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Comparison of respiratory function during TIVA and isoflurane anaesthesia in ponies, part II: breathing patterns and transdiaphragmatic pressure

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Abstract
Objective: To compare breathing patterns and transdiaphragmatic pressure during total intravenous (TIVA) and isoflurane anaesthesia in ponies. Study design: Experimental, cross-over study. Animals: Six healthy ponies weighing 286 (233-388)61kg, age 13 (9-16)3years. Methods: Following premedication with romifidine [80gkg(-1) intravenously (IV)], general anaesthesia was induced with midazolam (0.06mgkg(-1) IV) and ketamine (2.5mgkg(-1) IV) and maintained with either isoflurane (FeIso=1.1%) (T-ISO) or an IV combination of romifidine (120gkg(-1) per hour), midazolam (0.09mgkg(-1) hour(-1)) and ketamine (3.3mgkg(-1) hour(-1)) (T-TIVA), while breathing 60% oxygen (FIO2). The circumference changes of the rib cage (RC) and abdominal compartment (ABD) were recorded using respiratory ultrasonic plethysmography (RUP). Balloon tipped catheters were placed in the distal oesophagus and the stomach and maximal transdiaphragmatic pressure (P-di max) was calculated during Mueller's manoeuvre. Results: The breathing pattern T-ISO was more regular and respiratory rate significantly lower compared with T-TIVA. Ponies in T-TIVA showed regularly appearing sighs, which were never observed in T-ISO. Different contribution of the RC and ABD compartments to the breathing pattern was observed with a smaller participation of the RC to the total volume change during T-ISO. Transdiaphragmatic pressures (mean 13.7 +/- SD 8.61 versus 23.4 +/- 7.27 cmH(2)O, p<0.0001) were higher in T-TIVA compared to T-ISO. The sum of the RC and ABD circumferential changes was lower during T-TIVA compared to T-ISO (6.32 +/- 4.42 versus 11.72 +/- 4.38 units, p<0.0001). Conclusion and clinical relevance: Marked differences in breathing pattern and transdiaphragmatic pressure exist during inhalation- and TIVA and these should be taken into account for clinical estimation of anaesthetic depth.
Keywords
ponies, total intravenous anaesthesia, CHEST-WALL MECHANICS, isoflurane, breathing pattern, transdiaphragmatic pressure, THORACOABDOMINAL ASYNCHRONY, HALOTHANE ANESTHESIA, RIB CAGE, LUNG, ANESTHETIZED HORSE, DIAPHRAGMATIC CONTRACTILITY, KETAMINE ANESTHESIA, AIRWAY-OBSTRUCTION, VENTILATION

