Breath-by-breath assessment of acute pulmonary edema using electrical impedance tomography, spirometry and volumetric capnography in a sheep (Ovis Aries) model.

Background: The bedside diagnosis of acute pulmonary edema is challenging. This study evaluated the breath-by-breath information from electrical impedance tomography (EIT), respiratory mechanics and volumetric capnography (VCap) to assess acute pulmonary edema induced by xylazine administration in anesthetized sheep. Objective: To determine the ability and efficiency of each monitoring modality in detecting changes in lung function associated with onset of pulmonary edema. Methods: Twenty healthy ewes were anesthetized, positioned in sternal (prone) recumbency and instrumented. Synchronized recordings of EIT, spirometry and VCap were performed for 60 s prior to start of injection, during xylazine injection over 60 s (0-60 s) and continuously for 1 min (60-120 s) after the end of injection. After visual assessment of the recorded mean variables, statistical analysis was performed using a mixed effect model for repeated measures with Bonferroni's correction for multiple comparisons, to determine at which breath after start of injection the variable was significantly different from baseline. A significant change over time was defined as an adjusted p < 0.05. All statistics were performed using GraphPad Prism 0.1.0. Results: Electrical impedance tomography showed significant changes from baseline in all but two variables. These changes were observed simultaneously during xylazine injection at 48 s and were consistent with development of edema in dependent lung (decreased end-expiratory lung impedance, ventilation in centro-ventral and ventral lung region) and shift of ventilation into non-dependent lung (decreased non-dependent silent spaces and increased center of ventilation ventral to dorsal and increased ventilation in centro-dorsal and dorsal lung region). All changes in lung mechanics also occurred during injection, including decreased dynamic respiratory system compliance and increased peak expiratory flow, peak inspiratory pressure and airway resistance at 48, 54 and 60 s, respectively. Changes in VCap variables were delayed with all occurring after completion of the injection. Conclusion: In this model of pulmonary edema, EIT detected significant and rapid change in all assessed variables of lung function with changes in regional ventilation indicative of pulmonary edema. Volumetric capnography complemented the EIT findings, while respiratory mechanics were not specific to lung edema. Thus, EIT offers the most comprehensive method for pulmonary edema evaluation, including the assessment of ventilation distribution, thereby enhancing diagnostic capabilities.

Management of Body Condition Score between Pregnancy Scanning and Lamb Marking Impacts the Survival of Triplet-Bearing Ewes and Their Lambs.

This study evaluated the impacts of management of body condition score (BCS) between pregnancy scanning and lamb marking on the mortality of triplet-bearing ewes and their lambs at 19 research sites across Southern Australia. Triplet-bearing ewes of Maternal (crossbred or composite) or Merino breed were randomly allocated to treatment at pregnancy scanning at an average of 97 days from the start of joining: High or Low BCS. The BCS of individual ewes was assessed at pregnancy scanning, pre-lambing (average of 137 days from the start of joining) and marking (average of 165 days from the end of joining), and ewe and lamb mortality to marking, recorded for each mob. The average BCS at pregnancy scanning was 3.4 for Maternal ewes and 3.3 for Merino ewes. There were no breed by BCS treatment effects on the BCS of ewes at pregnancy scanning or lamb marking or on the change in BCS between pregnancy scanning and pre-lambing or between pre-lambing and marking. The change in BCS differed between the High and Low BCS treatments, between pregnancy scanning and pre-lambing (0.12 vs. -0.33; p < 0.001) and between pre-lambing and marking (-0.39 vs. 0.07; p < 0.001) but did not differ between breeds. The average BCS at marking for ewes managed at the High and Low BCS treatments was 3.1 and 3.0 for Maternals and 3.0 and 2.8 for Merinos. Survival of triplet-bearing Merino ewes (p < 0.01) and their lambs (p < 0.001) was greater when ewes were managed at the High BCS compared to the Low BCS. The BCS treatment did not impact the survival of Maternal ewes or their lambs. The survival of Merino but not Maternal lambs was higher when ewes were in greater BCS pre-lambing (p < 0.01) and when ewes gained BCS between pregnancy scanning and pre-lambing (p < 0.01). Ewe mortality was lower when ewes gained BCS between pregnancy scanning and pre-lambing (p < 0.05). Merino ewes were more likely to die than Maternal ewes for a given change in BCS between pregnancy scanning and pre-lambing (p = 0.065). Overall, our findings demonstrate that producers should manage the nutrition of triplet-bearing Merino ewes so that ewes are in greater BCS at lambing and/or to gain BCS between pregnancy scanning and lambing to improve ewe and lamb survival. Triplet-bearing Maternal ewes should be managed to gain BCS between pregnancy scanning and lambing to improve ewe survival.

