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Oxygen supplementation in dogs
A D VA N C E S
Respiratory Medicine OXYGEN SUPPLEMENTATION IN DOGS Background Brachycephalic airway syndrome most commonly occurs in bulldogs, pugs, Boston terriers, boxers, Pekingese, and cavalier King Charles spaniels. This syndrome includes stenotic nares, elongated soft palate, and eversion of the laryngeal saccules, which may lead to laryngeal collapse or be complicated by tracheal hypoplasia. A mechanical component causes partial airway obstruction, which is followed by turbulent airflow, local mucosal irritation, and edema formation. Signs of
PAG E 7
PAG E 8
A D VA N C E S
upper airway obstruction may be the primary reason for veterinary medical attention, although some may first be evident following general anesthesia. There can also be a relationship between upper respiratory and gastrointestinal tract problems in brachycephalic dogs that include regurgitation and/or vomiting. Signs of brachycephalic airway syndrome range from mild to severe respiratory distress. Moderately and severely affected animals have respiratory distress when stressed. Initial examinations must be performed with great caution to avert exacerbation of clinical signs. Some dogs present in life-threatening situations, requiring immediate tracheal intubation and surgery to alleviate the upper airway obstruction. Supplemental oxygen treatment in moderately to severely dyspneic patients include oxygen delivery by intranasal tube, oxygen cage, oxygen hood, temporary tracheostomy, or orotracheal intubation. Corticosteroid treatment to reduce oropharyngeal swelling, sedation to relieve anxiety, and cooling of hyperthermic patients may be beneficial. In the immediate postoperative period from upper airway surgery, respiratory distress is often aggravated by oropharyngeal swelling from surgical manipulation. Current recommendations are intubation for as long as possible after anesthesia, supplemental oxygen therapy, reintubation, or temporary tracheostomy if required, and intensive postoperative monitoring. A high incidence of complications and mortality is associated perioperatively with upper airway surgeries for brachycephalic syndrome in dogs.
Objectives To assess the utility of nasotracheal tubes in postoperative oxygen supplementation in dogs following corrective surgery for brachycephalic syndrome.
Procedure Medical records were reviewed of 36 dogs that underwent surgical interventions for brachycephalic syndrome including palatoplasty, ventriculectomy, and rhinoplasty. Data collected included signalment, presenting complaints, analgesic and surgical interventions, type of supplemental oxygen therapy, complications, and mortality occurring during hospitalization.
Results A nasotracheal tube (NTT) was placed in 20 dogs at the end of surgery, 8 dogs received other forms of oxygen supplementation, and the remaining 8 dogs received no oxygen supplementation during recovery. Eight of 20 dogs with NTTs and 7 of 16 dogs without NTTs had postoperative complications. However, respiratory distress was observed in 5 dogs without NTTs but was not observed in any dog while an NTT was in place. One dog in each group died postoperatively.
Journals Monitored • American Journal of Veterinary Research • Australian Veterinary Journal • Australian Veterinary Practitioner • Avian Diseases • British Veterinary Journal • Canadian Journal of Veterinary Research • Canadian Veterinary Journal
Author Conclusion Placement of an NTT is easy and may offer benefit in dogs with brachycephalic syndrome as a noninvasive means of delivering oxygen. The use of NTT may minimize severe postoperative morbidity, in particular by reducing postoperative respiratory distress.
Inclusions
• Journal of Avian Medicine and Surgery • Journal of the American Animal Hospital Association • Journal of the American Veterinary Medical Association • Journal of Small Animal Practice • Journal of Small Exotic Animal Medicine
One figure, 1 table, 17 references.
• Journal of Veterinary Dentistry
Editor Annotation
• Journal of Veterinary Emergency and Critical Care
Respiratory distress following surgery for palliation of brachycephalic anatomy is common. This may be due to upper airway swelling, aspiration of blood, and/or pneumonia. Supplemental oxygen, delivered via face mask or oxygen cage, does not address the upper airway obstructive component. This study retrospectively evaluated using nasotracheal catheter for post-operative oxygen supplementation. In this hospital, 36 dogs underwent brachcephalic surgery, and 20 had nasotracheal tubes placed after surgery, while 8 received supplemental oxygen via another route, and 8 did not get supplemental oxygen. While the overall complication rate was unaffected, dogs with nasotracheal oxygen did not show any respiratory distress. The authors concluded that nasotracheal oxygen is a viable method of supportive care. Nasotracheal oxygen is placed by directly feeding a catheter from the nose through the larynx, so it requires anesthesia for placement. However, it is a simple procedure and should be considered by the advanced practitioner. (ER) Senn D, Sigrist N, Forterre F, et al. Retrospective evaluation of postoperative nasotracheal tubes
• Journal of Veterinary Internal Medicine • Journal of Veterinary Pharmacology and Therapeutics • Journal of Zoo and Wildlife Medicine • New Zealand Veterinary Journal • Research in Veterinary Science • Veterinary and Comparative Orthopaedics and Traumatology • Veterinary Dermatology • Veterinary Immunology and Immunopathology • Veterinary Pathology • Veterinary Radiology & Ultrasound • Veterinary Record • Veterinary Research Communications • Veterinary Surgery ... and more than 20 others
for oxygen supplementation in dogs following surgery for brachycephalic syndrome: 36 cases (2003-2007). J Vet Emerg Crit Care 2011;21:261267.
