Journal List > J Vet Sci > v.21(2) > 1144502

Niyatiwatchanchai and Thengchaisri: Clinical assessment of the efficacy of supraglottic airway devices compared with endotracheal tubes in cats during volume-controlled ventilation

Abstract

The efficacies of a supraglottic airway device (SGAD) and an endotracheal tube (ETT) in cats under general anesthesia with volume-controlled ventilation (VCV) were compared. Thirty healthy cats were randomly allocated for airway control using either an SGAD or an ETT. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly tested, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. The dose of propofol necessary to insert the SGAD or ETT, the static respiratory pressure, leakage during VCV, and end tidal CO2 (ETCO2) were recorded. Dosages of propofol and static respiratory measurements for the SGAD and ETT groups were compared using a t-test. The distribution of leakages and hypercapnia (ETCO2 > 45 mmHg) were compared using Fisher's exact test. A significance level of p < 0.05 was established. No significant difference in dose of propofol was observed between the SGAD and ETT groups (7.1 ± 1.0, 7.3 ± 1.7 mg/kg; p = 0.55). Static resistance pressure of the SGAD (22.0 ± 8.1 cmH2 O/L/sec) was significantly lower than that of the ETT (36.6 ± 12.9 cmH2 O/L/sec; p < 0.01). Of the 75 trials, leakage was more frequent when using an SGAD (8 events) than when using an ETT (1 event; p = 0.03). Hypercapnia occurred more frequently with SGAD (18 events) than with ETT (3 events; p < 0.01). Although intubation with an ETT is the gold standard in small animal anesthesia, the use of an SGAD can reduce airway resistance and the work of breathing. Nonetheless, SGAD had more dead space and the tidal volume for VCV needs adjustment.

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Fig. 1.
Diagram illustrating the timeline of the protocol used in this study. Cats were randomly allocated to airway control groups using an ETT or a SGAD. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly applied during VCV, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. ETT, endotracheal tube; SGAD, supraglottic airway device; VCV, volume-controlled ventilation.
jvs-21-e27f1.tif
Fig. 2.
Comparison of average minute ventilation (MVe) in cats during VCV when using a SGAD or an ETT. There was no significant difference between the SGAD and ETT groups at the different tidal volume settings. ETT, endotracheal tube; SGAD, supraglottic airway device; VCV, volume-controlled ventilation.
jvs-21-e27f2.tif
Fig. 3.
Tidal volume (mL/kg) and respiratory rate (times/min) when using a SGAD or an ETT. No significant difference between the SGAD and ETT groups at different tidal volume settings was detected. ETT, endotracheal tube; SGAD, supraglottic airway device.
jvs-21-e27f3.tif
Table 1.
Age, sex, body weight, and body condition score of the sample and dose of propofol needed to insert the ETT or SGAD
Parameters ETT SGAD p-value
Number 15 15
Age (yr) 2.5 ± 0.5 2.3 ± 0.5 0.49
Sex     1.00
Male 8 7  
Female 7 8  
Body weight (kg) 3.7 ± 0.7 3.8 ± 0.7 0.17
Body condition score 3.4 ± 0.7 3.2 ± 0.5 0.20
Dose of propofol (mg/kg) 7.3 ± 1.7 7.1 ± 1.0 0.62

Values are presented as number or mean ± SD. ETT, endotracheal tube; SGAD, supraglottic airway device.

Table 2.
Static respiratory measurements of the ETT and SGAD groups*
Static respiratory measurements ETT SGAD p-value
PIP (cm H2 O) 7.8 ± 1.6 6.3 ± 2.0 0.04
Static compliance (mL/cm H2 O) 6.1 ± 2.0 7.0 ± 6.0 0.17
Static resistance (cm H2 O/L/sec) 36.6 ± 12.9 22.0 ± 8.1 < 0.01
Static elastance (cm H2 O/mL) 180.8 ± 62.6 151.4 ± 34.8 0.12

ETT, endotracheal tube; SGAD, supraglottic airway device; PIP, peak inspiratory pressure.

* Static respiratory measurements were recorded using a tidal volume of 10 mL/kg and minute ventilation of 100 mL/kg/min.

Table 3.
Number of airway leakages (> 20% of the baseline tidal volume) in the ETT group vs. the SGAD group
Tidal volume (mL/kg) ETT SGAD p-value
No leak Leak > 20% No leak Leak > 20%
6 15 0 13 2 0.48
8 15 0 15 0 1.00
10 15 0 14 1 1.00
12 15 0 13 2 0.48
14 14 1 12 3 0.60
Total 74 1 67 8 0.03

ETT, endotracheal tube; SGAD, supraglottic airway device.

Table 4.
Comparison of the occurrence of hypercapnia (ETCO2 > 45 mmHg) between the ETT and SGAD groups
Tidal volume (mL/kg) ETT SGAD p-value
ETCO2 (35–45 mm Hg) ETCO2 (> 45 mm Hg) ETCO2 (35–45 mm Hg) ETCO2 (> 45 mm Hg)
6 13 2 7 8 0.05
8 14 1 10 5 0.17
10 15 0 13 2 0.48
12 15 0 13 2 0.48
14 15 0 14 1 1.00
Total 72 3 57 18 0.01

ETT, endotracheal tube; SGAD, supraglottic airway device.

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