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Effects of vatinoxan in dogs premedicated with medetomidine and butorphanol followed by sevoflurane anaesthesia: a randomized clinical study. Vet Anaesth Analg 2022; 49:563-571. [PMID: 36115767 DOI: 10.1016/j.vaa.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate effects of vatinoxan in dogs, when administered as intravenous (IV) premedication with medetomidine and butorphanol before anaesthesia for surgical castration. STUDY DESIGN A randomized, controlled, blinded, clinical trial. ANIMALS A total of 28 client-owned dogs. METHODS Dogs were premedicated with medetomidine (0.125 mg m-2) and butorphanol (0.2 mg kg-1) (group MB; n = 14), or medetomidine (0.25 mg m-2), butorphanol (0.2 mg kg-1) and vatinoxan (5 mg m-2) (group MB-VATI; n = 14). Anaesthesia was induced 15 minutes later with propofol and maintained with sevoflurane in oxygen (targeting 1.3%). Before surgical incision, lidocaine (2 mg kg-1) was injected intratesticularly. At the end of the procedure, meloxicam (0.2 mg kg-1) was administered IV. The level of sedation, the qualities of induction, intubation and recovery, and Glasgow Composite Pain Scale short form (GCPS-SF) were assessed. Heart rate (HR), respiratory rate (fR), mean arterial pressure (MAP), end-tidal concentration of sevoflurane (Fe'Sevo) and carbon dioxide (Pe'CO2) were recorded. Blood samples were collected at 10 and 30 minutes after premedication for plasma medetomidine and butorphanol concentrations. RESULTS At the beginning of surgery, HR was 61 ± 16 and 93 ± 23 beats minute-1 (p = 0.001), and MAP was 78 ± 7 and 56 ± 7 mmHg (p = 0.001) in MB and MB-VATI groups, respectively. No differences were detected in fR, Pe'CO2, Fe'Sevo, the level of sedation, the qualities of induction, intubation and recovery, or in GCPS-SF. Plasma medetomidine concentrations were higher in group MB-VATI than in MB at 10 minutes (p = 0.002) and 30 minutes (p = 0.0001). Plasma butorphanol concentrations were not different between groups. CONCLUSIONS AND CLINICAL RELEVANCE In group MB, HR was significantly lower than in group MB-VATI. Hypotension detected in group MB-VATI during sevoflurane anaesthesia was clinically the most significant difference between groups.
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Machado ML, Soares JHN, Pypendop BH, Aguiar AJA, Braun C, Motta-Ribeiro GC, Jandre FC. Cardiovascular and Gas Exchange Effects of Individualized Positive End-Expiratory Pressures in Cats Anesthetized With Isoflurane. Front Vet Sci 2022; 9:865673. [PMID: 35601404 PMCID: PMC9114870 DOI: 10.3389/fvets.2022.865673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To compare the effects of four levels of end-expiratory pressure [zero (ZEEP) and three levels of positive end-expiratory pressure (PEEP)] on the cardiovascular system and gas exchange of cats anesthetized with isoflurane and mechanically ventilated for 3 h with a tidal volume of 10 ml/kg. Study Design Prospective, randomized, controlled trial. Animals Six healthy male neutered purpose-bred cats. Methods Anesthesia was induced with isoflurane and maintained at 1.3 minimum alveolar concentration. PEEP of maximal respiratory compliance (PEEPmaxCrs) was identified in a decremental PEEP titration, and cats were randomly ventilated for 3 h with one of the following end-expiratory pressures: ZEEP, PEEPmaxCrs minus 2 cmH2O (PEEPmaxCrs−2), PEEPmaxCrs, and PEEPmaxCrs plus 2 cmH2O (PEEPmaxCrs+2). Cardiovascular and gas exchange variables were recorded at 5, 30, 60, 120, and 180 min (T5 to T180, respectively) of ventilation and compared between and within ventilation treatments with mixed-model ANOVA followed by Dunnet's and Tukey's tests (normal distribution) or Friedman test followed by the Dunn's test (non-normal distribution). Significance to reject the null hypothesis was considered p < 0.05. Results Mean arterial pressure (MAP—mmHg) was lower in PEEPmaxCrs+2 [63 (49–69); median (range)] when compared to ZEEP [71 (67–113)] at T5 and stroke index (ml/beat/kg) was lower in PEEPmaxCrs+2 (0.70 ± 0.20; mean ± SD) than in ZEEP (0.90 ± 0.20) at T60. Cardiac index, oxygen delivery index (DO2I), systemic vascular resistance index, and shunt fraction were not significantly different between treatments. The ratio between arterial partial pressure and inspired concentration of oxygen (PaO2/FIO2) was lower in ZEEP than in the PEEP treatments at various time points. At T180, DO2I was higher when compared to T5 in PEEPmaxCrs. Dopamine was required to maintain MAP higher than 60 mmHg in one cat during PEEPmaxCrs and in three cats during PEEPmaxCrs+2. Conclusion In cats anesthetized with isoflurane and mechanically ventilated for 3 h, all levels of PEEP mildly improved gas exchange with no significant difference in DO2I when compared to ZEEP. The PEEP levels higher than PEEPmaxCrs−2 caused more cardiovascular depression, and dopamine was an effective treatment. A temporal increase in DO2I was observed in the cats ventilated with PEEPmaxCrs. The effects of these levels of PEEP on respiratory mechanics, ventilation-induced lung injury, as well as in obese and critically ill cats deserve future investigation for a better understanding of the clinical use of PEEP in this species.
