title: Noninvasive continuous positive airway pressure delivered using a pediatric helmet in dogs recovering from general anesthesia.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of noninvasive continuous positive airway pressure (CPAP) administered with a pediatric helmet in healthy dogs recovering from general anesthesia.
  
  
  METHODS
  Randomized, cross-over, clinical study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Fifteen healthy female, client-owned dogs recovering from general anesthesia following elective ovariohysterectomy.
  
  
  METHODS
  All dogs received the same standardized anesthetic protocol (acepromazine, morphine, propofol, and isoflurane in oxygen). After extubation, a pediatric helmet was placed on all dogs and connected to a venturi valve supplied with medical air. In all patients, the gas flow was set to 50 L/minute and the FiO2 to 0.21. Dogs received the following sequence of treatments, each lasting 20 minutes: 0 CPAP (pre-CPAP), CPAP of 5 cm H2 O (CPAP), and again 0 CPAP (post-CPAP).
  
  
  RESULTS
  During the entire study, the following data were collected: pressure and FiO2 inside the helmet, mean arterial pressure, respiratory rate, heart rate, sedation score (0 = awake, 10 = deep sedation), and tolerance to the helmet (0 = excellent, 4 = poor). At the end of each phase, an arterial blood sample was sampled. As compared with the pre-CPAP and the post-CPAP periods, during the CPAP period, the PaCO2 , alveolar-arterial oxygen gradient (P[A-a]O2 ), and respiratory rate significantly decreased. The PaO2 was higher at CPAP (105.6 ± 4.0 mm Hg) compared with pre-CPAP (80.6 ± 6.9 mm Hg) and post-CPAP (86.7 ± 5.8 mm Hg). Tolerance and sedation scores during the CPAP period were not different from those in the pre-CPAP and post-CPAP periods.
  
  
  CONCLUSIONS
  Noninvasive CPAP applied through a helmet is a feasible and effective supportive technique in dogs recovering from general anesthesia.
authors.affiliation: Dipartimento dell'Emergenza e dei Trapianti d'Organo, Sezione di Cliniche Veterinarie e Produzioni Animali.
authors.forename: Francesco
authors.initials: F
authors.lastname: Staffieri
authors.forename: Antonio
authors.initials: A
authors.lastname: Crovace
authors.forename: Valentina
authors.initials: V
authors.lastname: De Monte
authors.forename: Paola
authors.initials: P
authors.lastname: Centonze
authors.forename: Giulio
authors.initials: G
authors.lastname: Gigante
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grasso
mesh_terms: D000768:Anesthesia, General / Q000662:veterinary*; D000818:Animals; D001794:Blood Pressure; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000662:veterinary*; D004285:Dogs; D004867:Equipment Design; D005260:Female; D006339:Heart Rate; D006863:Hydrogen-Ion Concentration; D007044:Hysterectomy / Q000662:veterinary; D010052:Ovariectomy / Q000662:veterinary; D010100:Oxygen
chemical_list: D010100:Oxygen
keywords: CPAP; atelectasis; dogs; respiratory distress