Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Vet Anaesth Analg. 2022 Jul;49(4):382-389. doi: 10.1016/j.vaa.2022.04.004. Epub 2022 Apr 21.
To determine changes in distribution of lung ventilation with increasing intra-abdominal pressure (IAP) from carbon dioxide (CO) insufflation in standing sedated horses.
Prospective experimental study.
A group of six healthy adult horses.
Each horse was sedated with acepromazine, detomidine and butorphanol and sedation maintained with a detomidine infusion. The horse was restrained in a stocks system and a 32 electrode electrical impedance tomography (EIT) belt was wrapped around the thorax at the fifth-sixth intercostal space. EIT images and arterial blood samples for PaO and PaCO, pH and lactate concentration were obtained during capnoperitoneum at 0 (baseline A), 5, 8 and 12 mmHg as IAP increased and at 8, 5, 0 (baseline B) mmHg as IAP decreased. At each IAP, after a 2 minute stabilization period, EIT images were recorded for ≥ 2 minutes to obtain five consecutive breaths. Statistical analysis was performed using anova for repeated measures with Geisser-Greenhouse correction and a Tukey's multiple comparison test for parametric data. The relationship between PaO and the center of ventilation in the ventral-dorsal (CoV-VD) and right-left (CoV-RL) directions or total impedance change as a surrogate for tidal volume (ΔZV) were tested using linear regression analysis. Significance was assumed when p ≤ 0.05.
There were no significant changes in CoV-VD, CoV-RL, PaO, PaCO, lactate concentration, pH, heart rate and respiratory rate with targeted IAP. There was a significant decrease in ΔZV compared with baseline A at 5 mmHg IAP as IAP was increased.
Capnoperitoneum causes a significant decrease in ΔZV in standing sedated horses with increasing IAP.
在站立镇静马中，通过二氧化碳（CO）充气来确定随着腹内压（IAP）升高，肺通气分布的变化。
前瞻性实验研究。
一组六匹健康成年马。
每匹马用乙酰丙嗪、地托咪定和布托啡诺镇静，并通过地托咪定输注维持镇静。马被束缚在一个马厩系统中，在第五六肋间隙周围包裹一个 32 电极电阻抗断层成像（EIT）带。在气腹时，在 IAP 增加到 0（基线 A）、5、8 和 12mmHg 时，在 IAP 降低到 8、5、0（基线 B）mmHg 时，获得 EIT 图像和动脉血气样本，用于 PaO 和 PaCO、pH 和乳酸浓度。在每个 IAP 下，在 2 分钟稳定期后，记录 EIT 图像≥2 分钟，以获得 5 次连续呼吸。使用重复测量方差分析和 Geisser-Greenhouse 校正进行统计分析，对于参数数据使用 Tukey 的多重比较检验。使用线性回归分析测试 PaO 与腹背（CoV-VD）和左右（CoV-RL）方向的通气中心或作为潮气量（ΔZV）替代的总阻抗变化之间的关系。当 p≤0.05 时，认为差异具有统计学意义。
在目标 IAP 下，CoV-VD、CoV-RL、PaO、PaCO、乳酸浓度、pH、心率和呼吸率没有明显变化。随着 IAP 的增加，与基线 A 相比，在 5mmHg IAP 时，ΔZV 显著降低。
在站立镇静马中，随着 IAP 的升高，气腹会导致 ΔZV 显著减少。
