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对重症监护病房住院的气道积液犬的一种新的胸部物理治疗技术的评估。

Evaluation of a new chest physiotherapy technique in dogs with airway fluid accumulation hospitalized in an intensive care unit.

作者信息

Pouzot-Nevoret Céline, Goy-Thollot Isabelle, Billet Didier, Barthélemy Anthony, Blesch Maïlys, Pin Aurélie, Hopper Kate

机构信息

Intensive Care Unit (SIAMU).

APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis.

出版信息

J Vet Emerg Crit Care (San Antonio). 2018 May;28(3):213-220. doi: 10.1111/vec.12713. Epub 2018 Apr 12.

Abstract

OBJECTIVE

To evaluate the feasibility, benefits, and adverse effects of prolonged slow expiration (PSE) and assisted cough (AC) as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation.

DESIGN

Prospective interventional study.

SETTINGS

University teaching hospital.

ANIMALS

Intervention group of 30 client-owned dogs and retrospective control group of 71 client-owned dogs.

INTERVENTIONS

PSE was performed on dogs with evidence of airway fluid accumulation, identified based on physical examination and thoracic radiographs. AC was performed if spontaneous cough or swallowing were not evident. The PSE treatment was performed every 6 hours until normalization of respiratory status or hospital discharge. Animals were monitored for respiratory distress, discomfort, and SpO during the procedure. A retrospective control group was identified by computer search.

MEASUREMENTS AND MAIN RESULTS

One hundred thirty-three sessions of CP were performed on 30 dogs. Discomfort frequency during physiotherapy was low (9%). The most commonly used position for CP was in lateral recumbency (95%) and this was well tolerated in most cases. There was no significant difference in the median SpO before and after CP sessions (P = 0.24). Sixty percent of sessions had a spontaneous cough or swallowing evident, 21% had successful AC performed, and no cough or swallowing occurred in the remaining (19%) sessions despite attempts of AC being made. The length of hospitalization was significantly longer in the intervention group (6 days vs 4) (P = 0.02). There was no difference in survival between the intervention (76.7%) and the control (57.7%) group (P = 0.055).

CONCLUSIONS

PSE associated with AC are easily adaptable, well-tolerated techniques in dogs. The benefit of CP in dogs with airway fluid accumulation remains to be determined and it is hoped that future randomized controlled prospective studies may help answer this line of inquiry.

摘要

目的

评估延长缓慢呼气(PSE)和辅助咳嗽(AC)作为气道积液犬胸部物理治疗(CP)技术的可行性、益处及不良反应。

设计

前瞻性干预研究。

地点

大学教学医院。

动物

30只客户拥有犬的干预组和71只客户拥有犬的回顾性对照组。

干预措施

对经体格检查和胸部X线片证实存在气道积液的犬进行PSE。若未观察到自发咳嗽或吞咽,则进行AC。PSE治疗每6小时进行一次,直至呼吸状态恢复正常或出院。在操作过程中监测动物的呼吸窘迫、不适及血氧饱和度(SpO)。通过计算机检索确定回顾性对照组。

测量指标及主要结果

对30只犬进行了133次CP治疗。物理治疗期间不适发生率较低(9%)。CP最常用的体位是侧卧位(95%),大多数情况下耐受性良好。CP治疗前后SpO的中位数无显著差异(P = 0.24)。60%的治疗有明显的自发咳嗽或吞咽,21%的治疗成功进行了AC,其余19%的治疗尽管尝试进行AC但未出现咳嗽或吞咽。干预组的住院时间显著更长(6天对4天)(P = 0.02)。干预组(76.7%)和对照组(57.7%)的生存率无差异(P = 0.055)。

结论

PSE联合AC是犬类易于采用且耐受性良好的技术。CP对气道积液犬的益处仍有待确定,希望未来的随机对照前瞻性研究能有助于回答这一问题。

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