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    Aline Ambrosio

    Electrical impedance tomography (EIT) is a non-invasive real-time non-ionising imaging modality that has many applications. Since the first recorded use in 1978, the technology has become more widely used especially in human adult and... more
    Electrical impedance tomography (EIT) is a non-invasive real-time non-ionising imaging modality that has many applications. Since the first recorded use in 1978, the technology has become more widely used especially in human adult and neonatal critical care monitoring. Recently, there has been an increase in research on thoracic EIT in veterinary medicine. Real-time imaging of the thorax allows evaluation of ventilation distribution in anesthetised and conscious animals. As the technology becomes recognised in the veterinary community there is a need to standardize approaches to data collection, analysis, interpretation and nomenclature, ensuring comparison and repeatability between researchers and studies. A group of nineteen veterinarians and two biomedical engineers experienced in veterinary EIT were consulted and contributed to the preparation of this statement. The aim of this consensus is to provide an introduction to this imaging modality, to highlight clinical relevance and ...
    The anesthetic risk classification guides anesthesists to prevent complication, including coagulopaties. The prothrombine time (PT) and activated partial thromboplastine time (APTT) are in vitro parametres used routinely to assess the... more
    The anesthetic risk classification guides anesthesists to prevent complication, including coagulopaties. The prothrombine time (PT) and activated partial thromboplastine time (APTT) are in vitro parametres used routinely to assess the haemostatic profile. This study aimed to evaluate the values of PT and APTT in the time before (T-PRE) and post-anesthesia (T-POS). Were studied 67 animal divided in ASA i, II and III. There were no differences between the values os APTT and PT, comparing the three different groups, both in times. There were also no difference when analyzing the moments within the same group. It is concluded the anesthetic risk by itself has no impact on coagulation.
    The effects of different preanesthetic medications (acepromazine plus either meperidine or butorphanol) given before the induction of anesthesia with midazolam and ketamine on intraocular pressure, heart rate, and arterial blood pressure... more
    The effects of different preanesthetic medications (acepromazine plus either meperidine or butorphanol) given before the induction of anesthesia with midazolam and ketamine on intraocular pressure, heart rate, and arterial blood pressure were investigated in 20 dogs. Following administration of preanesthetics and induction of anesthesia, dogs were intubated and anesthesia was maintained with halothane for 10 minutes. Intraocular pressure was significantly higher (P <.05) at several evaluations for dogs premedicated with acepromazine/meperidine than for those premedicated with acepromazine/butorphanol. Mean heart rate and diastolic arterial blood pressure were significantly (P <.05) higher 5 minutes after administration of acepromazine/meperidine than after acepromazine/butorphanol. Results of this study suggest that acepromazine/butorphanol is a satisfactory preanesthetic combination to use before induction of anesthesia with midazolam and ketamine for ophthalmic surgery in dogs.