Respiratory Medicine OXYGEN SUPPLEMENTATION IN DOGS Background Brachycephalic airway syndrome most commonly occurs in bulldogs, pugs, Boston terriers, boxers, Pekingese, and cavalier King Charles spaniels. This syndrome includes stenotic nares, elongated soft palate, and eversion of the laryngeal saccules, which may lead to laryngeal collapse or be complicated by tracheal hypoplasia. A mechanical component causes partial airway obstruction, which is followed by turbulent airflow, local mucosal irritation, and edema formation. Signs of
PAG E 7
PAG E 8
A D VA N C E S
upper airway obstruction may be the primary reason for veterinary medical attention, although some may first be evident following general anesthesia. There can also be a relationship between upper respiratory and gastrointestinal tract problems in brachycephalic dogs that include regurgitation and/or vomiting. Signs of brachycephalic airway syndrome range from mild to severe respiratory distress. Moderately and severely affected animals have respiratory distress when stressed. Initial examinations must be performed with great caution to avert exacerbation of clinical signs. Some dogs present in life-threatening situations, requiring immediate tracheal intubation and surgery to alleviate the upper airway obstruction. Supplemental oxygen treatment in moderately to severely dyspneic patients include oxygen delivery by intranasal tube, oxygen cage, oxygen hood, temporary tracheostomy, or orotracheal intubation. Corticosteroid treatment to reduce oropharyngeal swelling, sedation to relieve anxiety, and cooling of hyperthermic patients may be beneficial. In the immediate postoperative period from upper airway surgery, respiratory distress is often aggravated by oropharyngeal swelling from surgical manipulation. Current recommendations are intubation for as long as possible after anesthesia, supplemental oxygen therapy, reintubation, or temporary tracheostomy if required, and intensive postoperative monitoring. A high incidence of complications and mortality is associated perioperatively with upper airway surgeries for brachycephalic syndrome in dogs.
Objectives To assess the utility of nasotracheal tubes in postoperative oxygen supplementation in dogs following corrective surgery for brachycephalic syndrome.
Procedure Medical records were reviewed of 36 dogs that underwent surgical interventions for brachycephalic syndrome including palatoplasty, ventriculectomy, and rhinoplasty. Data collected included signalment, presenting complaints, analgesic and surgical interventions, type of supplemental oxygen therapy, complications, and mortality occurring during hospitalization.
Results A nasotracheal tube (NTT) was placed in 20 dogs at the end of surgery, 8 dogs received other forms of oxygen supplementation, and the remaining 8 dogs received no oxygen supplementation during recovery. Eight of 20 dogs with NTTs and 7 of 16 dogs without NTTs had postoperative complications. However, respiratory distress was observed in 5 dogs without NTTs but was not observed in any dog while an NTT was in place. One dog in each group died postoperatively.
Journals Monitored • American Journal of Veterinary Research • Australian Veterinary Journal • Australian Veterinary Practitioner • Avian Diseases • British Veterinary Journal • Canadian Journal of Veterinary Research • Canadian Veterinary Journal
Author Conclusion Placement of an NTT is easy and may offer benefit in dogs with brachycephalic syndrome as a noninvasive means of delivering oxygen. The use of NTT may minimize severe postoperative morbidity, in particular by reducing postoperative respiratory distress.
Inclusions
• Journal of Avian Medicine and Surgery • Journal of the American Animal Hospital Association • Journal of the American Veterinary Medical Association • Journal of Small Animal Practice • Journal of Small Exotic Animal Medicine
One figure, 1 table, 17 references.
• Journal of Veterinary Dentistry
Editor Annotation
• Journal of Veterinary Emergency and Critical Care
Respiratory distress following surgery for palliation of brachycephalic anatomy is common. This may be due to upper airway swelling, aspiration of blood, and/or pneumonia. Supplemental oxygen, delivered via face mask or oxygen cage, does not address the upper airway obstructive component. This study retrospectively evaluated using nasotracheal catheter for post-operative oxygen supplementation. In this hospital, 36 dogs underwent brachcephalic surgery, and 20 had nasotracheal tubes placed after surgery, while 8 received supplemental oxygen via another route, and 8 did not get supplemental oxygen. While the overall complication rate was unaffected, dogs with nasotracheal oxygen did not show any respiratory distress. The authors concluded that nasotracheal oxygen is a viable method of supportive care. Nasotracheal oxygen is placed by directly feeding a catheter from the nose through the larynx, so it requires anesthesia for placement. However, it is a simple procedure and should be considered by the advanced practitioner. (ER) Senn D, Sigrist N, Forterre F, et al. Retrospective evaluation of postoperative nasotracheal tubes
• Journal of Veterinary Internal Medicine • Journal of Veterinary Pharmacology and Therapeutics • Journal of Zoo and Wildlife Medicine • New Zealand Veterinary Journal • Research in Veterinary Science • Veterinary and Comparative Orthopaedics and Traumatology • Veterinary Dermatology • Veterinary Immunology and Immunopathology • Veterinary Pathology • Veterinary Radiology & Ultrasound • Veterinary Record • Veterinary Research Communications • Veterinary Surgery ... and more than 20 others
for oxygen supplementation in dogs following surgery for brachycephalic syndrome: 36 cases (2003-2007). J Vet Emerg Crit Care 2011;21:261267.