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Review
. 2021 Oct;85(4):241-250.

Conventional versus high-flow oxygen therapy in dogs with lower airway injury

Meera Ramesh  1 , Elizabeth Thomovsky  1 , Paula Johnson  1
Affiliations
Review

Conventional versus high-flow oxygen therapy in dogs with lower airway injury

Meera Ramesh et al. Can J Vet Res. 2021 Oct.

Abstract
in English, French

Dogs with lower airway pathology that present in respiratory distress often receive oxygen therapy as the first line of treatment regardless of the underlying cause. Conventional "low-flow" systems deliver oxygen with a maximum flow rate of 15 L/minute. Traditionally, when an animal's respiratory status does not improve with conventional oxygen therapy and treatments for underlying disease, options might be limited to either intubation and mechanical ventilation or humane euthanasia. High-flow oxygen therapy (HFOT) has been gaining popularity in veterinary medicine as an alternative route of oxygen supplementation for animals that require support beyond conventional therapy. High-flow oxygen therapy can supply a mixture of air and oxygen via a heated and humidified circuit. It is user friendly and can be used in an environment in which mechanical ventilation is unavailable. This review article is written for emergency doctors and general practitioners who lack access to mechanical ventilation. This article briefly reviews pertinent respiratory physiology, traditional oxygen supplementation techniques, the physiology of HFOT, and the limited evidence available in veterinary medicine regarding the use of HFOT, its applications, and limitations. Guidelines for the use of HFOT are suggested and HFOT is compared to conventional therapy.

Les chiens avec une pathologie des voies respiratoires inférieures qui présentent une détresse respiratoire reçoivent souvent une oxygénothérapie en première intention, quelle que soit la cause sous-jacente. Les systèmes conventionnels à « faible débit » fournissent de l’oxygène avec un débit maximum de 15 L/minute. Traditionnellement, lorsque l’état respiratoire d’un animal ne s’améliore pas avec l’oxygénothérapie conventionnelle et les traitements de la maladie sous-jacente, les options peuvent se limiter à l’intubation et à la ventilation mécanique ou à l’euthanasie. L’oxygénothérapie à haut débit (HFOT) gagne en popularité en médecine vétérinaire en tant que voie alternative de supplémentation en oxygène pour les animaux qui nécessitent un soutien au-delà de la thérapie conventionnelle. L’oxygénothérapie à haut débit peut fournir un mélange d’air et d’oxygène via un circuit chauffé et humidifié. Il est convivial et peut être utilisé dans un environnement où la ventilation mécanique n’est pas disponible.Cet article de revue est écrit pour les médecins urgentistes et les médecins généralistes qui n’ont pas accès à la ventilation mécanique. L’article passe brièvement en revue la physiologie respiratoire pertinente, les techniques traditionnelles de supplémentation en oxygène, la physiologie de la HFOT et les preuves limitées disponibles en médecine vétérinaire concernant l’utilisation de la HFOT, ses applications et ses limites. Des lignes directrices pour l’utilisation de la HFOT sont suggérées et la HFOT est comparée au traitement conventionnel.(Traduit par Docteur Serge Messier).

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Figures

Figure 1
Figure 1
High-flow oxygen machine (Precision Flow Plus; Vapotherm, Exeter, New Hampshire, USA). The yellow hose is attached to medical/compressed air, the green hose is attached to the oxygen source and the black cord connects to the power source. The flow generator and humidifier are contained within the unit (black arrow).
Figure 2
Figure 2
Two sizes of nasal prongs used in high-flow oxygen therapy (Nasal prongs; Vapotherm).
Figure 3
Figure 3
Combination of tape and suture to secure nasal prongs in a dolichocephalic dog receiving high-flow oxygen therapy. Sutures are present on the lateral aspect of each nare.
Figure 4
Figure 4
Brachycephalic dog with nasal prongs sutured lateral to the nostrils. Note that a nasogastric feeding tube is also attached to the left nostril.
Figure 5
Figure 5
High-flow oxygen machine display. Photo courtesy of Dr. Mariana Pardo, MV, BVSc, DACVECC.
See this image and copyright information in PMC

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