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Affiliation(s)
- Marcela L. Machado
- William Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA, United States
| | - Joao H. N. Soares
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- *Correspondence: Joao H. N. Soares
| | - Bruno H. Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Antonio J. A. Aguiar
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- Departamento de Cirurgia e Anestesiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia, UNESP—Univ. Estadual Paulista, Botucatu, Brazil
| | - Christina Braun
- Anaesthesiology and Perioperative Intensive Care, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Gabriel C. Motta-Ribeiro
- Laboratory of Pulmonary and Cardiovascular Engineering, Biomedical Engineering Program/COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Frederico C. Jandre
- Laboratory of Pulmonary and Cardiovascular Engineering, Biomedical Engineering Program/COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Biomedical Instrumentation Laboratory, Biomedical Engineering Program/COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Martins ARC, Ambrósio AM, Fantoni DT, Pinto ACBCF, Villamizar-Martinez LA, Soares JHN, Otsuki DA, Malbouisson LMS. Computed Tomography Assessment of Tidal Lung Overinflation in Domestic Cats Undergoing Pressure-Controlled Mechanical Ventilation During General Anesthesia. Front Vet Sci 2022; 9:842528. [PMID: 35433898 PMCID: PMC9011143 DOI: 10.3389/fvets.2022.842528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/04/2022] [Indexed: 11/22/2022] Open
Abstract
Objective This study aimed to evaluate lung overinflation at different airway inspiratory pressure levels using computed tomography in cats undergoing general anesthesia. Study Design Prospective laboratory study. Animals A group of 17 healthy male cats, aged 1.9–4.5 years and weighing 3.5 ± 0.5 kg. Methods Seventeen adult male cats were ventilated in pressure-controlled mode with airway pressure stepwise increased from 5 to 15 cmH2O in 2 cmH2O steps every 5 min and then stepwise decreased. The respiratory rate was set at 15 movements per min and end-expiratory pressure at zero (ZEEP). After 5 min in each inspiratory pressure step, a 4 s inspiratory pause was performed to obtain a thoracic juxta-diaphragmatic single slice helical CT image and to collect respiratory mechanics data and an arterial blood sample. Lung parenchyma aeration was defined as overinflated, normally-aerated, poorly-aerated, and non-aerated according to the CT attenuation number (−1,000 to −900 HU, −900 to −500 HU, −500 to −100 HU, and −100 to +100 HU, respectively). Result At 5 cmH2O airway pressure, tidal volume was 6.7± 2.2 ml kg−1, 2.1% (0.3–6.3%) of the pulmonary parenchyma was overinflated and 84.9% (77.6%−87.6%) was normally inflated. Increases in airway pressure were associated with progressive distention of the lung parenchyma. At 15 cmH2O airway pressure, tidal volume increased to 31.5± 9.9 ml kg−1 (p < 0.001), overinflated pulmonary parenchyma increased to 28.4% (21.2–30.6%) (p < 0.001), while normally inflated parenchyma decreased 57.9% (53.4–62.8%) (p < 0.001). Tidal volume and overinflated lung fraction returned to baseline when airway pressure was decreased. A progressive decrease was observed in arterial carbon dioxide partial pressure (PaCO2) and end-tidal carbon dioxide (ETCO2) when the airway pressures were increased above 9 cmH2O (p < 0.001). The increase in airway pressure promoted an elevation in pH (p < 0.001). Conclusions and Clinical Relevance Ventilation with 5 and 7 cmH2O of airway pressure prevents overinflation in healthy cats with highly compliant chest walls, despite presenting acidemia by respiratory acidosis. This fact can be controlled by increasing or decreasing respiratory rate and inspiratory time.
