Efeitos locais e sistêmicos da síndrome obstrutiva aérea braquicefálica em cães das raças buldogue francês e pug
Data
2024-03-05
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Universidade Estadual Paulista (Unesp)
Resumo
A síndrome obstrutiva aérea braquicefálica (SOAB) é tida atualmente como uma das mais frequentes desordens relacionadas à conformação anatômica em pequenos animais, tendo recebido grande atenção nos últimos anos como motivo de preocupação do bem-estar animal. Comparada à síndrome da apneia obstrutiva do sono (AOS) em humanos, a SOAB também é causada por obstrução dos componentes anatômicos ao trato respiratório cranial, porém, ao contrário da AOS, os efeitos sistêmicos desta síndrome ainda são pouco elucidados. O objetivo deste estudo é avaliar as consequências da obstrução respiratória da SOAB nos tecidos do trato respiratório cranial e os efeitos sistêmicos desta síndrome em cães da raça Pug e Buldogue Francês, de forma a correlacionar os resultados obtidos com o grau de severidade clínica dos pacientes. Foram selecionados 52 pacientes das raças Buldogue Francês e Pug, com idade entre 1 e 8 anos, afetados apenas pela SOAB e que não foram previamente submetidos a procedimentos cirúrgicos corretivos de um ou mais componentes da síndrome, além de 15 caninos mesocefálicos hígidos, da raça beagle, com estatura corporal semelhante as raças braquicefálicas utilizadas e peso corporal máximo de 15 quilogramas. Os pacientes braquicefálicos foram submetidos a teste de exercício submáximo já validado para graduação da severidade da SOAB. O efeito local da obstrução respiratória foi estudado pela análise da elasticidade das estruturas laringeais utilizando a elastografia ARFI. Os efeitos sistêmicos da SOAB foram avaliados por avaliação de oxigenação por meio de análise de gases sanguíneos arteriais automática e de variáveis hematológicas e bioquímicas além de perfil inflamatório estabelecido por meio de leucograma e proteínas de fase aguda (proteína C reativa (PCR), haptoglobina (Hp), ceruloplasmina e alfa 1-ácido glicoproteína (AGP)). Os resultados obtidos por meio destas análises foram comparados e correlacionados aos graus da SOAB, com nível de significância fixada em 95% (p<0,05) para todos os testes estatísticos utilizados. Cães braquicefálicos apresentaram características evidentes das consequências sistêmicas da SOAB, evidenciadas pelo estado de hipoventilação (níveis mais elevados da pressão parcial de dióxido de carbono arterial, PaCO2, p=0,017), um estado inflamatório subclínico (níveis mais elevados de glicoproteína ácida alfa-1 (AGP), p<0,001 e haptoglobina, p=0,036), contagem elevada de hematócrito (HCT, p=0,045), e níveis de creatinina, proteína total (TP, p<0,001) e lactato (p=0,006). As variáveis HGB, HCT, proteína total, AGP, PaCO2, excesso de base arterial e HCO3- arterial são as mais correlacionadas (72%) com a doença nos dados analisados. Não houve diferença significativa da elasticidade laringeal entre cães braquicefálicos e mesocefálicos (p=0,839). A síndrome da via aérea obstrutiva braquicefálica foi correlacionada com características sistêmicas de hipoxemia crônica, hipoventilação e inflamação subclínica.
