Respiratory insufficiency and pulmonary health are important considerations in equine neonatal care, as the majority of foals are bred for athletic function. The administration of supplementary oxygen is readily implemented in equine practice settings, but this does not address respiratory insufficiency due to inadequate ventilation and is no longer considered optimal care for hypoxia in some settings. Non-invasive ventilatory strategies including continuous or bi-level positive airway pressure are effective in human and veterinary studies, and may offer improved respiratory support in equine clinical practice. The current study was conducted in two parts to investigate the use of a commercial bilevel positive airway pressure (biPAP) ventilator, designed for home care of people with obstructive respiratory conditions, for respiratory support of foals. In Part 1 a prospective observational study was conducted to evaluate the effect of sequential application of supplementary oxygen and then biPAP for respiratory support of five foals ≤ 4 days of age hospitalised with respiratory in sufficiency (Group 1) and four healthy, sedated foals < 28 days of age (Group 2). In Part 2, biPAP and supplementary oxygen were administered to six healthy foals with pharmacologically induced respiratory insufficiency in a two sequence, two phase, cross-over study (Group 3). Non-invasive ventilation by biPAP improved gas exchange and mechanics of breathing (increased tidal volume, decreased respiratory rate and increased peak inspiratory flow) in foals, but modest hypercapnia was observed in healthy, sedated foals (Groups 2 and 3). Clinical cases (Group 1) appeared less likely to develop hypercapnia in response to treatment, however the response in individual foals was variable, and close monitoring is necessary. Clinical observations, pulse oximetry and CO 2 monitoring of expired gases were of limited benefit in identification of foals responding inappropriately to biPAP, and improved methods to assess and monitor respiratory function are required in foals.

中文翻译：

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双向气道正压通气（biPAP）用于驹的无创呼吸支持

呼吸功能不全和肺部健康是马新生儿护理中的重要考虑因素，因为大多数小马驹都是出于运动功能而饲养的。在马术练习场中很容易实施补充氧气的给药，但这不能解决由于通气不足而引起的呼吸功能不全，在某些场合下不再被认为是缺氧的最佳护理方法。在人类和兽医研究中，包括持续或双水平气道正压通气的无创通气策略是有效的，并且在马的临床实践中可以提供更好的呼吸支持。当前的研究分为两个部分，以调查商用双水平气道正压通气机（biPAP）的使用情况，该呼吸机旨在用于阻塞性呼吸道疾病患者的家庭护理，为小马驹提供呼吸支持。在第1部分中，进行了一项前瞻性观察性研究，以评估先后应用补充氧气和biPAP对5例≤4天龄且有呼吸功能的住院小马驹（第1组）和四只健康的镇静小马驹<28的呼吸支持的效果。年龄（第2组）。在第2部分中，在两个序列，两阶段，交叉研究（组3）中，对六只健康的小马驹服用biPAP和补充氧气，这些小马驹具有药理学上的呼吸功能不全。biPAP的无创通气改善了小马驹的气体交换和呼吸机制（增加了潮气量，降低了呼吸频率并增加了峰值吸气量），但是在健康，镇静的小马驹中观察到了适度的高碳酸血症（第2组和第3组）。临床病例（第1组）似乎不太可能因治疗而出现高碳酸血症，但是个别小马驹的反应不尽相同，因此有必要进行密切监测。临床观察，脉搏血氧饱和度测定法和监测呼出气体的CO 2在鉴定对biPAP反应不当的小马驹方面的好处有限，因此需要改进的方法来评估和监测小马驹的呼吸功能。