Effects of continuous positive airway pressure on respiratory function in sedated foals

Raidal, Sharanne; McKean, Rosemary; Ellul, Paula A.; Nielsen, Sharon; Quinn, Christopher T.

doi:10.1111/vec.12816

Cited by 8 publications

(37 citation statements)

References 25 publications

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“…Increased Vt represents a more efficient ventilation strategy than increased RR, as there is increased alveolar ventilation relative to ventilation of airway dead space, and decreased RR is likely to be associated with decreased work of breathing. Increased inspiratory pressure during biPAP was associated with increased PIF, and the adverse effects on PEF observed during CPAP in previous studies (13) were not observed in the current study, presumably due to the lower expiratory pressures during biPAP ventilation. As expected, increased FiO 2 was observed during mask administration of supplementary O 2 and during biPAP, so observed increases in arterial oxygenation likely reflect the steeper diffusion gradient resulting from these changes.…”

Section: Discussionsupporting

confidence: 59%

“…Previous studies have demonstrated that CPAP is associated with improved respiratory function in a number of veterinary species (9–12). CPAP has recently been shown to improve gas exchange in healthy foals with pharmacologically induced respiratory suppression (13), however hypercapnia was observed in treated foals in this study, and has been observed previously in anaesthetised horses during CPAP (10, 11, 14).…”

Section: Introductionsupporting

confidence: 46%

“…Increased PaCO 2 was observed in Group 3 foals following respiratory support, including hypercapnia (PaCO 2 > 60 mmHg) following O 2 administration (two foals) or biPAP (one foal). Hypercapnia has been reported in response to O 2 supplementation in human neonates (28) and foals (13, 29), and may be due to reduced respiratory drive, increased metabolic rate, hypoventilation due to sedation or effects of equipment dead space. As noted above, mask administration of supplementary O 2 was associated with the accumulation of CO 2 within equipment dead space (rebreathing) in the current study, but this was not observed during biPAP.…”

Section: Discussionmentioning

confidence: 99%

“…Blood gas analysis was performed as described for Group 1 foals. Spirometry was performed on standing foals as previously described (Raidal, McKean et al 2019) by application of a large veterinary anaesthesia mask (SurgiVet large canine mask, product number 32393B1; Sound Veterinary Equipment, Rowville, Australia) placed on the foal's muzzle in such a way as to exclude air leaks and to minimise dead space, but not prevent opening of the nares. A respiratory flow head (Respiratory Flow Head 300 L, MLT300L, ADInstruments, Bella Vista, Australia) and gas sampling port were connected to the anaesthesia mask.…”

Section: Group 3 (Healthy Foals Pharmacological Induction Of Respiramentioning

confidence: 99%

“…Previous studies have demonstrated that CPAP is associated with improved respiratory function in a number of veterinary species (9)(10)(11)(12). CPAP has recently been shown to improve gas exchange in healthy foals with pharmacologically induced respiratory suppression (13), however hypercapnia was observed in treated foals in this study, and has been observed previously in anaesthetised horses during CPAP (10,11,14). Bi-level positive airway pressure (biPAP) is also recognised for the management of respiratory insufficiency in human neonates, and has recently demonstrated improved treatment outcomes in preterm human neonates in comparison to CPAP (15,16).…”

Section: Introductionmentioning

confidence: 99%

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Bi-level positive airway pressure (biPAP) for non-invasive respiratory support of foals