    To assess the cardiopulmonary effects of ephedrine and phenylephrine for management of isoflurane-induced hypotension in horses. Prospective randomized clinical study. Fourteen isoflurane-anesthetized horses undergoing digital palmar... more
    To assess the cardiopulmonary effects of ephedrine and phenylephrine for management of isoflurane-induced hypotension in horses. Prospective randomized clinical study. Fourteen isoflurane-anesthetized horses undergoing digital palmar neurectomy. Ephedrine (EPH group; 0.02 mg kg(-1) minute(-1); n = 7) or phenylephrine (PHE group; 0.002 mg kg(-1) minute(-1); n = 7) was administered to all horses when mean arterial pressure (MAP) was <60 mmHg. The infusions were ended when the target MAP was achieved, corresponding to a 50% increase over the pre-infusion MAP (baseline). The horses were instrumented with an arterial catheter to measure blood pressure and allow the collection of blood for pH and blood-gas analysis and a Swan-Ganz catheter for measurement of cardiac output using thermodilution. Cardiopulmonary parameters were recorded at baseline and at 5, 30, 60 and 90 minutes after achieving the target MAP. In both groups, the MAP and systemic vascular resistance (SVR) increased significantly at 5, 30, 60 and 90 minutes post infusion compared to baseline (p < 0.05). The EPH group had a significant increase in cardiac index (CI) and systemic oxygen delivery index at 5, 30, 60 and 90 minutes post infusion compared to baseline (p <…
    Foram utilizados 10 psitacídeos da espécie Amazonas aestiva (papagaio-verdadeiro). Após contenção física, a anestesia foi induzida com o auxílio de uma máscara facial conectada ao sistema de Maplesson D (BARAKA), utilizando sevofluorano a... more
    Foram utilizados 10 psitacídeos da espécie Amazonas aestiva (papagaio-verdadeiro). Após contenção física, a anestesia foi induzida com o auxílio de uma máscara facial conectada ao sistema de Maplesson D (BARAKA), utilizando sevofluorano a 6V% e fluxo diluente de O2 de 1,5/min de oxigênio. A determinação da Dose Anestésica Mínima (DAM) foi estabelecida de maneira similar àquela proposta por LUDDERS et al. (1990). A DAM obtida neste experimento 3,44V%, que eqüivale a concentração alveolar mínima de mamíferos mostrou-se maior nas aves analisadas quando comparada a obtida nos mamíferos. O anestésico mostrou-se bastante seguro para a espécie, não alterando de forma deletéria as variáveis fisiológicas analisadas.
    Os analgésicos opióides promovem analgesia intensa, possibilitando o emprego de concentrações reduzidas dos anestésicos inalatórios, minimizando assim a depressão cardiovascular que ocorre durante a anestesia. Vários opióides podem ser... more
    Os analgésicos opióides promovem analgesia intensa, possibilitando o emprego de concentrações reduzidas dos anestésicos inalatórios, minimizando assim a depressão cardiovascular que ocorre durante a anestesia. Vários opióides podem ser empregados na anestesia, sendo que dentre os mais potentes, o fentanil, sufentanil e alfentanil são os mais freqüentemente administrados no transoperatório. No presente estudo, comparou-se a ação no sistema cardiovascular desses três agentes durante a anestesia inalatória em cães, submetidos a procedimentos ortopédicos, bem como, avaliou-se a possibilidade de se manter a anestesia com baixas concentrações de halotano. Foram usados três grupos, de dez animais cada, que receberam, após estabilização da anestesia, doses equipotentes de um dos três agentes analgésicos - grupo I - 5µg/kg de fentanil IV, grupo II - 1µg/kg de sufentanil IV e grupo III - 25µg/kg de alfentanil IV. Os parâmetros cardiovasculares e respiratórios foram avaliados em diferentes tem...
    To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Prospective randomized clinical study. Twenty client-owned healthy horses aged 5 ± 2 years, weighing 456 ± 90... more
    To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Prospective randomized clinical study. Twenty client-owned healthy horses aged 5 ± 2 years, weighing 456 ± 90 kg. In the control group (CG; n = 10) weaning was performed by a gradual decrease in respiratory rate (fR ) and in the PSV group (PSVG; n = 10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2 > 50 mmHg, arterial pH < 7.35 plus PaCO2 > 50 mmHg or PaO2…
    To evaluate equine cardiopulmonary function and recovery quality after administration of 0.25 or 0.50 mg/kg xylazine intravenously (IV) during recovery. Randomized, blinded, prospective, clinical study. Horses (n = 20). During recovery... more
