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Management of acute respiratory distress

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Abstract

Acute respiratory distress in dogs and cats is a common presenting complaint and can be life-threatening. Early identification of unstable patients and timely therapeutic intervention are essential to limit compromise of tissue oxygenation and deterioration in condition. Oxygen supplementation, appropriate drug therapy, thoracocentesis, thoracostomy tube placement, emergency tracheostomy and positive pressure ventilation (PPV) may be required to relieve respiratory distress. It is important to consider signalment and history, assess posture, observe the pattern of respiration and perform an initial physical examination focused on the cardiorespiratory system. Based on these findings, a clinical estimation of the anatomical location of the problem can guide initial therapy. The chapter looks at General principles of therapy; Specific drug therapy; Ventilation; and Ancillary procedures.

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Figures

Image of 17.3
17.3 A ventilator breath is compared with a spontaneous patient breath. The spontaneous breath (dotted line) begins as a negative inspiratory effort, followed by a slightly positive airway pressure during exhalation. In contrast, the ventilator breath (solid line) generates exclusively positive airway pressure. In , the ventilator delivers a set number of breaths, to a set pressure or tidal volume. The machine delivers these breaths when the patient creates a negative pressure in the airway; if the patient is not breathing, the machine will automatically deliver the set respiration rate. If the patient breathes faster than the set rate, the machine is also triggered, and it will deliver the desired tidal volume for each patient-initiated breath. In , the ventilator is set to deliver a desired number of breaths, just as in AC. The breaths are delivered when the machine senses a negative pressure effort by the patient (‘synchronous’). Between each breath, if the patient breathes spontaneously, the machine does not ‘kick in’ with a breath of its own, and the patient-induced breaths only reach the negative pressure and tidal volume determined by the patient. (Reproduced from the .)

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