Bumbacher Seline, Schramel Johannes P, Mosing Martina
Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, Vienna, Austria.
Vet Anaesth Analg. 2017 Jul;44(4):775-784. doi: 10.1016/j.vaa.2016.10.007. Epub 2017 May 8.
To evaluate three routinely used tidal volumes (V; 10, 12 and 15 mL kg) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VT) and dead space (DS).
Prospective, randomized clinical trial.
A total of 36 client-owned dogs.
Dogs were randomly allocated to a V of 10 (G), 12 (G) or 15 (G) mL kg. After induction CMV was started. End-tidal carbon dioxide tension was maintained at 4.7-5.3 kPa by changing the respiratory frequency (f; 6<f<30 breaths minute). After 29 minutes, cardiovascular and respiratory variables were recorded for 3 minutes using a multiparameter monitor, volumetric capnography (VCap) and a blood gas analyser. The ratios of VT to body weight (VT kg) and airway DS to V (VD/V), Bohr's DS (VD), Enghoff's DS (VD) and the volume of expired carbon dioxide per breath (VTCO) were calculated. Mean airway pressure (MawP), f and peak inspiratory pressure (PIP) were recorded. Data were analysed using one-way anova and Student-Newman-Keuls tests with a statistical significance set at p<0.05.
No differences were observed for demographic data and cardiovascular variables between groups. A total of three dogs were excluded because of technical difficulties and one because of f>30. VT kg (p=0.001) increased and VD (p=0.002) decreased with greater V. VTCO (p=0.017) increased and VD/V (p=0.006), VD (p=0.008) and f (p=0.002) decreased between G and G. PIP (p=0.013) was significantly higher in G compared with that in G and G. No changes were observed in MawP.
A V of 15 mL kg is most appropriate for CMV in lung-healthy dogs (as evaluated by respiratory mechanics and VCap) and does not impair cardiovascular variables.
通过评估肺泡通气量（VT）和死腔（DS），评价三种常规使用的潮气量（V；10、12和15 mL/kg）用于健康肺麻醉犬的控制机械通气（CMV）的效果。
前瞻性随机临床试验。
共36只客户拥有的犬。
将犬随机分为10（G）、12（G）或15（G）mL/kg的V组。诱导后开始CMV。通过改变呼吸频率（f；6＜f＜30次/分钟）将呼气末二氧化碳分压维持在4.7 - 5.3 kPa。29分钟后，使用多参数监护仪、容积式二氧化碳描记法（VCap）和血气分析仪记录心血管和呼吸变量3分钟。计算VT与体重之比（VT/kg）、气道DS与V之比（VD/V）、玻尔死腔（VD）、恩霍夫死腔（VD）和每呼吸周期呼出二氧化碳量（VTCO）。记录平均气道压（MawP）、f和吸气峰压（PIP）。采用单因素方差分析和Student-Newman-Keuls检验分析数据，设定统计学显著性为p＜0.05。
各组间人口统计学数据和心血管变量无差异。总共3只犬因技术困难被排除，1只因f＞30被排除。随着V增大，VT/kg（p = 0.001）增加，VD（p = 0.002）降低。G组与G组相比，VTCO（p = 0.017）增加，VD/V（p = 0.006）、VD（p = 0.008）和f（p = 0.002）降低。G组的PIP（p = 0.013）显著高于G组和G组。MawP无变化。
15 mL/kg的V最适合健康肺犬的CMV（通过呼吸力学和VCap评估），且不损害心血管变量。