    To evaluate equine cardiopulmonary function and recovery quality after administration of 0.25 or 0.50 mg/kg xylazine intravenously (IV) during recovery. Randomized, blinded, prospective, clinical study. Horses (n = 20). During recovery after 3 hours of isoflurane anesthesia for arthroscopic surgery, horses were administered either 0.25 mg/kg (G25, n = 10) or 0.50 mg/kg (G50, n = 10) xylazine intravenously. Vital signs and arterial blood samples were obtained during recovery before sedation (baseline), 5, 10, 20, 30, and 45 minutes after xylazine and 30 minutes after standing. The quality of recovery scores ranged from 10 to 72 (10 = best, 72 = worst). G25 horses recovered faster (mean ± SD, 33 ± 5 min) than G50 horses (50 ± 7 min, P < .0001). Mean maximal decrease in arterial oxygen tension was 55 ± 11 mmHg in G25 (at 10 minutes; P < .05) and 54 ± 7 mmHg in G50 (at 20 minutes; P < .01). G25 group had a total recovery score (23 [range 18-29]) and number of attempts to stand (4 ± 2) greater than the G50 group (18 [10-23] and 1 ± 1, respectively; P…
    The hemodynamic response to acute normovolemic hemodilution (ANH) can be affected by the anesthetics used. We randomized 18 mongrel dogs to undergo ANH with 3 different inhaled anesthetics: halothane, isoflurane, or sevoflurane.... more
    The hemodynamic response to acute normovolemic hemodilution (ANH) can be affected by the anesthetics used. We randomized 18 mongrel dogs to undergo ANH with 3 different inhaled anesthetics: halothane, isoflurane, or sevoflurane. Hemodynamics, oxygen transport, and gastric pH were measured before blood withdrawal, at the end of hemodilution, and 30 and 60 min after the end of hemodilution. The baseline measurements of all hemodynamic variables were similar among groups, with the exception of heart rate, which was more rapid in the sevoflurane group. Thirty minutes after hemodilution, the cardiac index increased 88%, 86%, and 157% in the halothane, isoflurane, and sevoflurane groups, respectively, whereas arterial-venous oxygen differences and oxygen consumption were larger in the halothane group compared with the isoflurane and sevoflurane groups. Gastric pH obtained by tonometry did not change and was not different among groups. Because the hemodynamic response to ANH was not blunted, all three anesthetics may be safely used for the maintenance of anesthesia.
    Background In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological... more
    Background In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Methods Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to th...
    To compare static compliance (C) and alveolar-arterial oxygen tension difference [P(a-a)O] between positive end-expiratory pressures (PEEP) of 7, 12 and 17 cmHO applied after an alveolar recruitment maneuver (RM) in... more
    To compare static compliance (C) and alveolar-arterial oxygen tension difference [P(a-a)O] between positive end-expiratory pressures (PEEP) of 7, 12 and 17 cmHO applied after an alveolar recruitment maneuver (RM) in isoflurane-anesthetized horses. Prospective, randomized, clinical study. A group of 30 healthy adult horses undergoing arthroscopic surgery. Animals in dorsal recumbency and mechanically ventilated with a tidal volume of 14 mL kg and 7 cmHO PEEP (control; n = 6) were subjected to an RM by increasing PEEP from 7 to 22 cmHO in 5 cmHO increments at 5 minute intervals, and then decreased similarly to PEEP of 17 (RM17; n = 8), 12 (RM12; n = 8) or 7 cmHO (RM7; n = 8). C and P(a-a)O were assessed prior to (baseline) and after the RM at 5, 10, 15, 20, 40, 60 and 80 minutes after achieving each target PEEP, and during recovery from anesthesia. Post-RM improvements on P(a-a)O were maintained (baseline versus 80 minutes) in RM12 [216 ± 77 mmHg (28.8 ± 10.3 kPa) versus 194 ± 39 mmHg...
    To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia.... more
    To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia. Prospective randomized clinical study. Fourteen client-owned bitches weighing 26 ± 7 kg undergoing elective ovariohysterectomy. Isoflurane-anesthetized dogs in dorsal recumbency were ventilated with 0 cmH2O PEEP and pressure-controlled ventilation by adjusting the peak inspiratory pressure (PIP) to achieve a low (7 mL kg(-1); n = 7) or a high (12 mL kg(-1); n = 7) VT. Ninety minutes after induction (T90), an ARM (PIP 20 cmH2O for 10 seconds, twice with a 10 second interval) was performed followed by the application of 5 cmH2O PEEP for 35 minutes (RM35). The vertical (ventral=0%; dorsal=100%) and horizontal (right=0%; left=100%) center of ventilation (CoV), four regions of interest (ROI) (ventral, central-ventral, central-dorsal, dorsal) identified i...
