Evaluation of the effects of helmet continuous positive airway pressure on laryngeal size in dogs anesthetized with propofol and fentanyl using computed tomography

J Vet Emerg Crit Care (San Antonio). 2020 Sep;30(5):543-549. doi: 10.1111/vec.12977. Epub 2020 Jul 10.

Abstract

Objective: To evaluate the effect of 5 cm H2 O of continuous positive airway pressure (CPAP) on laryngeal size in spontaneously breathing anesthetized dogs via computed tomography (CT).

Design: Prospective, randomized, cross-over clinical study.

Setting: University teaching hospital and referral private practice.

Animals: Eight healthy client-owned dogs undergoing CT.

Interventions: Dogs were sedated with acepromazine 20 μg/kg IM and induced with fentanyl 2 μg/kg and propofol 3-5 mg/kg IV before being maintained on fentanyl (5 μg/kg/h) and propofol (0.3 mg/kg/min) constant rate infusion. Dogs received an air/oxygen mixture with (CPAP) and without (NO-CPAP) 5 cm H2 O of CPAP in a random order. Each study step lasted 15 minutes.

Measurements and main results: Ten minutes after the beginning of each study period, a CT scan of the laryngeal region was obtained at end-expiration. CT images were analyzed to determine the laryngeal cross-sectional area (CSA; cm2 ), total volume (VTOT ; cm3 ), and laterolateral and dorsoventral diameters (DLL and DDV , respectively; cm). Differences between the 2 treatments were analyzed with t-test for paired data (P < 0.05). Compared to the NO-CPAP, during CPAP the CSA increased by 53.3 ± 23.1% (ie, from 3.3 ± 0.8 to 5.1 ± 1.3 cm2 , P = 0.0004), VTOT increased by 52.4 ± 13.6% (from 6.2 ± 1.7 to 9.4 ± 2.4 cm3 , P < 0.0001), and DLL and DDV were 55.5 ± 13.3% (3.6 ± 0.8 vs 2.4 ± 0.5 cm, P = 0.006) and 20.3 ± 8.8% larger (3.2 ± 0.7 vs 2.7 ± 0.6 cm, P = 0.0002), respectively.

Conclusions: Laryngeal volume and cross sectional area increased during the application of 5 cm H2 O of helmet CPAP in spontaneously breathing anesthetized dogs.

Keywords: computed tomography; continuous positive airway pressure; dog; larynx; ventilation.

Publication types

  • Randomized Controlled Trial, Veterinary

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage
  • Adjuvants, Anesthesia / pharmacology
  • Animals
  • Continuous Positive Airway Pressure / veterinary*
  • Cross-Over Studies
  • Dogs / physiology*
  • Female
  • Fentanyl / administration & dosage
  • Fentanyl / pharmacology*
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / pharmacology
  • Larynx / anatomy & histology
  • Larynx / drug effects*
  • Larynx / physiology
  • Male
  • Oxygen
  • Propofol / administration & dosage
  • Propofol / pharmacology*
  • Prospective Studies
  • Tomography
  • Tomography, X-Ray Computed*

Substances

  • Adjuvants, Anesthesia
  • Hypnotics and Sedatives
  • Oxygen
  • Fentanyl
  • Propofol