Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
College of Agricultural and Life Sciences, Cornell University, Ithaca, New York, USA.
Vet Surg. 2024 Jul;53(5):872-880. doi: 10.1111/vsu.14111. Epub 2024 May 27.
To evaluate the effect of continuous positive airway pressure (CPAP) on respiratory function in the early postoperative period of brachycephalic dogs.
Prospective, randomized clinical trial.
A total of 32 dogs.
Dogs were assigned to recover with or without CPAP (control) and assessed at specific time points over 1 h. Treatment was discontinued for dogs with a CPAP tolerance score of 3 or more (from a range of 0-4). The primary outcome was pulse oximetry (SpO). Secondary outcomes were arterial O pressure (PaO)/FiO ratio (PaO/FiO), arterial CO pressure (PaCO), and rectal temperature. For dogs that reached a CPAP tolerance score of 3 or more, only the data collected up to the time point before discontinuation were included in the analysis. The treatment effect (β) was analyzed using random effects models and the results were reported with 95% confidence intervals.
Dogs were assigned randomly to each protocol. Baseline characteristics in both groups were comparable. Arterial blood gases were obtained in seven control group dogs and nine CPAP group dogs. Treatment did not affect SpO (β = -0.1, -2.1 to 2.0) but affected the PaO/FiO ratio (β = 58.1, 2.6 to 113.6), with no effects on PaCO (β = -4.3, -10.5 to 1.9) or temperature (β = 0.4, -0.8 to 1.6).
In postoperative brachycephalic dogs, CPAP had no effect on SpO but improved the PaO/FiO ratio in brachycephalic dogs postoperatively.
Continuous positive airway pressure offers a valuable solution to improve gas exchange efficiency, a prevalent concern in postoperative brachycephalic dogs, with the potential to enhance overall outcomes.
评估持续气道正压通气(CPAP)对短头犬术后早期呼吸功能的影响。
前瞻性、随机临床试验。
共 32 只狗。
狗被分配在有或没有 CPAP(对照组)的情况下恢复,并在 1 小时内的特定时间点进行评估。对于 CPAP 耐受评分达到 3 或更高的狗(评分范围为 0-4),停止治疗。主要结果是脉搏血氧饱和度(SpO)。次要结果是动脉氧分压(PaO)/FiO 比值(PaO/FiO)、动脉二氧化碳分压(PaCO)和直肠温度。对于达到 CPAP 耐受评分 3 或更高的狗,仅包括在停止治疗之前的时间点收集的数据进行分析。使用随机效应模型分析治疗效果(β),并报告 95%置信区间的结果。
狗被随机分配到每个方案。两组的基线特征相似。在对照组的 7 只狗和 CPAP 组的 9 只狗中获得了动脉血气。治疗并没有影响 SpO(β=-0.1,-2.1 至 2.0),但影响了 PaO/FiO 比值(β=58.1,2.6 至 113.6),对 PaCO 没有影响(β=-4.3,-10.5 至 1.9)或温度(β=0.4,-0.8 至 1.6)。
在短头犬术后,CPAP 对 SpO 没有影响,但改善了短头犬术后的 PaO/FiO 比值。
持续气道正压通气为改善短头犬术后常见的气体交换效率提供了一种有价值的解决方案,有可能改善整体预后。