Abstract
Purpose
To determine the effect of heat and moisture exchange (HME) on the tracheobronchial tree (TBT) using a unidirectional anesthesic circuit with or without CO2 absorber and high or low fresh gas flow (FGF), in dogs.
Methods
Thirty-two dogs were randomly allocated to four groups: G1 (n = 8) valvular circuit without CO2 absorber and high FGF (5 L· min−1); G2 (n=8) as G1 with HME; G3 (n=8) circuit with CO2 absorber with a low FGF (1 L· min−1); G4 (n=8) as G3 with HME. Anesthesia was induced and maintained with pentobarbital. Tympanic temperature (TT), inhaled gas temperature (IGT), relative (RH) and absolute humidity (AH) of inhaled gas were measured at 15 (control), 60, 120 and 180 min of controlled ventilation. Dogs were euthanized and biopsies in the areas of TBT were performed by scanning electron microscopy.
Results
The G2 and G4 groups showed the highest AH (> 20 mgH2O· L−1) and G1 the lowest (< 10 mgH2O· L−1) and G3 was intermediate (< 20 mgH2O· L−1) (P < 0.01), There was no difference of TT and IGT among groups. Alterations of the mucociliary system were greatest in G1, least in G2 and G4, and intermediate in G3.
Conclusion
In dogs, introduction of HME to a unidirectional anesthetic circuit with/without CO2 absorber and high or low FGF preserved humidity of inspired gases. HME attenuated but did not prevent alterations of the mucociliary system of the TBT.
Objectif
Déterminer, chez des chiens, l’effet de l’échange de chaleur et d’humidité (ECH) sur l’arbre trachéobronchique (ATB) en utilisant un circuit anesthésique unidirectionnel avec ou sans absorption de CO2 et un haut ou bas débit de gaz frais (DGF).
Méthode
Trente-deux chiens ont été répartis au hasard en quatre groupes: G1 (n=8), un circuit à valve sans absorption de CO2 et avec un haut DGF (5 L· min−1); G2 (n=8), comme G1 avec ECH; G3 (n = 8), un circuit avec absorption de CO2 et un bas DGF (1 L· min−1); G4 (n = 8), comme G3 avec ECH. L’anesthésie a été induite et maintenue avec du pentobarbital. La température tympanique (TT), la température des gaz inhalés (TGI), l’humidité relative (HR) et absolue (HA) des gaz inhalés ont été mesurées après 15 (témoin), 60, 120 et 180 min de ventilation contrôlée. Les chiens ont été sacrifiés et des biopsies de l’ATB ont été réalisées par microscopie électronique à balayage.
Résultats
Les groupes G2 et G4 ont affiché les plus hauts taux d’HA (> 20 mgH2O· L−1), G1 avait le plus bas taux (< 10 mgH2O· L−1) et G3 était intermédiaire (< 20 mgH2O· L−1) (P < 0,01). Il n’y a pas eu de différence intergroupe concernant la TT et la TGI. Les modifications du système mucociliaire ont été plus importantes dans le G1, moindres dans les G2 et G4 et intermédiaires dans le G3.
Conclusion
L’introduction, chez des chiens, d’un ECH à un circuit anesthésique avec ou sans absorption de CO2 et avec un haut ou bas DGF a préservé l’humidité des gaz inhalés. L’ECH a diminué, mais n’a pas empêché, les modifications du système mucociliaire de l’ATB.
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Bisinotto, F.M.B., Braz, J.R.C., Martins, R.H.G. et al. Tracheobronchial consequences of the use of heat and moisture exchangers in dogs. Can J Anesth 46, 897–903 (1999). https://doi.org/10.1007/BF03012983
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DOI: https://doi.org/10.1007/BF03012983