸系统顺应性计算的影响","authors":"Virginia García-Sanz, Susana Canfrán, Ignacio A. Gómez de Segura, Delia Aguado","doi":"10.1016/j.vaa.2024.03.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To compare respiratory system compliance (<em>C</em><sub>RS</sub>), expressed per kilogram of bodyweight (<em>C</em><sub>RS</sub>BW), calculated without end-inspiratory pause (EIP) and after three EIP times (0.2, 0.5 and 1 seconds) with that after 3 second EIP (considered the reference EIP for static <em>C</em><sub>RS</sub>) and to determine the EIP times that provided <em>C</em><sub>RS</sub>BW values in acceptable agreement with static <em>C</em><sub>RS</sub>BW during controlled mechanical ventilation (CMV) in anaesthetized dogs.</p></div><div><h3>Study design</h3><p>Prospective, randomized, nonblinded, crossover clinical study.</p></div><div><h3>Animals</h3><p>A group of 24 client-owned dogs with healthy lungs undergoing surgery in lateral recumbency.</p></div><div><h3>Methods</h3><p>During CMV in dogs undergoing general anaesthesia, five EIPs [0 (no EIP), 0.2, 0.5, 1 and 3 seconds] were consecutively applied in random order. Tidal volume (V<span>t</span>) was set at 10 mL kg<sup>–1</sup> and positive end-expiratory pressure (PEEP) was not applied. Respiratory rate and inspiratory time were established according to each EIP time, setting EIP between 0 and 50% of the inspiratory time. The <em>C</em><sub>RS</sub>BW was calculated as [expired V<span>t</span>/(plateau pressure – PEEP)]/bodyweight and recorded every 15 seconds for 2 minutes after a 5 minute equilibration period with each EIP. One-way <span>anova</span> for repeated measures and the Bland–Altman analysis were used to compare <em>C</em><sub>RS</sub>BW and evaluate agreement between EIP times, respectively.</p></div><div><h3>Results</h3><p>The <em>C</em><sub>RS</sub>BW was significantly greater as the EIP time increased up to 1 second (<em>p</em> < 0.05). In the Bland–Altman analysis, none of the tested EIPs (0, 0.2, 0.5 and 1 seconds) provided 95% confidence intervals for limits of agreement within the maximum allowed difference considered for acceptable agreement with 3 second EIP.</p></div><div><h3>Conclusions</h3><p><strong>and clinical relevance</strong> An EIP ≤ to 1 second does not provide a <em>C</em><sub>RS</sub>BW value in acceptable agreement with static <em>C</em><sub>RS</sub>BW in healthy dogs. Besides, the application of an EIP ≤ to 0.5 seconds underestimates the static <em>C</em><sub>RS</sub>BW to an increasing extent as the EIP time decreases.</p></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of end-inspiratory pause duration on respiratory system compliance calculation in mechanically ventilated dogs with healthy lungs\",\"authors\":\"Virginia García-Sanz, Susana Canfrán, Ignacio A. Gómez de Segura, Delia Aguado\",\"doi\":\"10.1016/j.vaa.2024.03.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To compare respiratory system compliance (<em>C</em><sub>RS</sub>), expressed per kilogram of bodyweight (<em>C</em><sub>RS</sub>BW), calculated without end-inspiratory pause (EIP) and after three EIP times (0.2, 0.5 and 1 seconds) with that after 3 second EIP (considered the reference EIP for static <em>C</em><sub>RS</sub>) and to determine the EIP times that provided <em>C</em><sub>RS</sub>BW values in acceptable agreement with static <em>C</em><sub>RS</sub>BW during controlled mechanical ventilation (CMV) in anaesthetized dogs.</p></div><div><h3>Study design</h3><p>Prospective, randomized, nonblinded, crossover clinical study.</p></div><div><h3>Animals</h3><p>A group of 24 client-owned dogs with healthy lungs undergoing surgery in lateral recumbency.</p></div><div><h3>Methods</h3><p>During CMV in dogs undergoing general anaesthesia, five EIPs [0 (no EIP), 0.2, 0.5, 1 and 3 seconds] were consecutively applied in random order. Tidal volume (V<span>t</span>) was set at 10 mL kg<sup>–1</sup> and positive end-expiratory pressure (PEEP) was not applied. Respiratory rate and inspiratory time were established according to each EIP time, setting EIP between 0 and 50% of the inspiratory time. The <em>C</em><sub>RS</sub>BW was calculated as [expired V<span>t</span>/(plateau pressure – PEEP)]/bodyweight and recorded every 15 seconds for 2 minutes after a 5 minute equilibration period with each EIP. One-way <span>anova</span> for repeated measures and the Bland–Altman analysis were used to compare <em>C</em><sub>RS</sub>BW and evaluate agreement between EIP times, respectively.