    To compare the effects of pressure controlled ventilation (PCV) with volume-controlled ventilation (VCV) on lung compliance, gas exchange, and hemodynamics in isoflurane-anesthetized dogs. Prospective randomized study. Veterinary teaching... more
    To compare the effects of pressure controlled ventilation (PCV) with volume-controlled ventilation (VCV) on lung compliance, gas exchange, and hemodynamics in isoflurane-anesthetized dogs. Prospective randomized study. Veterinary teaching hospital. Forty client-owned bitches undergoing elective ovariohysterectomy. Dogs were randomly assigned to be ventilated with 100% oxygen using PCV (n = 20) or VCV (n = 20). The respiratory rate was 20/min and positive end-expiratory pressure (PEEP) was 5 cm H2 O, with a tidal volume of 10 mL/kg. Cardiac output (CO) was measured using thermodilution. Cardiopulmonary and blood gas data were obtained during spontaneous ventilation and after 30 (T30) and 60 minutes (T60) of controlled ventilation. In dogs ventilated with PCV, at T30 and T60, PIP was lower (11.4 ± 1.9 and 11.1 ± 1.5 cm H2 O, respectively) and static compliance (CST ) was higher (51 ± 7 and 56 ± 6 mL/cm H2 O, respectively) than in VCV group (PIP of 14.3 ± 1.3 and 15.5 ± 1.4 cm H2 O; CS...
    The effects of different preanesthetic medications (acepromazine plus either meperidine or butorphanol) given before the induction of anesthesia with midazolam and ketamine on intraocular pressure, heart rate, and arterial blood pressure... more
    The effects of different preanesthetic medications (acepromazine plus either meperidine or butorphanol) given before the induction of anesthesia with midazolam and ketamine on intraocular pressure, heart rate, and arterial blood pressure were investigated in 20 dogs. Following administration of preanesthetics and induction of anesthesia, dogs were intubated and anesthesia was maintained with halothane for 10 minutes. Intraocular pressure was significantly higher (P <.05) at several evaluations for dogs premedicated with acepromazine/meperidine than for those premedicated with acepromazine/butorphanol. Mean heart rate and diastolic arterial blood pressure were significantly (P <.05) higher 5 minutes after administration of acepromazine/meperidine than after acepromazine/butorphanol. Results of this study suggest that acepromazine/butorphanol is a satisfactory preanesthetic combination to use before induction of anesthesia with midazolam and ketamine for ophthalmic surgery in dogs.
    This prospective randomized blinded clinical study aimed to investigate the potential of vedaprofen for preventive analgesia, comparing its analgesic effects with ketoprofen administered post-operatively in dogs undergoing maxillectomy or... more
    This prospective randomized blinded clinical study aimed to investigate the potential of vedaprofen for preventive analgesia, comparing its analgesic effects with ketoprofen administered post-operatively in dogs undergoing maxillectomy or mandibulectomy. Pain control was effective and rescue analgesia was not necessary in any group. Pain scores were not significantly different between groups. The respiratory rate and rectal temperature were decreased in all groups at extubation until 6 hours post-extubation compared to baseline. Cortisol and epinephrine levels were increased only at 0.5 hours after extubation in all groups compared to baseline. Vedaprofen did not present any preventive analgesic effect. Pre- and postoperative vedaprofen were as effective as ketoprofen for postoperative pain control.
    ... USE OF ALFENTANIL, SUFENTANIL AND FENTANYL IN DOGS ANESTHETIZED WITH HALOTHANE Denise Tabacchi Fantoni1 Aline Magalhães Ambrosio2 Fábio Futema2 Elton Rodrigues Migliati2 Eunice Yuriko Tamura2 ...
