Effects of fluid load on cardiovascular function during stepwise lung recruitment manoeuvre in healthy dogs.

Vet J. 2013 Jun 20;
Canfrán S, Gómez de Segura IA, Cediel R, García-Fernández J

The aim of this study was to evaluate the effects of a stepwise lung recruitment manoeuvre (RM) on cardiac output (CO) in mechanically ventilated dogs, with or without a previous fluid load. Eight healthy adult Beagle dogs were enrolled in a prospective crossover study. Following sedation with dexmedetomidine and methadone, anaesthesia was induced with propofol and maintained with isoflurane. CO (thermodilution method) and direct arterial blood pressure were monitored. The dogs were mechanically ventilated in a volume-controlled mode (tidal volume, VT=10mL/kg; positive end-expiratory pressure [PEEP]=0cm H2O) until normocapnia was achieved (end tidal CO2 35-45mmHg). The RM was then performed in a pressure-controlled mode, with progressive increases of the PEEP and end-inspiratory pressure of 5cm H2O, until 15cm H2O and 30cm H2O were reached, respectively. After the RM, the ventilatory mode was returned to volume-control, and the PEEP was sequentially decreased to 10, 5 and 0cm H2O. Baseline ventilation was maintained for 30min. Next, 10mL/kg of lactated Ringer’s solution was administered within 10min, prior to a second RM. The CO was determined before each RM (baseline) and at each pressure step. A repeated measures ANOVA test was used to compare data. Compared to baseline, CO decreased during the RM in both groups. However, there was a significantly higher CO during the second RM at the highest pressure step (P<0.05) and during all decreasing pressure steps (P<0.05). In conclusion, a previous crystalloid fluid load could reduce the impact of a RM on CO in healthy dogs. HubMed – Methadone

METHADONE FOR CHRONIC NONCANCER PAIN (CNCP) IN ADULTS.

J Pain Palliat Care Pharmacother. 2013 Jun; 27(2): 180
Wiffen PJ

ABSTRACT The Cochrane Library of Systematic Reviews is published quarterly as a DVD but monthly online ( http://www.thecochranelibrary.com ). The January 2013 issue (1st DVD for 2013) contains 5328 complete reviews, 2291 protocols for reviews in production, and almost 19,600 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 681,000 randomized controlled trials, and 15,700 cited papers in the Cochrane methodology register. The health technology assessment database contains some 12,000 citations. One hundred and twenty-two new reviews have been published in the previous 3 months, of which five have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 5.715. Readers are encouraged to access the full report for any articles of interest as only a brief commentary is provided.
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