Cardiovascular and Gas Exchange Effects of Individualized Positive End-Expiratory Pressures in Cats Anesthetized With Isoflurane

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dc.contributor.authorMachado, Marcela L.
dc.contributor.authorSoares, Joao H. N.
dc.contributor.authorPypendop, Bruno H.
dc.contributor.authorAguiar, Antonio J. A. [UNESP]
dc.contributor.authorBraun, Christina
dc.contributor.authorMotta-Ribeiro, Gabriel C.
dc.contributor.authorJandre, Frederico C.
dc.contributor.institutionDavis
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionUniversity of Veterinary Medicine Vienna
dc.contributor.institutionFederal University of Rio de Janeiro
dc.date.accessioned2023-03-01T20:43:57Z
dc.date.available2023-03-01T20:43:57Z
dc.date.issued2022-05-04
dc.description.abstractObjectives: To compare the effects of four levels of end-expiratory pressure [zero (ZEEP) and three levels of positive end-expiratory pressure (PEEP)] on the cardiovascular system and gas exchange of cats anesthetized with isoflurane and mechanically ventilated for 3 h with a tidal volume of 10 ml/kg. Study Design: Prospective, randomized, controlled trial. Animals: Six healthy male neutered purpose-bred cats. Methods: Anesthesia was induced with isoflurane and maintained at 1.3 minimum alveolar concentration. PEEP of maximal respiratory compliance (PEEPmaxCrs) was identified in a decremental PEEP titration, and cats were randomly ventilated for 3 h with one of the following end-expiratory pressures: ZEEP, PEEPmaxCrs minus 2 cmH2O (PEEPmaxCrs−2), PEEPmaxCrs, and PEEPmaxCrs plus 2 cmH2O (PEEPmaxCrs+2). Cardiovascular and gas exchange variables were recorded at 5, 30, 60, 120, and 180 min (T5 to T180, respectively) of ventilation and compared between and within ventilation treatments with mixed-model ANOVA followed by Dunnet's and Tukey's tests (normal distribution) or Friedman test followed by the Dunn's test (non-normal distribution). Significance to reject the null hypothesis was considered p < 0.05. Results: Mean arterial pressure (MAP—mmHg) was lower in PEEPmaxCrs+2 [63 (49–69); median (range)] when compared to ZEEP [71 (67–113)] at T5 and stroke index (ml/beat/kg) was lower in PEEPmaxCrs+2 (0.70 ± 0.20; mean ± SD) than in ZEEP (0.90 ± 0.20) at T60. Cardiac index, oxygen delivery index (DO2I), systemic vascular resistance index, and shunt fraction were not significantly different between treatments. The ratio between arterial partial pressure and inspired concentration of oxygen (PaO2/FIO2) was lower in ZEEP than in the PEEP treatments at various time points. At T180, DO2I was higher when compared to T5 in PEEPmaxCrs. Dopamine was required to maintain MAP higher than 60 mmHg in one cat during PEEPmaxCrs and in three cats during PEEPmaxCrs+2. Conclusion: In cats anesthetized with isoflurane and mechanically ventilated for 3 h, all levels of PEEP mildly improved gas exchange with no significant difference in DO2I when compared to ZEEP. The PEEP levels higher than PEEPmaxCrs−2 caused more cardiovascular depression, and dopamine was an effective treatment. A temporal increase in DO2I was observed in the cats ventilated with PEEPmaxCrs. The effects of these levels of PEEP on respiratory mechanics, ventilation-induced lung injury, as well as in obese and critically ill cats deserve future investigation for a better understanding of the clinical use of PEEP in this species.en
dc.description.affiliationWilliam Pritchard Veterinary Medical Teaching Hospital University of California Davis
dc.description.affiliationDepartment of Surgical and Radiological Sciences School of Veterinary Medicine University of California Davis
dc.description.affiliationDepartamento de Cirurgia e Anestesiologia Veterinária Faculdade de Medicina Veterinária e Zootecnia UNESP—Univ. Estadual Paulista
dc.description.affiliationAnaesthesiology and Perioperative Intensive Care University of Veterinary Medicine Vienna
dc.description.affiliationLaboratory of Pulmonary and Cardiovascular Engineering Biomedical Engineering Program/COPPE Federal University of Rio de Janeiro
dc.description.affiliationBiomedical Instrumentation Laboratory Biomedical Engineering Program/COPPE Federal University of Rio de Janeiro
dc.description.affiliationUnespDepartamento de Cirurgia e Anestesiologia Veterinária Faculdade de Medicina Veterinária e Zootecnia UNESP—Univ. Estadual Paulista
dc.description.sponsorshipCenter for Companion Animal Health, University of California, Davis
dc.description.sponsorshipIdCenter for Companion Animal Health, University of California, Davis: 38665
dc.description.sponsorshipIdCenter for Companion Animal Health, University of California, Davis: 44336
dc.identifierhttp://dx.doi.org/10.3389/fvets.2022.865673
dc.identifier.citationFrontiers in Veterinary Science, v. 9.
dc.identifier.doi10.3389/fvets.2022.865673
dc.identifier.issn2297-1769
dc.identifier.scopus2-s2.0-85130568437
dc.identifier.urihttp://hdl.handle.net/11449/241030
dc.language.isoeng
dc.relation.ispartofFrontiers in Veterinary Science
dc.sourceScopus
dc.subjectanesthesia
dc.subjectcardiovascular
dc.subjectcat
dc.subjectgas exchange
dc.subjectmechanical ventilation
dc.subjectpositive end-expiratory pressure (PEEP)
dc.titleCardiovascular and Gas Exchange Effects of Individualized Positive End-Expiratory Pressures in Cats Anesthetized With Isofluraneen
dc.typeArtigo

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