Tag: Respiratory
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Laryngeal paralysis
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This patient was brought to us for exercise intolerance, breathing difficulty and loud airway sounds. The patient has laryngeal paralysis. This is where the muscles controlling the arytenoids cartilages do not work and leads to failure of opening of the arytenoids during inspiration. Most commonly seen in middle-aged large breed dogs, it can occur acutely,…
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Blood gas analysis, pt 7: evaluating oxygenation and ventilation
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In patients with respiratory compromise, it is important to look at the respiratory components of the blood gas to determine both oxygenation ability and adequacy of ventilation. To assess oxygenation, the partial pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2) ratio, and alveolar-arterial gradient (A-a gradient) can be used. Conversely, the partial…
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Blood gas analysis, pt 6: compensatory response
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Simple acid-base disorders are compensated by predictable compensatory changes. The primary disorder shifts the pH, while the compensatory mechanisms aim to normalise the pH and bring it back to neutral. This is achieved by attempting to normalise the bicarbonate (HCO3-) to partial pressure of CO2 (PCO2) ratio in a paralleled manner. For example, an increase…
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Blood gas analysis, pt 5: metabolic acidosis and alkalosis
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Base excess (BE) and bicarbonate (HCO3-) represent the metabolic components of the acid base equation. In general, both components will change in the same direction. Decreased HCO3– and BE indicate either a primary metabolic acidosis or a metabolic compensation for a chronic respiratory alkalosis. Elevated HCO3– and BE indicate either a primary metabolic alkalosis or…
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Blood gas analysis, pt 4: respiratory acidosis and alkalosis
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Assessing the respiratory component is simple. A quick glance at the partial pressure of carbon dioxide (PCO2) level can tell you whether a respiratory acidosis or alkalosis is present. If the PCO2 level is elevated (respiratory acidosis) then either a primary respiratory acidosis is present, or it is the result of a compensatory response to…
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Blood gas analysis, pt 3: interpreting pH
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After taking note of the direction of the pH shift – acidaemia or alkalaemia – it is important to determine the primary and secondary causes. If an acidaemia is present (pH less than 7.35), an underlying respiratory or metabolic acidosis, or both, must exist. Similarly, if an alkalaemia is present (pH more than 7.45), an…
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Blood gas analysis, pt 2: acid-base disturbances
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Acid-base disturbances are common in critical patients. These changes must be identified, as even minor deviations from the normal range can lead to significant abnormal body functions. Acidaemia and alkalaemia Acidaemia, which occurs when blood pH falls below 7.35, will lead to: impedance of cardiac output reduced cardiac contractility a blunted response to catecholamine manifesting…
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Blood gas analysis, pt 1: why everyone needs to know about it
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For those of you who have received referral histories from emergency or specialists hospitals, blood gas analysis is probably no stranger to you. For those who have never heard of them before, fear not – you are in for a treat. In my emergency hospital, the blood gas analyser is arguably one of the most…
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Encouraging mums ‘back to what they love’
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A mother of four appointed as the new head of nursing services at one of the UK’s leading animal hospitals is marking International Women’s Day (today, 8 March) by urging more mums to consider returning to work after having children. Kathryn Latimer Jones has taken on the senior role at Linnaeus-owned Northwest Veterinary Specialists (NWVS)…
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Focus on GDV, part 4: the recovery
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Postoperatively, gastric dilatation-volvulus (GDV) patients remain in our intensive care unit for at least two to three days. Monitoring includes standard general physical examination parameters, invasive arterial blood pressures, ECG, urine output via urinary catheter and pain scoring. I repeat PCV/total protein, lactate, blood gas and activated clotting times (ACT) immediately postoperatively and then every…