title: Indication, management, and outcome of brachycephalic dogs requiring mechanical ventilation.
abstract: OBJECTIVE
  To evaluate the frequency, and need for mechanical ventilation (MV) in a population of brachycephalic dogs (BD) compared with non-BD. Also, to describe the pre-MV abnormalities, ventilator settings used, the cardiovascular and pulmonary monitoring results and complications encountered in the same BD population. In addition, we sought to identify factors associated with successful weaning and describe outcomes of BD requiring MV.
  
  
  METHODS
  Retrospective observational study (1990-2008).
  
  
  METHODS
  University Small Animal Teaching Hospital.
  
  
  METHODS
  Fifteen BD managed with MV.
  
  
  METHODS
  None.
  
  
  RESULTS
  Signalment, indication for MV, ventilator settings, arterial blood gas values, duration of MV, complications, and outcome were recorded for each patient enrolled in study. BD were more likely to receive MV than non-BD (P=0.036). Out of the 15 dogs that fulfilled the inclusion criteria 7 (47%) underwent MV for impending respiratory fatigue, 6 (40%) for hypoxemia and 2 for hypercapnea. The most common underlying disease was aspiration pneumonia. Duration of MV ranged from 2 to 240 hours (median 15 hours). Seven patients were weaned (47%). Seven dogs had a temporary tracheostomy tube and 5 of them (71%) were weaned. Dogs that were weaned had a significantly greater preweaning trial PaO₂/FiO₂ ratio than those that were not (359 ± 92 versus 210 ± 57 mm Hg, P=0.025). No significant difference for weaning success between dogs with and those without a tracheostomy was detected (P=0.132). The discharge rate was 27% (all from the respiratory fatigue group).
  
  
  CONCLUSIONS
  Among all dogs admitted to ICU, BD were more likely to receive MV than non-BD. Aspiration pneumonia was frequently identified as the underlying cause of respiratory compromise. The survival rate for BD undergoing MV was not markedly different from previous studies. Weaning of BD from MV may be facilitated by employing preemptive strategies such as performing tracheostomy tube placements.
authors.affiliation: Section of Critical Care, Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA. ghoareau@ucdavis.edu
authors.forename: Guillaume L
authors.initials: GL
authors.lastname: Hoareau
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Mellema
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Silverstein
mesh_terms: D000046:Academic Medical Centers; D000818:Animals; D001344:Autopsy / Q000662:veterinary; D003398:Craniosynostoses / Q000150:complications / Q000628:therapy*; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004285:Dogs / Q000033:anatomy & histology; D005260:Female; D008297:Male; D011015:Pneumonia, Aspiration / Q000150:complications / Q000000981:diagnostic imaging / Q000662:veterinary*; D011859:Radiography; D012121:Respiration, Artificial / Q000379:methods / Q000662:veterinary*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000662:veterinary