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应用电阻抗断层成像技术测量健康马和左侧心腔容量超负荷马的肺通气分布。

Electrical impedance tomography to measure lung ventilation distribution in healthy horses and horses with left-sided cardiac volume overload.

机构信息

School of Veterinary Medicine, Murdoch University, Perth, Australia.

Equine Clinic, Department for Equine Medicine, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland.

出版信息

J Vet Intern Med. 2021 Sep;35(5):2511-2523. doi: 10.1111/jvim.16227. Epub 2021 Aug 4.

Abstract

BACKGROUND

Left-sided cardiac volume overload (LCVO) can cause fluid accumulation in lung tissue changing the distribution of ventilation, which can be evaluated by electrical impedance tomography (EIT).

OBJECTIVES

To describe and compare EIT variables in horses with naturally occurring compensated and decompensated LCVO and compare them to a healthy cohort.

ANIMALS

Fourteen adult horses, including university teaching horses and clinical cases (healthy: 8; LCVO: 4 compensated, 2 decompensated).

METHODS

In this prospective cohort study, EIT was used in standing, unsedated horses and analyzed for conventional variables, ventilated right (VAR) and left (VAL) lung area, linear-plane distribution variables (avg-max VΔZ , VΔZ ), global peak flows, inhomogeneity factor, and estimated tidal volume. Horses with decompensated LCVO were assessed before and after administration of furosemide. Variables for healthy and LCVO-affected horses were compared using a Mann-Whitney test or unpaired t-test and observations from compensated and decompensated horses are reported.

RESULTS

Compared to the healthy horses, the LCVO cohort had significantly less VAL (mean difference 3.02; 95% confidence interval .77-5.2; P = .02), more VAR (-1.13; -2.18 to -.08; P = .04), smaller avg-max VΔZL (2.54; 1.07-4.00; P = .003) and VΔZL (median difference 5.40; 1.71-9.09; P = .01). Observation of EIT alterations were reflected by clinical signs in horses with decompensated LCVO and after administration of furosemide.

CONCLUSIONS AND CLINICAL IMPORTANCE

EIT measurements of ventilation distribution showed less ventilation in the left lung of horses with LCVO and might be useful as an objective assessment of the ventilation effects of cardiogenic pulmonary disease in horses.

摘要

背景

左侧心脏容量超负荷(LCVO)可导致肺组织内液体积聚,改变通气分布,这可通过电阻抗断层成像(EIT)进行评估。

目的

描述并比较自然发生的代偿性和失代偿性 LCVO 马的 EIT 变量,并与健康马群进行比较。

动物

14 匹成年马,包括大学教学马和临床病例(健康:8 匹;LCVO:4 匹代偿性,2 匹失代偿性)。

方法

在这项前瞻性队列研究中,使用站立、未镇静的 EIT 对马匹进行检测,并对常规变量、通气右侧(VAR)和左侧(VAL)肺区、线性平面分布变量(平均-最大 VΔZ、VΔZ)、整体峰值流量、不均匀性因子和估计潮气量进行分析。对失代偿性 LCVO 马在给予呋塞米前后进行评估。使用 Mann-Whitney 检验或未配对 t 检验比较健康和 LCVO 马的变量,并报告代偿性和失代偿性马的观察结果。

结果

与健康马相比,LCVO 马的 VAL 明显减少(平均差异 3.02;95%置信区间.77-5.2;P =.02),VAR 增加(-1.13;-2.18 至 -.08;P =.04),平均-最大 VΔZL 变小(2.54;1.07-4.00;P =.003),VΔZL 变小(中位数差异 5.40;1.71-9.09;P =.01)。失代偿性 LCVO 马的临床症状和给予呋塞米后,EIT 改变的观察结果得到了反映。

结论和临床意义

LCVO 马的通气分布 EIT 测量显示左肺通气减少,这可能是评估马心源性肺病通气影响的一种有用的客观方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a61d/8478054/74b82e92512b/JVIM-35-2511-g005.jpg

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