RESUMEN
OBJECTIVE: To compare the portion of tidal volume (VT) ventilating dead space volumes in nonbrachycephalic cats and dogs with small body mass receiving volume-controlled ventilation (VCV) with a fixed VT. STUDY DESIGN: Prospective, experimental study. ANIMALS: A group of eight healthy adult cats and dogs [ideal body weight (IBW): 3.0 ± 0.5 and 3.8 ± 1.1 kg, respectively]. METHODS: Anesthetized cats and dogs received VCV with a 12 mL kg-1 VT (inspiratory pause ≥ 0.5 seconds). Respiratory rate (fR) was adjusted to maintain normocapnia. Airway dead space (VDaw) and alveolar tidal volume (VTalv) were measured by volumetric capnography. Physiological dead space (VDphys) and VDphys/VT ratio were calculated using the Bohr-Enghoff method. Data recorded before surgery were compared by an unpaired t-test or Mann-Whitney U test (p < 0.05 considered significant). RESULTS: The IBW (p = 0.07), PaCO2 (p = 0.40) and expired VT [VT(exp)] (p = 0.77) did not differ significantly between species. The VDaw (mL kg-1) was lower in cats (3.7 ± 0.4) than in dogs (7.7 ± 0.9) (p < 0.0001). The VTalv (mL kg-1) was larger in cats (8.3 ± 0.7) than in dogs (4.3 ± 0.7) (p < 0.0001). Cats presented a smaller VDphys/VT ratio (0.33 ± 0.03) and VDphys (4.0 ± 0.3 mL kg-1) than dogs (VDphys/VT: 0.60 ± 0.09; VDphys: 7.2 ± 1.4 mL kg-1) (p < 0.0001). The fR and minute ventilation (VT(exp) × fR) were lower in cats than in dogs (p = 0.048 and p = 0.038, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: A fixed VT results in more effective ventilation in cats than in dogs with small body mass because of species-specific differences in and VDaw and VDphys. Because of the smaller VDaw and VDphys in cats than in dogs, a lower fR is required to maintain normocapnia in cats.
RESUMEN
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.
RESUMEN
OBJECTIVE: To determine the analgesic and systemic effects of thoracic epidural administration of ketamine, lidocaine, or both in conscious dogs. ANIMALS: 6 adult mixed-breed dogs. PROCEDURES: Each dog received 2% lidocaine hydrochloride without epinephrine (3.8 mg/kg), 5% ketamine hydrochloride (3.0 mg/kg), or both in randomized order with ≥ 1 week between treatments. Drugs were administered in a total volume of 0.25 mL/kg through a thoracic epidural catheter implanted via the lumbosacral approach. Heart rate, blood pressure, respiratory rate, rectal temperature, analgesia, sedation, and ataxia were determined before treatment (baseline [time 0]) and at 5, 10, 15, 20, 30, 40, 50, 60, 90, 120, 150, and 180 minutes after administration. RESULTS: The main areas of analgesia for the 3 treatments were the thorax and forelimbs bilaterally. Median duration of analgesia was shorter after administration of ketamine (30 minutes) than after administration of lidocaine (40 minutes) and lidocaine plus ketamine (90 minutes). All treatments caused moderate motor blockade, and only the ketamine and lidocaine plus ketamine treatments caused mild sedation. Significant decreases in systolic and mean arterial blood pressure were observed only with the lidocaine plus ketamine treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Thoracic epidural administration of lidocaine plus ketamine resulted in longer duration of analgesia of the thorax and forelimbs bilaterally in conscious dogs, compared with administration of ketamine or lidocaine alone. Additional studies are needed to determine whether this technique adequately relieves postoperative pain after thoracic surgical procedures and whether it causes respiratory depression in dogs.