Proof of concept of the efficacy of the prototype device "Automatic Cycler for Resuscitator" in an adult swine
DOI:
https://doi.org/10.14409/favecv.v20iSuppl..11068Abstract
In this study, the safety and functionality of the prototype device “Automatic Cycler for Resuscitator” (ACR) was evaluated in a proof of concept in a swine with similar weight to that of an adult human. Tidal volumes of 5.8, 7 and 9.7 ml/kg were studied for positive pressures at the end of expiration (PPEE) of 5, 10 and 15 cmH2O. Indicative parameters of the homeostatic state of the animal were obtained through a multiparameter monitor and EPOC® blood biochemical analysis system. The parameters were kept within normal physiological ranges when tidal volumes of 7 and 9.7 ml/kg were evaluated. However, the tidal volume of 5.8 ml/kg was not sufficient to maintain adequate ventilation and it was manifested by hypercapnia and a drop in pH. As a general conclusion, we inferred that with adaptations in the ventilation patterns (7 and 9.7 ml/kg), the use of the ACR prototype can keep the animal alive for 24 h, preserving its homeostasis.
References
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.
Downloads
Published
Issue
Section
License
FAVE Sección Ciencias Veterinarias ratifies the open access model, in which contents (in full) are available free to anyone in the internet. The costs of production and publication are not transfered to the authors. This policy intends to break social and economical barriers that generate inequities in the access to information, and for the publication of research results.
All articles can be accessed at http://bibliotecavirtual.unl.edu.ar/publicaciones/index.php/FAVEveterinaria/issue/current/, under license Creative CommonsAtribución-NoComercial-Compartir Igual 4.0 Internacional.