The brachycephalic obstructive airway syndrome (BOAS) is currently considered one of the most frequent disorders related to anatomical conformation in small animals, having received significant attention in recent years as a concern for animal welfare. Compared to obstructive sleep apnea syndrome (OSA) in humans, BOAS is also caused by obstruction of anatomical components in the cranial respiratory tract; however, unlike OSA, the systemic effects of this syndrome are still not well understood. The aim of this study is to assess the consequences of respiratory obstruction in BOAS on the tissues of the cranial respiratory tract and the systemic effects of this syndrome in Pug and French Bulldog breeds, correlating the results with the clinical severity of the patients. Fifty-two patients of French Bulldog and Pug breeds, aged between 1 and 8 years, affected only by BOAS and not previously subjected to corrective surgical procedures for one or more components of the syndrome, were selected. Additionally, 15 healthy mesocephalic dogs of the Beagle breed, with a body stature similar to the brachycephalic breeds used and a maximum body weight of 15 kilograms, were included. The brachycephalic patients underwent a validated submaximal exercise test for grading the severity of BOAS. The local effect of respiratory obstruction was studied by analyzing the elasticity of laryngeal structures using ARFI elastography. The systemic effects of BOAS were assessed by oxygenation analysis through automatic arterial blood gas analysis and hematological and biochemical variables, as well as an inflammatory profile established through leukogram and acute-phase proteins (C-reactive protein (CRP), haptoglobin (Hp), ceruloplasmin, and alpha-1 acid glycoprotein (AGP)). Results obtained through these analyses were compared and correlated with the grades of BOAS, with a significance level set at 95% (p < 0.05) for all statistical tests used. Brachycephalic dogs exhibited evident features of systemic consequences of BOAS, manifested by a hypoventilation state (higher levels of arterial carbon dioxide partial pressure, PaCO2, p=0.017), a subclinical inflammatory state (higher levels of alpha-1 acid glycoprotein (AGP), p<0.001, and haptoglobin, p=0.036), elevated hematocrit (HCT, p=0.045), and levels of creatinine, total protein (TP, p<0.001), and lactate (p=0.006). The variables HGB, HCT, total protein, AGP, PaCO2, arterial base excess, and arterial HCO3 - are the most correlated (72%) with the disease in the analyzed data. There was no significant difference in laryngeal elasticity between brachycephalic and mesocephalic dogs (p=0.839). Brachycephalic obstructive airway syndrome is correlated with systemic features of chronic hypoxemia, hypoventilation, and subclinical inflammation.
The brachycephalic obstructive airway syndrome (BOAS) is currently considered one of the most frequent disorders related to anatomical conformation in small animals, having received significant attention in recent years as a concern for animal welfare. Compared to obstructive sleep apnea syndrome (OSA) in humans, BOAS is also caused by obstruction of anatomical components in the cranial respiratory tract; however, unlike OSA, the systemic effects of this syndrome are still not well understood. The aim of this study is to assess the consequences of respiratory obstruction in BOAS on the tissues of the cranial respiratory tract and the systemic effects of this syndrome in Pug and French Bulldog breeds, correlating the results with the clinical severity of the patients. Fifty-two patients of French Bulldog and Pug breeds, aged between 1 and 8 years, affected only by BOAS and not previously subjected to corrective surgical procedures for one or more components of the syndrome, were selected. Additionally, 15 healthy mesocephalic dogs of the Beagle breed, with a body stature similar to the brachycephalic breeds used and a maximum body weight of 15 kilograms, were included. The brachycephalic patients underwent a validated submaximal exercise test for grading the severity of BOAS. The local effect of respiratory obstruction was studied by analyzing the elasticity of laryngeal structures using ARFI elastography. The systemic effects of BOAS were assessed by oxygenation analysis through automatic arterial blood gas analysis and hematological and biochemical variables, as well as an inflammatory profile established through leukogram and acute-phase proteins (C-reactive protein (CRP), haptoglobin (Hp), ceruloplasmin, and alpha-1 acid glycoprotein (AGP)). Results obtained through these analyses were compared and correlated with the grades of BOAS, with a significance level set at 95% (p < 0.05) for all statistical tests used. Brachycephalic dogs exhibited evident features of systemic consequences of BOAS, manifested by a hypoventilation state (higher levels of arterial carbon dioxide partial pressure, PaCO2, p=0.017), a subclinical inflammatory state (higher levels of alpha-1 acid glycoprotein (AGP), p<0.001, and haptoglobin, p=0.036), elevated hematocrit (HCT, p=0.045), and levels of creatinine, total protein (TP, p<0.001), and lactate (p=0.006). The variables HGB, HCT, total protein, AGP, PaCO2, arterial base excess, and arterial HCO3 - are the most correlated (72%) with the disease in the analyzed data. There was no significant difference in laryngeal elasticity between brachycephalic and mesocephalic dogs (p=0.839). Brachycephalic obstructive airway syndrome is correlated with systemic features of chronic hypoxemia, hypoventilation, and subclinical inflammation.
Descrição
Palavras-chave
Braquicefalia, Cirurgia veterinária, Inflamação sistêmica, Obstrução respiratória, Ultrassonografia veterinária
Como citar
FACIN, A. C. - Efeitos locais e sistêmicos da síndrome obstrutiva aérea braquicefálica em cães das raças buldogue francês e pug - 2024, 56f - Tese (Doutorado em Cirurgia Veterinária) - Universidade Estadual Paulista, Jaboticabal, 2024.