    The hemodynamic response to acute normovolemic hemodilution (ANH) can be affected by the anesthetics used. We randomized 18 mongrel dogs to undergo ANH with 3 different inhaled anesthetics: halothane, isoflurane, or sevoflurane.... more
    The hemodynamic response to acute normovolemic hemodilution (ANH) can be affected by the anesthetics used. We randomized 18 mongrel dogs to undergo ANH with 3 different inhaled anesthetics: halothane, isoflurane, or sevoflurane. Hemodynamics, oxygen transport, and gastric pH were measured before blood withdrawal, at the end of hemodilution, and 30 and 60 min after the end of hemodilution. The baseline measurements of all hemodynamic variables were similar among groups, with the exception of heart rate, which was more rapid in the sevoflurane group. Thirty minutes after hemodilution, the cardiac index increased 88%, 86%, and 157% in the halothane, isoflurane, and sevoflurane groups, respectively, whereas arterial-venous oxygen differences and oxygen consumption were larger in the halothane group compared with the isoflurane and sevoflurane groups. Gastric pH obtained by tonometry did not change and was not different among groups. Because the hemodynamic response to ANH was not blunted, all three anesthetics may be safely used for the maintenance of anesthesia.
    Positive end-expiratory pressure (PEEP) and sustained inspiratory insufflations (SI) during acute lung injury (ALI) are suggested to improve oxygenation and respiratory mechanics. We aimed to investigate the hemodynamic effects of PEEP... more
    Positive end-expiratory pressure (PEEP) and sustained inspiratory insufflations (SI) during acute lung injury (ALI) are suggested to improve oxygenation and respiratory mechanics. We aimed to investigate the hemodynamic effects of PEEP with and without alveolar recruiting maneuver in a mild ALI model induced by inhalation of hydrochloric acid. Thirty-two pigs were randomly allocated into four groups (Control-PEEP, Control-SI, ALI-PEEP and ALI-SI). ALI was induced by intratracheal instillation of hydrochloric acid. PEEP values were progressively increased and decreased from 5, 10, 15 and 20 cmH2O in all groups. Three SIs maneuvers of 30 cmH2O for 20 s were applied to the assignable groups between each PEEP level. Transesophageal echocardiography (TEE), global hemodynamics, oxygenation indexes and gastric tonometry were measured 5 min after the maneuvers had been concluded and at each established value of PEEP (5, 10, 15 and 20 cmH2O). The cardiac index, ejection fraction and end-diastolic volume of right ventricle were significantly (P < 0.001) decreased with PEEP in both Control and ALI groups. Left ventricle echocardiography showed a significant decrease in end-diastolic volume at 20 cmH2O of PEEP (P < 0.001). SIs did not exert any significant hemodynamic effects either early (after 5 min) or late (after 3 h). In a mild ALI model induced by inhalation of hydrochloric acid, significant hemodynamic impairment characterized by cardiac function deterioration occurred during PEEP increment, but SI, probably due to low applied values (30 cmH2O), did not exert further negative hemodynamic effects. PEEP should be used cautiously in ALI caused by acid gastric content inhalation.
    The anesthetic risk classification guides anesthesists to prevent complication, including coagulopaties. The prothrombine time (PT) and activated partial thromboplastine time (APTT) are in vitro parametres used routinely to assess the... more
    The anesthetic risk classification guides anesthesists to prevent complication, including coagulopaties. The prothrombine time (PT) and activated partial thromboplastine time (APTT) are in vitro parametres used routinely to assess the haemostatic profile. This study aimed to evaluate the values of PT and APTT in the time before (T-PRE) and post-anesthesia (T-POS). Were studied 67 animal divided in ASA i, II and III. There were no differences between the values os APTT and PT, comparing the three different groups, both in times. There were also no difference when analyzing the moments within the same group. It is concluded the anesthetic risk by itself has no impact on coagulation.