ORCID Profile
0000-0001-6063-1275
Current Organisation
Murdoch University
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Publisher: Wiley
Date: 13-04-2023
DOI: 10.1111/JVIM.16651
Abstract: Continuous positive airway pressure (CPAP) and pressure support ventilation (PSV) can improve respiratory mechanics and gas exchange, but different airway pressures have not been compared in foals. Assess the effect of different airway pressures during CPAP and PSV have on respiratory function in healthy foals with pharmacologically induced respiratory insufficiency. We hypothesized that increased airway pressures would improve respiratory mechanics and increased positive end‐expiratory pressure (PEEP) would be associated with hypercapnia. Six healthy foals from a university teaching herd. A prospective, 2‐phase, 2‐treatment, randomized cross‐over study design was used to evaluate sequential interventions in sedated foals using 2 protocols (CPAP and PSV). Outcome measures included arterial blood gases, spirometry, volumetric capnography, lung volume and aeration assessed using computed tomography (CT). Sedation and dorsal recumbency were associated with significant reductions in arterial oxygen pressure (PaO 2 ), respiratory rate, and tidal volume. Continuous positive airway pressure was associated with improved PaO 2 , without concurrent hypercapnia. Volumetric capnography identified improved ventilation:perfusion (V/Q) matching and increased carbon dioxide elimination during ventilation, and spirometry identified decreased respiratory rate and increased tidal volume. Peak inspiratory pressure was moderately associated with PaO 2 and lung volume. Improved pulmonary aeration was evident in CT images, and lung volume was increased, particularly during CPAP. Both CPAP and PSV improved lung mechanics and gas exchange in healthy foals with induced respiratory insufficiency.
Publisher: Wiley
Date: 04-08-2021
DOI: 10.1111/JVIM.16227
Abstract: Left‐sided cardiac volume overload (LCVO) can cause fluid accumulation in lung tissue changing the distribution of ventilation, which can be evaluated by electrical impedance tomography (EIT). To describe and compare EIT variables in horses with naturally occurring compensated and decompensated LCVO and compare them to a healthy cohort. Fourteen adult horses, including university teaching horses and clinical cases (healthy: 8 LCVO: 4 compensated, 2 decompensated). In this prospective cohort study, EIT was used in standing, unsedated horses and analyzed for conventional variables, ventilated right (VA R ) and left (VA L ) lung area, linear‐plane distribution variables (avg‐max VΔZ Line , VΔZ Line ), global peak flows, inhomogeneity factor, and estimated tidal volume. Horses with decompensated LCVO were assessed before and after administration of furosemide. Variables for healthy and LCVO‐affected horses were compared using a Mann‐Whitney test or unpaired t ‐test and observations from compensated and decompensated horses are reported. Compared to the healthy horses, the LCVO cohort had significantly less VA L (mean difference 3.02 95% confidence interval .77‐5.2 P = .02), more VA R (−1.13 −2.18 to −.08 P = .04), smaller avg‐max VΔZ L Line (2.54 1.07‐4.00 P = .003) and VΔZ L Line (median difference 5.40 1.71‐9.09 P = .01). Observation of EIT alterations were reflected by clinical signs in horses with decompensated LCVO and after administration of furosemide. EIT measurements of ventilation distribution showed less ventilation in the left lung of horses with LCVO and might be useful as an objective assessment of the ventilation effects of cardiogenic pulmonary disease in horses.
Publisher: Wiley
Date: 07-12-2022
DOI: 10.1111/EVE.13603
Abstract: A 3‐year‐old Thoroughbred filly presented with a several‐month history of weight loss, polydipsia and polyuria, intermittent diarrhoea and behavioural changes and intermittently uncoordinated gait. Neurological examination revealed hyperexcitability, bilaterally reduced pupillary light reflexes and quadrilateral ataxia with proprioceptive deficits more obvious in the forelimbs than in the hindlimbs. A multifocal neurological lesion was suspected. The laboratory finding of a persistent hyperchloraemia and an apparent negative anion gap prompted measurement of serum bromide concentration and subsequently confirmed bromide intoxication. Further questioning of the trainer revealed that the filly had been administered oral potassium bromide for behavioural modification over several months. Clinical signs of bromide intoxication resolved within 20 days following the last bromide administration, without specific medical intervention. This case report describes the risk of inadvertent bromide overdosing in horses and highlights the need for control of bromide use in the equine industry.
No related grants have been discovered for Muriel Sacks.