Effects of pressure- and volume-controlled ventilation on the work of breathing in cats using a cuffed endotracheal tube

Research (Published online: 29-09-2021)

34. Effects of pressure- and volume-controlled ventilation on the work of breathing in cats using a cuffed endotracheal tube

Nutawan Niyatiwatchanchai and Naris Thengchaisri

Veterinary World, 14(9): 2568-2573

Nutawan Niyatiwatchanchai: Surgery Unit, Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, 10900, Thailand.

Naris Thengchaisri: Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, 10900, Thailand; Tippimarn Veterinary Hospital, Chulabhorn Royal Academy, 906/1 Pong Ta Long Subdistrict, Pak Chong District, Nakhon Ratchasima, 30130, Thailand.

doi: www.doi.org/10.14202/vetworld.2021.2568-2573

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Article history: Received: 09-06-2021, Accepted: 24-08-2021, Published online: 29-09-2021

Corresponding author: Naris Thengchaisri

E-mail: ajnaris@yahoo.com

Citation: Niyatiwatchanchai N, Thengchaisri N (2021) Effects of pressure- and volume-controlled ventilation on the work of breathing in cats using a cuffed endotracheal tube, Veterinary World, 14(9): 2568-2573.

Abstract

Background and Aim: Mechanical ventilation is essential for supporting patients' respiratory function when they are under general anesthesia. For cats with limited lung capacity, the different effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory function remain elusive. The objective of the present study was to compare the efficacy of VCV and PCV in cats under general anesthesia using a cuffed endotracheal tube (ETT).

Materials and Methods: Twelve healthy cats were randomly allocated to either a VCV or PCV group. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly applied to assess the efficacy of VCV, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. Peak inspiratory pressures (4, 5, 6, 7, and 8 mmHg) were randomly applied to assess the efficacy of PCV, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. Blood pressure, gas leakages, and end-tidal CO₂ were recorded from 60 trials for airway control during the use of VCV or PCV. Data were compared using Fisher's exact test with a significance level of p<0.05.

Results: Leakages did not differ between VCV (1/60 events) and PCV (0/60 events; p=0.500). Hypercapnia was identified when using VCV (6/60 events) less frequently than when using PCV (7/60 events; p=0.762), but did not reach statistical significance. Hypotension (mean arterial blood pressure <60 mmHg) occurred less frequently with VCV (0/60 events) than with PCV (9/60 events; p=0.003). Moreover, VCV provided a significantly lower work of breathing (151.10±65.40 cmH₂O mL) compared with PCV (187.84±89.72 cmH₂O mL; p<0.05).

Conclusion: VCV in cats using a cuffed ETT causes less hypotension than PCV. It should be noted that VCV provides a more stable tidal volume compared with PCV, resulting in a more stable minute volume. Nonetheless, VCV should not be used in patients with an airway obstruction because higher peak airway pressure may occur and lead to lung injury.

Keywords: endotracheal tube, hypotension, pressure-controlled ventilation, respiratory work, volume-controlled ventilation.