</p></div><div><h3>Results</h3><p>The <em>C</em><sub>RS</sub>BW was significantly greater as the EIP time increased up to 1 second (<em>p</em> < 0.05). In the Bland–Altman analysis, none of the tested EIPs (0, 0.2, 0.5 and 1 seconds) provided 95% confidence intervals for limits of agreement within the maximum allowed difference considered for acceptable agreement with 3 second EIP.</p></div><div><h3>Conclusions</h3><p><strong>and clinical relevance</strong> An EIP ≤ to 1 second does not provide a <em>C</em><sub>RS</sub>BW value in acceptable agreement with static <em>C</em><sub>RS</sub>BW in healthy dogs. Besides, the application of an EIP ≤ to 0.5 seconds underestimates the static <em>C</em><sub>RS</sub>BW to an increasing extent as the EIP time decreases.</p></div>\",\"PeriodicalId\":23626,\"journal\":{\"name\":\"Veterinary anaesthesia and analgesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-03-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary anaesthesia and analgesia\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1467298724000412\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary anaesthesia and analgesia","FirstCategoryId":"97","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1467298724000412","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Effect of end-inspiratory pause duration on respiratory system compliance calculation in mechanically ventilated dogs with healthy lungs
Objective
To compare respiratory system compliance (CRS), expressed per kilogram of bodyweight (CRSBW), calculated without end-inspiratory pause (EIP) and after three EIP times (0.2, 0.5 and 1 seconds) with that after 3 second EIP (considered the reference EIP for static CRS) and to determine the EIP times that provided CRSBW values in acceptable agreement with static CRSBW during controlled mechanical ventilation (CMV) in anaesthetized dogs.
A group of 24 client-owned dogs with healthy lungs undergoing surgery in lateral recumbency.
Methods
During CMV in dogs undergoing general anaesthesia, five EIPs [0 (no EIP), 0.2, 0.5, 1 and 3 seconds] were consecutively applied in random order. Tidal volume (Vt) was set at 10 mL kg–1 and positive end-expiratory pressure (PEEP) was not applied. Respiratory rate and inspiratory time were established according to each EIP time, setting EIP between 0 and 50% of the inspiratory time. The CRSBW was calculated as [expired Vt/(plateau pressure – PEEP)]/bodyweight and recorded every 15 seconds for 2 minutes after a 5 minute equilibration period with each EIP. One-way anova for repeated measures and the Bland–Altman analysis were used to compare CRSBW and evaluate agreement between EIP times, respectively.
Results
The CRSBW was significantly greater as the EIP time increased up to 1 second (p < 0.05). In the Bland–Altman analysis, none of the tested EIPs (0, 0.2, 0.5 and 1 seconds) provided 95% confidence intervals for limits of agreement within the maximum allowed difference considered for acceptable agreement with 3 second EIP.
Conclusions
and clinical relevance An EIP ≤ to 1 second does not provide a CRSBW value in acceptable agreement with static CRSBW in healthy dogs. Besides, the application of an EIP ≤ to 0.5 seconds underestimates the static CRSBW to an increasing extent as the EIP time decreases.
期刊介绍:
Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome:
the basic sciences;
pathophysiology of disease as it relates to anaesthetic management
equipment
intensive care
chemical restraint of animals including laboratory animals, wildlife and exotic animals
welfare issues associated with pain and distress
education in veterinary anaesthesia and analgesia.
Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.