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Predicting the effect of fresh gas flow on tidal volume in volume-controlled mechanically ventilated dogs

Published:November 03, 2022DOI:https://doi.org/10.1016/j.vaa.2022.10.003

      Abstract

      Objectives

      To determine if the tidal volume (VT) delivered (VTDEL) to canine patients being mechanically ventilated by a volume-controlled ventilator differed from the volume set on the ventilator (VTSET) at three fresh gas flow (FGF) rates. To determine if VTDEL could be accurately predicted by an FGF-based mathematical model.

      Study design

      Prospective proof-of-concept study.

      Animals

      A total of 23 adult client-owned dogs undergoing elective orthopedic surgery.

      Methods

      Dogs were anesthetized and ventilated with a volume-controlled mechanical ventilator with constant respiratory rate (fR) of 10 breaths minute–1, inspiratory-to-expiratory ratio of 1:2 [fraction of inspiratory time (TI) in one respiratory cycle (Ttot) 1:3], and VTSET as body weight (kg) × 15 (mL kg–1). VTDEL was measured in 20 dogs at three FGF (500, 1000 and 4000 mL minute–1). A mathematical model was used to calculate predicted volume (VTPRED) for each animal at each FGF: VTSET + {FGF × [(TI/Ttot)/fR]}. Linear repeated measures models were fit comparing VTDEL to VTSET and to VTPRED by FGF.

      Results

      VTDEL was significantly higher than VTSET at every FGF (p < 0.05), and differences were larger at higher FGF (p < 0.001). There were no statistically significant differences between VTDEL and VTPRED at FGF rates of 500 and 4000 mL minute–1 and, although the mean VTDEL was statistically significantly higher than VTPRED at FGF 1000 mL minute–1 (p = 0.017), the mean difference of 9 mL was not clinically significant.

      Conclusions and clinical relevance

      Dogs on volume-controlled ventilators may be ventilated at a higher VTDEL than intended depending on the FGF settings. Ventilation of small animals at high FGF could inadvertently induce pulmonary damage. A mathematical equation can be used to achieve a desired VTDEL by adjusting VTSET values based on FGF, fR and TI/Ttot.

      Keywords

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