Prueba de concepto de la eficacia del equipo prototipo “Ciclador Automático para Resucitador” en un cerdo adulto
DOI:
https://doi.org/10.14409/favecv.v20iSuppl..11068Resumen
En este estudio se evaluó en una prueba de concepto, la seguridad y funcionalidad del equipo prototipo Ciclador Automático para Resucitador (CAR) en un cerdo de peso similar al de un humano adulto. Para ello, se estudiaron los volúmenes corrientes de 5.8, 7 y 9.7 ml/kg para las presiones positivas al final de la expiración (PEEP) de 5, 10 y 15 cmH2O. Los parámetros indicativos del estado homeostático del animal se obtuvieron a través de un equipo multiparamétrico y un sistema de análisis bioquímicos de sangre EPOC®. En los periodos en los que se evaluaron los volúmenes corrientes de 7 y 9.7 ml/kg los parámetros se mantuvieron dentro de rangos fisiológicos normales. Sin embargo, el volumen corriente de 5.8 ml/kg no fue suficiente para mantener una ventilación adecuada lo que se manifestó a través de hipercapnia y caída del pH. Como conclusión general se puede inferir que con adaptaciones en los patrones de ventilación (7 y 9.7 ml/kg), la utilización del prototipo CAR permitió mantener al animal con vida durante 24 h conservando su homeostasis.
Citas
Allinovi M, Parise A, Giacalone M, Amerio A, Delsante M, Odone A, Franci A, Gigliotti F, Amadasi S, Delmonte D, Parri N, Mangia A. 2020. Lung ultrasound may support diagnosis and monitoring of COVID-19 pneumonia. Ultrasound. Med. Biol. 46: 2908-2917.
Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, Greninger AL, Pipavath S, Wurfel MM, Evans L, Kritek PA, West TE, Luks A, Gerbino A, Dale CR, Goldman JD, O'Mahony S, Mikacenic C. 2020. Covid-19 in critically Ill patients in the seattle region - Case Series. N. Engl. J. Med. 382: 2012-2022.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395: 507-513.
Čobanović N, Janković L, Vasilev D, Dimitrijević M, Teodorović V, Kureljušić B, Karabasil N. 2019. Slaughterline records of various postmortem pathological lesions and their influence on carcass and meat quality in slaughtered pigs. Anim. Sci. J. 90: 1475-1483.
Conway H, Lau G, Zochios V. 2020. Personalizing invasive mechanical ventilation strategies in coronavirus disease 2019 (COVID-19)-associated lung injury: the utility of lung ultrasound. J. Cardiothorac. Vasc. Anesth. 34: 2571-2574.
Dondorp AM, Hayat M, Aryal D, Beane A, Schultz MJ. 2020. Respiratory support in COVID-19 patients, with a focus on resource-limited settings. Am. J. Trop. Med. Hyg. 102: 1191-1197.
Ferioli M, Cisternino C, Leo V, Pisani L, Palange P, Nava S. 2020. Protecting health care workers from SARS-CoV-2 infection: practical indications. Eur. Respir. Rev. 29: 200068.
Garmendia O, Rodríguez-Lazaro MA, Otero J, Phan P, Stoyanova A, Dinh-Xuan AT, Gozal D, Navajas D, Montserrat JM, Farré R. 2020. Low-cost, easy-to-build noninvasive pressure support ventilator for under-resourced regions: open source hardware description, performance and feasibility testing. Eur. Respir. J. 55: 2000846.
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, Cereda D, Coluccello A, Foti G, Fumagalli R, Lotti G, Latronico N, Lorini L, Merler S, Natalini G, Piatti A, Ranieri MV, Scandroglio AM, Storti E, Cecconi M, Pesenti A. 2020. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 323: 1574-1581.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS. 2019. China medical treatment expert group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med. 382: 1708-20.
Hanneman SK, Clubb FJ Jr, McKay K, Costas G. 2004. Feasibility of a porcine adult intensive care model. Comp. Med. 54: 36-43.
Hannon JP, Bossone CA, Wade CE. 1990. Normal physiological values for conscious pigs used in biomedical research. Lab. Anim. Sci. 40: 293-298.
Hering R, Kreyer S, Putensen C. 2017. Effects of lung protective mechanical ventilation associated with permissive respiratory acidosis on regional extra-pulmonary blood flow in experimental ARDS. BMC Anesthesiol. 17: 149.
Hua J, Qian C, Luo Z, Li Q, Wang F. 2020. Invasive mechanical ventilation in COVID-19 patient management: the experience with 469 patients in Wuhan. Crit. Care 24: 348.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395: 497-506.
Lyengar K, Bahl S, Raju Vaishya, Vaish A. 2020. Challenges and solutions in meeting up the urgent requirement of ventilators for COVID-19 patients. Diabetes Metab. Syndr. 14: 499-501.
