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Continuous-flow apneic ventilation during thoracotomy.

M F Babinski, R B Smith, L Bunegin

    Anesthesiology
    |October 1, 1986
    PubMed
    Summary
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    Continuous-flow apneic ventilation (CFAV) effectively supports gas exchange in dogs during thoracotomy. This method ensures adequate oxygenation and ventilation even with an open chest for extended periods.

    Area of Science:

    • Veterinary Anesthesiology
    • Respiratory Physiology
    • Surgical Ventilation

    Background:

    • Thoracotomy requires effective respiratory support.
    • Traditional ventilation methods can be challenging during open-chest procedures.
    • Continuous-flow apneic ventilation (CFAV) offers an alternative approach.

    Purpose of the Study:

    • To evaluate the efficacy of CFAV in maintaining adequate gas exchange in dogs undergoing thoracotomy.
    • To assess the impact of different fractional inspired oxygen concentrations (FIO2) and continuous positive airway pressure (CPAP) levels during CFAV.
    • To determine the feasibility of prolonged CFAV in an open-chest model.

    Main Methods:

    • CFAV was delivered via endobronchial catheters in anesthetized and paralyzed dogs.

    Related Experiment Videos

  • Gas exchange (PaO2, PaCO2) was measured under various conditions: closed chest, open chest with different FIO2 and CPAP settings.
  • Group 1 dogs underwent short-term CFAV evaluation, while Group 2 was monitored for 5 hours of CFAV with an open chest.

    • Main Results:

    • Optimal gas exchange was achieved with FIO2 0.4 and CPAP 5 mmHg, yielding PaO2 of 113.1 mmHg and PaCO2 of 35.0 mmHg.
    • Prolonged 5-hour CFAV in open-chested dogs maintained adequate oxygenation (PaO2 138.1 mmHg) and ventilation (PaCO2 41.8 mmHg).
    • No significant changes in vascular pressures were observed; hemodynamic variations were attributed to anesthesia.

    Conclusions:

    • CFAV is a viable technique for supporting gas exchange during thoracotomy in dogs.
    • The method ensures adequate oxygenation and ventilation, even during prolonged open-chest procedures.
    • CFAV demonstrates potential as a safe and effective ventilation strategy in thoracic surgery.