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Affiliation(s)
| | - Aline M. Ambrósio
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Denise T. Fantoni
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Ana Carolina B. C. F. Pinto
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | | | - João H. N. Soares
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, United States
| | - Denise A. Otsuki
- Discipline of Anesthesiology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- *Correspondence: Denise A. Otsuki
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Donati P, Londoño LA, Tunes M, Villalta C, Guillemi EC. Retrospective evaluation of the use of quick Sepsis-related Organ Failure Assessment (qSOFA) as predictor of mortality and length of hospitalization in dogs with pyometra (2013-2019): 52 cases. J Vet Emerg Crit Care (San Antonio) 2022; 32:223-228. [PMID: 35166423 DOI: 10.1111/vec.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/04/2020] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the prognostic utility of quick Sepsis-related Organ Failure Assessment (qSOFA) for prediction of in-hospital mortality and length of hospitalization in dogs with pyometra. DESIGN Retrospective cohort study from February 2013 to April 2019 SETTING: Tertiary referral hospital ANIMALS: Fifty-two dogs referred with confirmed diagnosis of pyometra INTERVENTIONS: None MEASUREMENTS AND PRINCIPAL OUTCOMES: Sixty-five percent of dogs survived to discharge. A cut-off score of ≥2 for qSOFA was associated with in-hospital mortality (odds ratio 6.51 [95% CI: 1.35 - 31.3]) P = 0.019. The area under the receiver operator characteristic curve for a qSOFA score ≥ 2 for mortality was 0.72 (95% CI: 0.59-0.85), with a sensitivity of 77.8% and a specificity of 66.7%. The mean ± SD number of organs with dysfunction was significantly higher in dogs with a qSOFA score ≥2 1.76 ± 0.83 compared to dogs with a qSOFA score < 2 1.08 ± 1.09, P = 0.015. The presence of a qSOFA score ≥ 2 was associated with a longer time of hospitalization in survivors with a median (interquartile range) length of stay in qSOFA < 2 (48 [33]) hours versus qSOFA score ≥ 2 (78 [52]) hours, P = 0.027. CONCLUSIONS In dogs with pyometra, the qSOFA score was associated with mortality and length of hospitalization. This score might be useful to improve the risk stratification in dogs with pyometra. Further studies are necessary to evaluate the predictive capacity of qSOFA in other septic patient populations.
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Affiliation(s)
| | - Leonel A Londoño
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA
| | | | - Cesar Villalta
- Clínica Veterinaria VET`S, Suecia 3580, Providencia, Santiago, Chile
| | - Eliana C Guillemi
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Machado ML, Soares JHN, Pypendop BH, Henao-Guerrero N, Oliveira RLS. Effect of fentanyl, with or without treatment of bradycardia, on the minimum alveolar concentration of isoflurane and cardiovascular function in dogs. Vet Anaesth Analg 2021; 49:26-35. [PMID: 34654643 DOI: 10.1016/j.vaa.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the effect of fentanyl on the minimum alveolar concentration of isoflurane (MACISO) and cardiovascular variables in dogs, and how the treatment of bradycardia affects them. STUDY DESIGN Prospective, randomized crossover-controlled trial. ANIMALS A total of six male Beagle dogs weighing 9.9 ± 0.7 kg (mean ± standard deviation) and aged 13 months. METHODS To each dog, two treatments were assigned on different days: fentanyl (FENTA) or fentanyl plus glycopyrrolate (FENTAglyco) to maintain heart rate (HR) between 100 and 132 beats minute-1. Determinations of MACISO were performed with 10 plasma fentanyl target concentrations ([Fenta]Target (0, 0.16, 0.32, 0.64, 1.25, 2.5, 5.0, 10.0, 20.0 and 40.0 ng mL-1) for FENTA and 5 [Fenta]Target (0, 1.25, 2.5, 5.0, 10.0 ng mL-1)) for FENTAglyco. During each MACISO determination, cardiovascular variables [mean arterial pressure (MAP), HR and cardiac index (CI)] were measured, and systemic vascular resistance index (SVRI) calculated. Pharmacodynamic models were used to describe the plasma fentanyl concentration [Fenta]-response relationship for the effect on MACISO and cardiovascular variables. A mixed-model analysis of variance followed by Dunnett's or Tukey's test, and the Bonferroni adjustment were used for comparisons within and between each treatment, respectively. Significance was set as p < 0.05. RESULTS Fentanyl decreased MACISO by a maximum of 84%. The [Fenta] producing 50% decrease in MAC, HR and CI were 2.64, 3.65 and 4.30 ng mL-1 (typical values of population model), respectively. The prevention of fentanyl-mediated bradycardia caused no significant effect on MACISO, but increased HR, MAP and CI, and decreased SVRI when compared with isoflurane alone. CONCLUSIONS AND CLINICAL RELEVANCE Fentanyl caused a plasma concentration-dependent decrease in MACISO, HR and CI and an increase in SVRI. Cardiovascular improvements associated with fentanyl in isoflurane-anesthetized dogs only occurred when the fentanyl-mediated bradycardia was prevented.
