Positive-pressure ventilation outcomes in dogs and cats with heart

Abstract

OBJECTIVE: To describe the indications, duration of ventilation, underlying cardiac diseases, and outcome of dogs and cats undergoing positive-pressure ventilation (PPV) for treatment of congestive heart failure (CHF). DESIGN: Two-site retrospective study (1992-2012). SETTING: Two university small animal teaching hospitals. ANIMALS: Six cats and 10 dogs undergoing PPV for CHF. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records were searched to identify patients requiring PPV for treatment of pulmonary edema secondary to CHF. Sixteen animals fulfilled these criteria. Patient signalment, duration of PPV, underlying cardiac disease, arterial or venous blood gas values, pharmacologic therapy before, during, and after PPV, anesthetic drugs, complications, and outcome were recorded. Overall survival to discharge was 62.5% (10/16). Mean (±SD) duration of PPV was 30.8 ± 21.3 hours and average time from presentation for CHF to initiation of PPV was 5.9 ± 6.4 hours. Azotemia at the time of initiation of ventilation, development of anuria or oliguria, and use of pentobarbital for anesthesia were negatively associated with survival (P = 0.011, P = 0.036, and P = 0.036, respectively). Survival-to-discharge rate was 77% (10/13) for patients treated after 2005 and those not receiving pentobarbital. There was no significant effect attributed to age, sex, weight, species, nature of heart disease, furosemide dose, length of ventilation, use of vasopressors, first-time CHF events, or plasma lactate concentration on survival to discharge. CONCLUSIONS: Dogs and cats requiring PPV for CHF have a good overall prognosis for hospital discharge and require PPV for a relatively short duration. Azotemia, oliguria or anuria, and the use of pentobarbital are negatively associated with outcome.