Regional distribution of ventilation in horses in dorsal recumbency during spontaneous and mechanical ventilation assessed by electrical impedance tomography: a case series

医学 电阻抗断层成像 通风(建筑) 机械通风 麻醉 计算机断层摄影术 系列(地层学) 断层摄影术 解剖 外科 放射科 地质学 工程类 机械工程 古生物学
作者
Martina Mosing,Charlotte Marly‐Voquer,Paul MacFarlane,David Bardell,Fernando Suárez-Sipmann,Regula Bettschart‐Wolfensberger,Andreas D. Waldmann
出处
期刊:Veterinary Anaesthesia and Analgesia [Elsevier BV]
卷期号:44 (1): 127-132 被引量:27
标识
DOI:10.1111/vaa.12405
摘要

To evaluate the regional distribution of ventilation in horses during spontaneous breathing and controlled mechanical ventilation (CMV) using electrical impedance tomography (EIT).Prospective, experimental case series.Four anaesthetized experimental horses.Horses were anaesthetized with isoflurane in an oxygen-air mixture and medetomidine continuous rate infusion, placed in dorsal recumbency with an EIT belt around the thorax, and allowed to breathe spontaneously until PaCO2 reached 13.3 kPa (100 mmHg), when volume CMV was started. For each horse, the EIT signal was recorded for at least 2 minutes immediately before (T1), and at 30 (n = 3) or 60 (n = 1) minutes after the start of CMV (T2). The centre of ventilation (CoV), dependent silent spaces (DSS) (likely to represent atelectatic lung areas), non-dependent silent spaces (NSS) (likely to represent lung areas with low ventilation) and total ventilated area (TVA) were evaluated. Cardiac output (CO) was measured and venous admixture and oxygen delivery (DO2) were calculated at T1 and T2. Data are presented as median and range.After the initiation of CMV, the CoV moved ventrally towards the non-dependent lung by 10% [from 57.4% (49.6-60.2%) to 48.3% (41.9-54.4%)]. DSS increased [from 4.1% (0.2-13.9%) to 18.7% (7.5-27.5%)], while NSS [21.7% (9.4-29.2%) to 9.9% (1.0-20.7%)] and TVA [920 (699-1051) to 837 (662-961) pixels] decreased. CO, venous admixture and DO2 also decreased.In spontaneously breathing anaesthetized horses in dorsal recumbency, ventilation was essentially centred within the dependent dorsal lung regions and moved towards non-dependent ventral regions as soon as CMV was started. This shows a major lack of ventilation in the dependent lung, which may be indicative of atelectasis.
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