Effects of an alveolar recruitment maneuver on cardiovascular and respiratory parameters during total intravenous anesthesia in ponies

Daniela Wettstein; Yves Moens; Nicola Jaeggin-Schmucker; Stephan H Böhm; Hans Ulrich Rothen; Martina Mosing; Sabine B R Kästner; Urs Schatzmann

doi:10.2460/ajvr.67.1.152

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Effects of an alveolar recruitment maneuver on cardiovascular and respiratory parameters during total intravenous anesthesia in ponies

Journal article

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Peer reviewed

Effects of an alveolar recruitment maneuver on cardiovascular and respiratory parameters during total intravenous anesthesia in ponies

Daniela Wettstein, Yves Moens, Nicola Jaeggin-Schmucker, Stephan H Böhm, Hans Ulrich Rothen, Martina Mosing, Sabine B R Kästner and Urs Schatzmann

American journal of veterinary research, Vol.67(1), pp.152-159

2006

DOI: https://doi.org/10.2460/ajvr.67.1.152

PMID: 16426225

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Abstract

Objective—To evaluate pulmonary and cardiovascular effects of a recruitment maneuver (RM) combined with positive end-expiratory pressure (PEEP) during total intravenous anesthesia in ponies. Animals—6 healthy adult Shetland ponies. Procedure—After premedication with detomidine (10 μg/kg, IV), anesthesia was induced with climazolam (0.06 mg/kg, IV) and ketamine (2.2 mg/kg, IV) and maintained with a constant rate infusion of detomidine (0.024 mg/kg/h), climazolam (0.036 mg/kg/h), and ketamine (2.4 mg/kg/h). The RM was preceded by an incremental PEEP titration and followed by a decremental PEEP titration, both at a constant airway pressure difference ([.Delta]P) of 20 cm H2O. The RM consisted of a stepwise increase in [.Delta]P by 25, 30, and 35 cm H2O obtained by increasing peak inspiratory pressure (PIP) to 45, 50, and 55 cm H2O, while maintaining PEEP at 20 cm H2O. Hemodynamic and pulmonary variables were analyzed at every step of the PEEP titration–RM. Results—During the PEEP titration–RM, there was a significant increase in PaO 2 (+12%), dynamic compliance (+ 62%), and heart rate (+17%) and a decrease in shunt (-19%) and mean arterial blood pressure (-21%) was recorded. Cardiac output remained stable. Conclusions and Clinical Relevance—Although baseline oxygenation was high, PaO 2 and dynamic compliance further increased during the RM. Despite the use of high PIP and PEEP and a high tidal volume, limited cardiovascular compromise was detected. A PEEP titration–RM may be used to improve oxygenation in anesthetized ponies. During stable hemodynamic conditions, PEEP titration–RM can be performed with acceptable adverse cardiovascular effects.

Details

Title: Effects of an alveolar recruitment maneuver on cardiovascular and respiratory parameters during total intravenous anesthesia in ponies
Authors/Creators: Daniela Wettstein
Yves Moens
Nicola Jaeggin-Schmucker
Stephan H Böhm
Hans Ulrich Rothen
Martina Mosing
Sabine B R Kästner
Urs Schatzmann
Publication Details: American journal of veterinary research, Vol.67(1), pp.152-159
Publisher: AVMA Publications
Identifiers: 991005578577307891
Copyright: © 2006 American Veterinary Medical Association. All rights reserved.
Murdoch Affiliation: Centre for Sustainable Aquatic Ecosystems
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.43 Anesthesiology; 1.43.1642 Veterinary Anesthesia
Web Of Science research areas: Veterinary Sciences
ESI research areas: Plant & Animal Science