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Affiliation(s)
- Marcela L Machado
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Joao H N Soares
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.
| | - Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Natalia Henao-Guerrero
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Renato L S Oliveira
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
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Donati PA, Gogniat E, Madorno M, Guevara JM, Guillemi EC, Lavalle MDC, Scorza FP, Mayer GF, Rodriguez PO. Sizing the lung in dogs: the inspiratory capacity defines the tidal volume. Rev Bras Ter Intensiva 2018; 30:144-152. [PMID: 29995078 PMCID: PMC6031426 DOI: 10.5935/0103-507x.20180028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/10/2018] [Indexed: 11/20/2022] Open
Abstract
Objective To evaluate a novel physiological approach for setting the tidal volume in
mechanical ventilation according to inspiratory capacity, and to determine
if it results in an appropriate mechanical and gas exchange measurements in
healthy and critically ill dogs. Methods Twenty healthy animals were included in the study to assess the tidal volume
expressed as a percentage of inspiratory capacity. For inspiratory capacity
measurement, the mechanical ventilator was set as follows: pressure control
mode with 35cmH2O of inspired pressure and zero end-expiratory
pressure for 5 seconds. Subsequently, the animals were randomized into four
groups and ventilated with a tidal volume corresponding to the different
percentages of inspiratory capacity. Subsequently, ten critically ill dogs
were studied. Results Healthy dogs ventilated with a tidal volume of 17% of the inspiratory
capacity showed normal respiratory mechanics and presented expected
PaCO2 values more frequently than the other groups. The
respiratory system and transpulmonary driving pressure were significantly
higher among the critically ill dogs but below 15 cmH2O in all
cases. Conclusions The tidal volume based on the inspiratory capacity of each animal has proven
to be a useful and simple tool when setting ventilator parameters. A similar
approach should also be evaluated in other species, including human beings,
if we consider the potential limitations of tidal volume titration based on
the calculated ideal body weight.
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Affiliation(s)
| | - Emiliano Gogniat
- Unidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina
| | - Matías Madorno
- Instituto Tecnológico de Buenos Aires - Buenos Aires, Argentina
| | | | | | | | | | - Germán Federico Mayer
- Unidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina
| | - Pablo Oscar Rodriguez
- Unidade de Terapia Intensiva, Centro de Educación Médica e Investigaciones Clínicas - Buenos Aires, Argentina
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Peripherally acting α-adrenoceptor antagonist MK-467 with intramuscular medetomidine and butorphanol in dogs: A prospective, randomised, clinical trial. Vet J 2018; 240:22-26. [DOI: 10.1016/j.tvjl.2018.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/28/2018] [Accepted: 08/12/2018] [Indexed: 11/21/2022]
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Martin-Flores M, Sakai DM, Honkavaara J, Campoy L, Portela DA, Gleed RD. Hemodynamic effects of MK-467 following intravenous administration to isoflurane-anesthetized cats concurrently receiving dexmedetomidine. Am J Vet Res 2018; 79:711-717. [DOI: 10.2460/ajvr.79.7.711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
This review attempts to provide insights into factors associated with fatigue in human and nonhuman animals by using the two fundamental approaches of comparative physiology: determining common principles that govern structure and function in animals that are relatively invariant between animals and evaluating animals that have been highly adapted by natural selection to demonstrate extreme performance. In this review, I approach the topic of fatigue by considering factors that are associated with its reciprocal or inverse or duration of sustained performance before fatigue sets in to end the performance. The two general factors that I consider that affect endurance time more than any other are body temperature and body mass. The former affects endurance time because of thermodynamic effects on chemical reaction rates and metabolism; the latter acts through the mechanism of allometry or scaling. The examples of extreme animal performance that I discuss are two examples of bird migration, the diving performance of marine mammals, and the unique relationship that governs energy cost of locomotion in hopping kangaroos.
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Affiliation(s)
- James H Jones
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
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