Kahn C, Line S. 2007. Manual Merck de Veterinaria. Sexta Edición. Merck & CO, NJ, USA. Tomo II. p: 2548-2549.
Kuniya T, Nakama Y, Tokuda Y. 2020. Demand and supply of invasive and noninvasive ventilators at the peak of the COVID-19 outbreak in Okinawa. J. Gen. Fam. Med. 21: 98-101.
Lentz S, Roginski MA, Montrief T, Ramzy M, Gottlieb M, Long B. 2020. Initial emergency department mechanical ventilation strategies for COVID-19 hypoxemic respiratory failure and ARDS. Am. J. Emerg. Med. 38: 2194-2202.
Lisciandro GR, Fosgate GT, Fulton RM. 2014. Frequency and number of ultrasound lung rockets (B-lines) using a regionally based lung ultrasound examination named vet BLUE (veterinary bedside lung ultrasound exam) in dogs with radiographically normal lung findings. Vet. Radiol. Ultrasound. 55: 315-322.
McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM, Thomas KM, Moore WH. 2020. Increased incidence of barotrauma in patients with COVID-19 on invasive mechanical ventilation. Radiology 297: E252-E262.
Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, Deshpande R, Zhang L, Meng J, Tong C, Liu H, Xiong L. 2020. Intubation and ventilation amid the COVID-19 outbreak: Wuhan's experience. Anesthesiology 132: 1317-1332.
Monti G, Cremona G, Zangrillo A, Lombardi G, Sartini C, Sartorelli M, Colombo S, Serpa Neto A, Landoni G. 2020. Home ventilators for invasive ventilation of patients with COVID-19. Crit. Care Resusc. 22: 266-270.
Nay MA, Auvet A, Mankikian J, Herve V, Dequin PF, Guillon A. 2017. Evaluation of a flexible bronchoscope prototype designed for bronchoscopy during mechanical ventilation: a proof-of-concept study. Anaesthesia 72: 719-728.
Plotnikow GA, Matesa A, Nadur JM, Alonso M, Nuñez I, Vergara G, Alfageme MJ, Vitale A, Gil M, Kinzler V, Melia M, Pugliese F, Donnianni M, Pochettino J, Brozzi I, Scapellato JL; Grupo Argentino Telegram nCoV19. 2020. Characteristics and outcomes of patients infected with nCoV19 requiring invasive mechanical ventilation in Argentina. Rev. Bras. Ter. Intensiva 32 : 348-353.
Pons-Ódena M, Valls A, Grifols J, Farré R, Cambra Lasosa FJ, Rubin BK. 2020. COVID-19 and respiratory support devices. Paediatr. Respir. Rev. 35: 61-63.
Rubulotta F, Soliman-Aboumarie H, Filbey K, Geldner G, Kuck K, Ganau M, Hemmerling TM. 2020. Technologies to optimize the care of severe coronavirus disease 2019 patients for health care providers challenged by limited resources. Anesth. Analg. 131: 351-364.
Tosi U, De Angelis E, Gabrielli L, Marruchella G. 2021. Enzootic pneumonia-like lesions: ultrasound vs pathological findings under field conditions. J. Swine. Health. Prod. 29: 90-96.
Tusman G, Campos M, Gogniat E. 2020. COVID-19: how to transform a noninvasive ventilation device in a critical care ventilator. Rev. Esp. Anestesiol. Reanim.. 67: 367-373.
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. 2019. Pathophysiology, transmission, diagnosis and treatment of Coronavirus disease 2019 (COVID-19): a review. JAMA 324: 782-793.
Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. 2020. Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med. 46: 586-590.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. 2020. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 395: 1054-1062.
Ziehr DR, Alladina J, Petri CR, Maley JH, Moskowitz A, Medoff BD, Hibbert KA, Thompson BT, Hardin CC. 2020. Respiratory Pathophysiology of Mechanically Ventilated Patients with COVID-19: A Cohort Study. Am. J. Respir. Crit. Care Med. 201: 1560-1564.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
FAVE Sección Ciencias Veterinarias ratifica el modelo Acceso Abierto en el que los contenidos de las publicaciones científicas se encuentran disponibles a texto completo libre y gratuito en Internet, sin embargos temporales, y cuyos costos de producción editorial no son transferidos a los autores. Esta política propone quebrar las barreras económicas que generan inequidades tanto en el acceso a la información, como en la publicación de resultados de investigaciones.
Los artículos de la revista son publicados en http://bibliotecavirtual.unl.edu.ar/publicaciones/index.php/FAVEveterinaria/issue/current/, en acceso abierto bajo licencia Creative CommonsAtribución-NoComercial-Compartir Igual 4.0 Internacional.