Assessment of Regional Ventilation During Recruitment Maneuver by Electrical Impedance Tomography in Dogs.

BACKGROUND: During protective mechanical ventilation, electrical impedance tomography (EIT) is used to monitor alveolar recruitment maneuvers as well as the distribution of regional ventilation. This technique can infer atelectasis and lung overdistention during mechanical ventilation in anesthetized patients or in the ICU. Changes in lung tissue stretching are evaluated by monitoring the electrical impedance of lung tissue with each respiratory cycle. OBJECTIVE: This study aimed to evaluate the distribution of regional ventilation during recruitment maneuvers based on the variables obtained in pulmonary electrical impedance tomography during protective mechanical ventilation, focusing on better lung recruitment associated with less or no overdistention. METHODS: Prospective clinical study using seven adult client-owned healthy dogs, weighing 25 ± 6 kg, undergoing elective ovariohysterectomy or orchiectomy. The animals were anesthetized and ventilated in volume-controlled mode (7 ml.kg-1) with stepwise PEEP increases from 0 to 20 cmH2O in steps of 5 cmH2O every 5 min and then a stepwise decrease. EIT, respiratory mechanics, oxygenation, and hemodynamic variables were recorded for each PEEP step. RESULTS: The results show that the regional compliance of the dependent lung significantly increased in the PEEP 10 cmH2O decrease step when compared with baseline (p < 0.027), and for the nondependent lung, there was a decrease in compliance at PEEP 20 cmH2O (p = 0.039) compared with baseline. A higher level of PEEP was associated with a significant increase in silent space of the nondependent regions from the PEEP 10 cmH2O increase step (p = 0.048) until the PEEP 15 cmH2O (0.019) decrease step with the highest values at PEEP 20 cmH20 (p = 0.016), returning to baseline values thereafter. Silent space of the dependent regions did not show any significant changes. Drive pressure decreased significantly in the PEEP 10 and 5 cmH2O decrease steps (p = 0.032) accompanied by increased respiratory static compliance in the same PEEP step (p = 0.035 and 0.018, respectively). CONCLUSIONS: The regional ventilation distribution assessed by EIT showed that the best PEEP value for recruitment maintenance, capable of decreasing areas of pulmonary atelectasis in dependent regions promoting less overinflation in nondependent areas, was from 10 to 5 cmH2O decreased steps.

Evaluation of ventral laparoscopic abomasopexy using surgical staples associated with suture material in dairy cattle

Background: Displaced Abomasum is known for being on of the main illnesses that affect milking cows. Increase in diagnosis of this illness is due to advancement in diagnosis techniques. Increase in incidence of this illness can be explained by genetic selection of animals with high production, breed systems and changes to the diet with a higher level of protein. For laparoscopic treatment, several surgical changes were performed to optimize the procedure and thus achieve better results. The main purpose of this study was to evaluate applicability of the ventral laparoscopic abomasopexy technique, using surgical clamps attached to the suture thread, to milking cows.Materials, Methods & Results: Six adult cows were placed under anesthesia with isoflurane and placed in dorsal decubitus. Animals were kept with no water for 24 h and no food for 48 h. Four laparoscopic accesses were performed. The first one was created with the intention of inspecting the abdominal cavity and the remaining three for access of surgical instruments. Serous membrane of the abomasum was cauterized, combined with suture threads and placed at the greater abomasal curvature. The free part of suture threads was kept out of the abdominal cavity and after traction of the abomasum against the abdominal wall was tied to the skin. Ultrasound exam was performed for abdominal evaluation after abomasopexy. Anesthesia time and surgery time were recorded and analyzes through average and standard deviation (SD). The average anesthesia time recorded was 94 min (SD 14.63 min) and average surgery time was 51 min (SD 14.71 min). The fasting period was considered adequate, however all animals had to undergo intubation with orogastric tube to drain liquids and gas during the procedure. Four of the six animals had lineal adhesion. Three of the four animals that had adhesion did not keep the abomasum at the retroperitoneal area, however viscera movement was stopped in the abdominal cavity.[...]

Evaluation of ventral laparoscopic abomasopexy using surgical staples associated with suture material in dairy cattle

Background: Displaced Abomasum is known for being on of the main illnesses that affect milking cows. Increase in diagnosis of this illness is due to advancement in diagnosis techniques. Increase in incidence of this illness can be explained by genetic selection of animals with high production, breed systems and changes to the diet with a higher level of protein. For laparoscopic treatment, several surgical changes were performed to optimize the procedure and thus achieve better results. The main purpose of this study was to evaluate applicability of the ventral laparoscopic abomasopexy technique, using surgical clamps attached to the suture thread, to milking cows.Materials, Methods & Results: Six adult cows were placed under anesthesia with isoflurane and placed in dorsal decubitus. Animals were kept with no water for 24 h and no food for 48 h. Four laparoscopic accesses were performed. The first one was created with the intention of inspecting the abdominal cavity and the remaining three for access of surgical instruments. Serous membrane of the abomasum was cauterized, combined with suture threads and placed at the greater abomasal curvature. The free part of suture threads was kept out of the abdominal cavity and after traction of the abomasum against the abdominal wall was tied to the skin. Ultrasound exam was performed for abdominal evaluation after abomasopexy. Anesthesia time and surgery time were recorded and analyzes through average and standard deviation (SD). The average anesthesia time recorded was 94 min (SD 14.63 min) and average surgery time was 51 min (SD 14.71 min). The fasting period was considered adequate, however all animals had to undergo intubation with orogastric tube to drain liquids and gas during the procedure. Four of the six animals had lineal adhesion. Three of the four animals that had adhesion did not keep the abomasum at the retroperitoneal area, however viscera movement was stopped in the abdominal cavity.[...](AU)