Raidal

Burgemeestre

Catanchin

et al. 2020

Preprint

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Respiratory insufficiency and pulmonary health are important considerations in equine neonatal care, as the majority of foals are bred for athletic function. The administration of supplementary oxygen is readily implemented in equine practice settings, but this does not address respiratory insufficiency due to inadequate ventilation and is no longer considered optimal care for hypoxia in some settings. Non-invasive ventilatory strategies including continuous or bi-level positive airway pressure are effective in human and veterinary studies, and may offer improved respiratory support in equine clinical practice. The current study was conducted in two parts to investigate the use of a commercial bilevel positive airway pressure (biPAP) ventilator, designed for home care of people with obstructive respiratory conditions, for respiratory support of foals. In Part 1 a prospective observational study was conducted to evaluate the effect of sequential application of supplementary oxygen and then biPAP for respiratory support of five foals ≤ 4 days of age hospitalised with respiratory in sufficiency (Group 1) and four healthy, sedated foals < 28 days of age (Group 2). In Part 2, biPAP and supplementary oxygen were administered to six healthy foals with pharmacologically induced respiratory insufficiency in a two sequence, two phase, cross-over study (Group 3). Non-invasive ventilation by biPAP improved gas exchange and mechanics of breathing (increased tidal volume, decreased respiratory rate and increased peak inspiratory flow) in foals, but modest hypercapnia was observed in healthy, sedated foals (Groups 2 and 3). Clinical cases (Group 1) appeared less likely to develop hypercapnia in response to treatment, however the response in individual foals was variable, and close monitoring is necessary. Clinical observations, pulse oximetry and CO2 monitoring of expired gases were of limited benefit in identification of foals responding inappropriately to biPAP, and improved methods to assess and monitor respiratory function are required in foals.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Group 3 (Healthy Foals Pharmacological Induction Of Respiramentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Bi-level positive airway pressure (biPAP) for non-invasive respiratory support of foals

Raidal

Burgemeestre

Catanchin

et al. 2020

Preprint

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Nasal high flow oxygen therapy in hospitalised neonatal foals

Floyd

Danks²,

Comyn

et al. 2021

Equine Veterinary Journal

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Supplemental oxygen is commonly administered to critically ill neonatal foals via nasal canulae. 1 However, some foals remain hypoxaemic despite conventional oxygen therapy and require a greater degree of respiratory support. Mechanical ventilation (MV) can be used 1,2 but requires specialist equipment, expertise and facilities.Mechanical ventilation can also be associated with complications such as barotrauma, nosocomial infection and may not be well tolerated by the patient.In human neonatal care, non-invasive ventilation is commonly used due to concerns about long-term adverse effects of MV such as bronchopulmonary dysplasia (BPD) in pre-term infants. 3 Multiple techniques can be used to provide non-invasive ventilation which includes continuous positive airway pressure (CPAP) and HFOT. 4 The use of CPAP has been recently described in neonatal foals with pharmacologically induced respiratory suppression with encouraging results. 5 In human neonatal care, conflicting evidence exists as to which method of NIV is superior. 6 In humans, the use of CPAP can be associated with complications such as nasal trauma and

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Effects of 2 modes of positive pressure ventilation on respiratory mechanics and gas exchange in foals

Raidal

Catanchin

Sacks

et al. 2023

Veterinary Internal Medicne

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Background: Continuous positive airway pressure (CPAP) and pressure support ventilation (PSV) can improve respiratory mechanics and gas exchange, but different airway pressures have not been compared in foals.Hypothesis/Objectives: Assess the effect of different airway pressures during CPAP and PSV have on respiratory function in healthy foals with pharmacologically induced respiratory insufficiency. We hypothesized that increased airway pressures would improve respiratory mechanics and increased positive end-expiratory pressure (PEEP) would be associated with hypercapnia.Animals: Six healthy foals from a university teaching herd. Methods: A prospective, 2-phase, 2-treatment, randomized cross-over study design was used to evaluate sequential interventions in sedated foals using 2 protocols (CPAP and PSV). Outcome measures included arterial blood gases, spirometry, volumetric capnography, lung volume and aeration assessed using computed tomography (CT). Results: Sedation and dorsal recumbency were associated with significant reductions in arterial oxygen pressure (PaO 2 ), respiratory rate, and tidal volume. Continuous positive airway pressure was associated with improved PaO 2 , without concurrent hypercapnia. Volumetric capnography identified improved ventilation:perfusion (V/Q) matching and increased carbon dioxide elimination during ventilation, and spirometry identified decreased respiratory rate and increased tidal volume. Peak inspiratory pressure was moderately associated with PaO 2 and lung volume. Improved pulmonary aeration was evident in CT images, and lung volume was increased, particularly during CPAP.

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Effects of continuous positive airway pressure on respiratory function in sedated foals

Cited by 8 publications

References 25 publications

Bi-level positive airway pressure (biPAP) for non-invasive respiratory support of foals

Bi-level positive airway pressure (biPAP) for non-invasive respiratory support of foals

Nasal high flow oxygen therapy in hospitalised neonatal foals

Effects of 2 modes of positive pressure ventilation on respiratory mechanics and gas exchange in foals

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