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Novel Continuous Positive Airway Pressure System for Respiratory Support of Foals
R. McKean, S.L. Raidal, S.G...
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A human sleep apnoea continuous positive airway pressure (CPAP) unit was adapted to deliver safe, portable, efficacious, and cost-effective respiratory support to foals, and with refinement may prove suitable for treatment of respiratory distress in foals.
1. Introduction
Respiratory insufficiency in foals is routinely managed by nasal insufflation or, more rarely, ventilator support. In humans, especially neonates, CPAP optimizes both ventilatory mechanics and respiratory efficiency. The current project aimed to critically evaluate a practical foal CPAP system suited to clinical equine practice.
2. Materials and Methods
A commercial device was adapted to provide CPAP to five foals (age 6 –10 wk) following pharmacological induction of respiratory insufficiency. Respiratory support derived from CPAP (10 cmH2O plus 5 L.min-1 O2) was compared with non-pressurized mask O2 (5 L.min-1 ) by randomized crossover design, with foals receiving both treatments on two occasions in random order, followed by nasal O2 insufflation. Respiratory function was assessed by analysis of arterial blood gases, oxygen saturation, tracheal gas composition, spirometry (flow/ volume), respiration rate, and blood pressure.
3. Results
CPAP and mask O2 normalized pre-treatment hypoxemia. Oxygen extraction and CO2 elimination were highest with CPAP at a lower respiratory rate than mask O2 (P < .05). Nasal O2 caused supra-physiological arterial oxygen pressures, decreased tidal volume and increased respiratory rate compared with CPAP (P < .05). All treatments caused modest hypercarbia with no adverse cardiovascular effects.
4. Discussion
The CPAP system provided an improved method of clinical respiratory support for foals without ventilator-assisted respiratory therapy. Additional studies are required to optimize delivery and characterize efficacy in compromised neonates.
Acknowledgments
Declaration of Ethics
The Authors declare that they have adhered to the principles of Veterinary Medical Ethics of the AVMA.
Conflict of Interest
The Authors declare no conflicts of interest.
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About
Affiliation of the authors at the time of publication
Moorong Veterinary Clinic, Wagga Wagga 2650, Australia (McKean); School of Animal and Veterinary Sciences (Raidal, Quinn), and Quantitative Consultancy Unit, Research Office (Nielsen), Charles Sturt University, Wagga Wagga 2650, Australia
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