Decreasing Mob Size at Lambing Increases the Survival of Triplet Lambs Born on Farms across Southern Australia.

Industry consultation in Australia revealed that the potential impact of the mob size of ewes during lambing on the survival of triplet-born lambs was an important research priority. Previous research has demonstrated that smaller mob sizes at lambing improve the survival of single- and especially twin-born lambs, regardless of ewe stocking rate. Therefore, we hypothesised that lambing triplet-bearing ewes in smaller mobs, regardless of stocking rate, will increase the survival of their lambs. Research sites were established on 12 commercial sheep farms across southern Australia between 2019 and 2021. One farm used Merinos whilst the remainder of the farms used non-Merino breeds, consisting of composite ewes joined to composite or terminal sires. Three of the farms were used in two years of the experiment. Adult, triplet-bearing ewes were randomly allocated into one of two treatments, 'High' or 'Low' mob size, at an average of 135 days from the start of joining. Ewe and lamb survival were assessed between allocation to treatments and lamb marking. Lamb survival was significantly greater for lambs born in the Low (65.6%) compared with the High (56.6%) mob size treatments (p < 0.001). There was no effect of mob size at lambing on the mortality of triplet-bearing ewes. Analysis of the effect of the actual mob sizes showed that reducing the mob size at lambing by 10 triplet-bearing ewes increased the survival of their lambs to marking by 1.5% (p < 0.001). This study has shown that the survival of triplet-born lambs can be improved by lambing triplet-bearing ewes in smaller mobs regardless of stocking rate when ranging from 0.7-13 ewes/ha.

Reproductive Performance of Triplet-Bearing Ewes on Commercial Farms and Research Priorities Identified by Sheep Producers to Improve the Survival of Triplet-Bearing Ewes and Their Lambs.

Consultation with sheep producers was used to quantify the mortality of triplet-bearing ewes and their lambs, identify management practices adopted by producers to reduce these losses and prioritise future research needs to improve the survival of triplet-bearing ewes and their lambs. Surveys were completed by 64 producers across Australia who identified and separated triplet-bearing ewes from twin-bearing ewes in 2017 and/or 2018. On average, 5.9% of all ewes mated were identified as carrying triplets (6.6% of non-Merino ewes and 2.9% of Merino ewes). The average mortality of triplet-bearing ewes was 6.4%, and ewe mortality did not differ significantly between ewe breeds. The average survival of triplet-born lambs was 59%, and survival was significantly higher for lambs from non-Merino compared to Merino ewes (60.1 vs. 52.9%, p < 0.05). The key strategies adopted to reduce the mortality of triplet-bearing ewes and their lambs included management of condition score, feed-on-offer, mob size at lambing and use of shelter. There were no differences (p > 0.05) in the average mortality of triplet-bearing ewes or their lambs between producers that prioritised the adoption of certain management practices. However, significant variation existed between producers in their targets at lambing for ewe condition score (2.8 to 3.5), mob size (10 to 150 ewes) and feed-on-offer (800 to 2500 kg dry matter/ha). Overwhelmingly, the highest priorities for further research identified by producers from surveys, workshops and a webinar were ewe condition score, mob size, feed-on-offer at lambing and mineral supplementation. This study informs benchmarks for mortality of triplet-bearing ewes and their lambs under extensive grazing conditions in Australia, and the priorities for future research to reduce these losses.