Preliminary evaluation of the use of high‐flow nasal cannula oxygen therapy during recovery from general anesthesia in dogs with obstructive upper airway breathing

Abstract

BackgroundBrachycephalic airway syndrome can pose a risk of complicated recovery from anesthesia as a result of irritation to the excess pharyngeal andlaryngeal tissue present in affected dogs. High‐flow nasal cannula (HFNC) oxygen therapy is a respiratory support modality that offers provision of continuous positive airway pressure via high gas flow rates. The HFNC system actively warms and humidifies inspired gases, which improves comfort and facilitates tolerance of the high flow rates in people and dogs. HFNC oxygen therapy was applied to brachycephalic dogs that developed increased work of breathing or hypoxemia in the recovery phase of anesthesia to determine if this device would be tolerable and effective for relief of upper respiratory difficulty.Key FindingsThe HFNC nasal prong interface is well suited to the brachycephalic facial structure. The application of HFNC was found to reduce dyspnea scores in patients with signs of upper airway obstruction after general anesthesia. Aerophagia and changes in PCO2 were noted.SignificanceApplication of HFNC in the recovery period may result in improved airflow during times of somnolent obstructive breathing, not unlike the use of continuous positive airway pressure therapy in sleep‐disordered breathing in people.

Impact of flow and temperature on non‐dyspnoeic dogs' tolerance undergoing high‐flow oxygen therapy

“…Paediatric cannulas are described to be very comfortable, easier to place and with a better accommodation to the facial structure of dogs (Jagodich et al . 2019, 2020), suggesting the same results. Moreover, dog's normal rectal temperature is 38.5°C, and the Airvo™ 2 System temperature set up is optimal for human with a normal temperature of 37.5°C.…”

“…2019, Jagodich et al . 2020). Its efficacy in increasing the arterial partial pressure of oxygen (PaO 2 ) compared to COT has also been demonstrated (Daly et al .…”

“…Described flow rates in dogs range from 0.2 to 2.5 L/kg/min (Jagodich et al . 2019, 2020; Pouzot‐Nevoret et al . 2019) or predefined flow rates of 20 to 30 L/min (Daly et al .…”

Clinical review of high-flow nasal oxygen therapy in human and veterinary patients

“…The use of post-extubation HFNOT in brachycephalic dogs has also be investigated ( 29 ). Jagodich et al's prospective study included five brachycephalic dogs with signs of upper airway obstruction in the immediate post-anesthetic period.…”

“…Dyspnoea scores and respiratory rates improved over time with stable normoxemia despite decreasing FiO 2 and flow rates. HFNOT was able to be discontinued in <12 h in 3 dogs and all dogs survived to discharge without requirement of reintubation ( 29 ). Unfortunately, the design of this study did not allow for comparison with standard treatment.…”