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Citation

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MLA
Kowalczyk, Lidia, Barbara Steblaj, Stijn Schauvliege, et al. “Comparison of Respiratory Function During TIVA and Isoflurane Anaesthesia in Ponies, Part II: Breathing Patterns and Transdiaphragmatic Pressure.” VETERINARY ANAESTHESIA AND ANALGESIA 41.6 (2014): 592–601. Print.
APA
Kowalczyk, L., Steblaj, B., Schauvliege, S., Schramel, J. P., Pavlidou, K., Savvas, I., Duchateau, L., et al. (2014). Comparison of respiratory function during TIVA and isoflurane anaesthesia in ponies, part II: breathing patterns and transdiaphragmatic pressure. VETERINARY ANAESTHESIA AND ANALGESIA, 41(6), 592–601.
Chicago author-date
Kowalczyk, Lidia, Barbara Steblaj, Stijn Schauvliege, Johannes Peter Schramel, Kiriaki Pavlidou, Ioannis Savvas, Luc Duchateau, Frank Gasthuys, and Yves Moens. 2014. “Comparison of Respiratory Function During TIVA and Isoflurane Anaesthesia in Ponies, Part II: Breathing Patterns and Transdiaphragmatic Pressure.” Veterinary Anaesthesia and Analgesia 41 (6): 592–601.
Chicago author-date (all authors)
Kowalczyk, Lidia, Barbara Steblaj, Stijn Schauvliege, Johannes Peter Schramel, Kiriaki Pavlidou, Ioannis Savvas, Luc Duchateau, Frank Gasthuys, and Yves Moens. 2014. “Comparison of Respiratory Function During TIVA and Isoflurane Anaesthesia in Ponies, Part II: Breathing Patterns and Transdiaphragmatic Pressure.” Veterinary Anaesthesia and Analgesia 41 (6): 592–601.
Vancouver
1.
Kowalczyk L, Steblaj B, Schauvliege S, Schramel JP, Pavlidou K, Savvas I, et al. Comparison of respiratory function during TIVA and isoflurane anaesthesia in ponies, part II: breathing patterns and transdiaphragmatic pressure. VETERINARY ANAESTHESIA AND ANALGESIA. 2014;41(6):592–601.
IEEE
[1]
L. Kowalczyk et al., “Comparison of respiratory function during TIVA and isoflurane anaesthesia in ponies, part II: breathing patterns and transdiaphragmatic pressure,” VETERINARY ANAESTHESIA AND ANALGESIA, vol. 41, no. 6, pp. 592–601, 2014.
@article{5840925,
  abstract     = {Objective: To compare breathing patterns and transdiaphragmatic pressure during total intravenous (TIVA) and isoflurane anaesthesia in ponies. 
Study design: Experimental, cross-over study. 
Animals: Six healthy ponies weighing 286 (233-388)61kg, age 13 (9-16)3years. 
Methods: Following premedication with romifidine [80gkg(-1) intravenously (IV)], general anaesthesia was induced with midazolam (0.06mgkg(-1) IV) and ketamine (2.5mgkg(-1) IV) and maintained with either isoflurane (FeIso=1.1%) (T-ISO) or an IV combination of romifidine (120gkg(-1) per hour), midazolam (0.09mgkg(-1) hour(-1)) and ketamine (3.3mgkg(-1) hour(-1)) (T-TIVA), while breathing 60% oxygen (FIO2). The circumference changes of the rib cage (RC) and abdominal compartment (ABD) were recorded using respiratory ultrasonic plethysmography (RUP). Balloon tipped catheters were placed in the distal oesophagus and the stomach and maximal transdiaphragmatic pressure (P-di max) was calculated during Mueller's manoeuvre. 
Results: The breathing pattern T-ISO was more regular and respiratory rate significantly lower compared with T-TIVA. Ponies in T-TIVA showed regularly appearing sighs, which were never observed in T-ISO. Different contribution of the RC and ABD compartments to the breathing pattern was observed with a smaller participation of the RC to the total volume change during T-ISO. Transdiaphragmatic pressures (mean 13.7 +/- SD 8.61 versus 23.4 +/- 7.27 cmH(2)O, p<0.0001) were higher in T-TIVA compared to T-ISO. The sum of the RC and ABD circumferential changes was lower during T-TIVA compared to T-ISO (6.32 +/- 4.42 versus 11.72 +/- 4.38 units, p<0.0001). 
Conclusion and clinical relevance: Marked differences in breathing pattern and transdiaphragmatic pressure exist during inhalation- and TIVA and these should be taken into account for clinical estimation of anaesthetic depth.},
  author       = {Kowalczyk, Lidia and Steblaj, Barbara and Schauvliege, Stijn and Schramel, Johannes Peter and Pavlidou, Kiriaki and Savvas, Ioannis and Duchateau, Luc and Gasthuys, Frank and Moens, Yves},
  issn         = {1467-2987},
  journal      = {VETERINARY ANAESTHESIA AND ANALGESIA},
  keywords     = {ponies,total intravenous anaesthesia,CHEST-WALL MECHANICS,isoflurane,breathing pattern,transdiaphragmatic pressure,THORACOABDOMINAL ASYNCHRONY,HALOTHANE ANESTHESIA,RIB CAGE,LUNG,ANESTHETIZED HORSE,DIAPHRAGMATIC CONTRACTILITY,KETAMINE ANESTHESIA,AIRWAY-OBSTRUCTION,VENTILATION},
  language     = {eng},
  number       = {6},
  pages        = {592--601},
  title        = {Comparison of respiratory function during TIVA and isoflurane anaesthesia in ponies, part II: breathing patterns and transdiaphragmatic pressure},
  url          = {http://dx.doi.org/10.1111/vaa.12151},
  volume       = {41},
  year         = {2014},
}

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