Continuous positive airway pressure (CPAP) provision with a pediatric helmet for treatment of hypoxemic acute respiratory failure in dogs.

Abstract

OBJECTIVE: To evaluate arterial blood gas parameters and pulmonary radiography, before and after provision of continuous positive airway pressure (CPAP) via a pediatric helmet in dogs with acute hypoxemic respiratory failure. DESIGN: Single-center, observational study conducted from 2016 to 2017. SETTING: University teaching hospital. ANIMALS: Seventeen dogs presenting with clinical signs compatible with respiratory failure, confirmed by arterial blood gas analyses. INTERVENTIONS: For each animal arterial blood samples and thoracic radiographs were performed at arrival (T). Hypoxemic dogs (PaO&#xa0;<80&#xa0;mm&#xa0;Hg), without evidence of pneumothorax or pleural effusion, received CPAP ventilation via a pediatric Helmet for at least 1 hour. At the end of CPAP ventilation, a second arterial blood gas analysis was performed at room air (T). The F-shunt was also calculated. MEASUREMENT AND MAIN RESULTS: Respiratory rate, heart rate and rhythm, mean blood pressure, mucosal membrane color, and rectal temperature were recorded. Tolerance to the helmet was evaluated using a predetermined scoring system. Two dogs were excluded from the study for low tolerance to the helmet. In 15 of 17 dogs, a significant difference between Tand Twas noted for PaO(60.84&#xa0;&#xb1;&#xa0;3&#xa0;mm&#xa0;Hg vs 80.2&#xa0;&#xb1;&#xa0;5.5&#xa0;mm&#xa0;Hg), P(A-a)O(52.4&#xa0;&#xb1;&#xa0;4.4&#xa0;mm&#xa0;Hg vs 35.2&#xa0;&#xb1;&#xa0;6&#xa0;mm&#xa0;Hg), PaO/FiO(289.7&#xa0;&#xb1;&#xa0;14.3 vs 371&#xa0;&#xb1;&#xa0;21), and %SO(91.3 vs 98.8). In 15 of 17 dogs, the helmet was well tolerated. F-shunt significantly decreased following provision of CPAP (37%; range, 8.4-68% vs 6%; range, -5.6-64.3%). CONCLUSION: The use of a pediatric helmet appears to be a suitable device for delivery of CPAP in dogs with hypoxemic acute respiratory failure. The device appears to be reasonably tolerated and improved oxygenation in most dogs.