Haemodynamic changes during propofol induction in dogs: New findings and approach of monitoring

Abstract Background Propofol is one of the most widely used injectable anaesthetic agents in veterinary practice. Cardiovascular effects related to propofol use in dogs remain less well defined. The main objective of this study was to evaluate the haemodynamic changes during induction of general anaesthesia with propofol in healthy dogs, by a beat-to-beat continuous monitoring. All dogs were premedicated with intramuscular acepromazine (0.015 mg/kg) and methadone (0.15 mg/kg). Transthoracic echocardiography was used to measure the velocity time integral (VTI) of the left ventricular outflow tract. A syringe driver, programmed to deliver propofol 5 mg/kg over 30 s followed by a continuous infusion of 25 mg/kg/h, was used to induce and maintain anaesthesia. From the initiation of propofol administration, heart rate (HR) and mean invasive arterial blood pressure (MAP) were recorded every 5 s for 300 s, while aortic blood flow was continuously recorded and stored for 300 S. maximum cardiovascular depression was defined the lowest MAP (MAP_Tpeak) recorded during the monitored interval. VTI and VTI*HR were calculated at 0, 30, 90, 120, 150 and 300 s post administration of propofol, and at MAP_Tpeak. Haemodynamic effects of propofol in relation to plasma and biophase concentrations were also evaluated by pharmacokinetics simulation. Results The median (range) HR was significantly higher (p = 0.006) at the moment of maximum hemodynamic depression (Tpeak) [105(70–148) bpm] compared with pre-induction values (T0) [65(50–120) bpm]. The median (range) MAP was significantly lower (p < 0.001) at Tpeak [61(51–69) mmHg] compared with T0 [88(72–97) mmHg]. The median (range) VTI and VTI*HR were similar at the two time points [11.9(8.1–17.3) vs 13,3(9,4-16,5) cm, and 1172(806–1554) vs 1002(630–1159) cm*bpm, respectively]. Conclusions Induction of anaesthesia with propofol causes a drop of arterial pressure in healthy dogs, however cardiac output is well maintained by compensatory chronotropic response. The magnitude of MAP_Tpeak may be strictly related with propofol plasma concentration

Immunologic status of agricultural workers in the region of Lombardy, Northern Italy

Purpose. Farming is associated with a wide variety of hazardous exposures including physical, chemicals and biological agents. Animal farmers are exposed to dust which contains microorganisms, mycotoxins, endotoxins, animal feed particles, allergens and chemical agents. Organic dust exposure is known to cause allergic and non-allergic rhinitis, and organic dust toxic syndrome. This study was undertaken to evaluate the relationship between occupational health hazards and serum pro-inflammatory cytokines among agricultural workers, in particular we investigated whether animal breeders react differently to biological agents than non breeder farmers. Methods. One hundred subjects working in agricultural enterprises in the region of Lombardy, were enrolled into the study in 2010. Serum cytokines including interleukin (IL)-6, IL-8, IL-10, IFN\u3b3 and tumor necrosis factor-\u3b1 (TNF\u3b1) were measured. Cytokines were assessed by commercially available enzyme-linked-immunosorbent assay (ELISA). Results of the study. Compared to control subjects, increased TNF-\u3b1, IL-8, and IL-10 levels were found in animal breeders, and a statistically significant relationship between type of job (breeder/non breeder workers) and increased serum pro-inflammatory cytokines. Results suggest that animal breeders might be at higher risk of occupational diseases and biological hazards than other farmers with less contact to animals

Research for food and health in Europe: themes, needs and proposals

Background Diet, in addition to tobacco, alcohol and physical exercise, is a major factor contributing to chronic diseases in Europe. There is a pressing need for multidisciplinary research to promote healthier food choices and better diets. Food and Health Research in Europe (FAHRE) is a collaborative project commissioned by the European Union. Among its tasks is the description of national research systems for food and health and, in work reported here, the identification of strengths and gaps in the European research base. Methods A typology of nine research themes was developed, spanning food, society, health and research structures. Experts were selected through the FAHRE partners, with balance for individual characteristics, and reported using a standardised template. Results Countries usually commission research on food, and on health, separately: few countries have combined research strategies or programmes. Food and health are also strongly independent fields within the European Commission's research programmes. Research programmes have supported food and bio-technology, food safety, epidemiological research, and nutritional surveillance; but there has been less research into personal behaviour and very little on environmental influences on food choices - in the retail and marketing industries, policy, and regulation. The research is mainly sited within universities and research institutes: there is relatively little published research contribution from industry. Discussion National food policies, based on epidemiological evidence and endorsed by the World Health Organisation, recommend major changes in food intake to meet the challenge of chronic diseases. Biomedical and biotechnology research, in areas such as 'nutrio-genomics', 'individualised' diets, 'functional' foods and 'nutri-pharmaceuticals' appear likely to yield less health benefit, and less return on public investment, than research on population-level interventions to influence dietary patterns: for example policies to reduce population consumption of trans fats, saturated fats, salt and energy density. Research should now address how macro-diets, rather than micro-nutritional content, can be improved for beneficial impacts on health, and should evaluate the impact of market changes and policy interventions, including regulation, to improve public health. Conclusions European and national research on food and health should have social as well as commercial benefits. Strategies and policies should be developed between ministries of health and national research funding agencies. Collaboration between member states in the European Union can yield better innovation and greater competitive advantage

Animal influence on water, sanitation and hygiene measures for zoonosis control at the household level: A systematic literature review

Neglected zoonotic diseases (NZDs) have a significant impact on the livelihoods of the world’s poorest populations, which often lack access to basic services. Water, sanitation and hygiene (WASH) programmes are included among the key strategies for achieving the World Health Organization’s 2020 Roadmap for Implementation for control of Neglected Tropical Diseases (NTDs). There exists a lack of knowledge regarding the effect of animals on the effectiveness of WASH measures. This review looked to identify how animal presence in the household influences the effectiveness of water, hygiene and sanitation measures for zoonotic disease control in low and middle income countries; to identify gaps of knowledge regarding this topic based on the amount and type of studies looking at this particular interaction

Use of systolic pressure variation to predict the cardiovascular response to mini-fluid challenge in anaesthetised dogs

Systolic pressure variation (SPV), the maximum variation in systolic pressure values following a single positive pressure breath delivered by controlled mechanical ventilation (CMV), is highly correlated with volaemia in dogs. The aim of this study was to determine an SPV value that would indicate when fluid administration would be beneficial in clinical practice. Twenty-six client-owned dogs were anaesthetised, following which CMV with a peak inspiratory pressure (PIP) of 8 cmH2O was applied. After SPV measurement and recording of heart rate (HR) and blood pressure (BP), 3 mL/kg fluid were administered, then HR and BP were recorded again. Dogs exhibiting a 10% decrease in HR and/or an increase in BP were defined as responders, and their SPV pre-bolus was analysed retrospectively. SPV values > 4 mmHg or >4.5% predicted haemodynamic improvement in dogs with normal cardiovascular function, with a sensitivity of 90% and a specificity of 87%. The area under the curve receiver operating characteristic value for SPV was 0.931 mmHg (95% confidence interval, CI, 0.76-0.99 mmHg) and 0.944% (95% CI 0.78-0.99%). It is proposed that SPV values > 4.5% in dogs with a normal cardiovascular function, anaesthetised with isoflurane in oxygen and air, and on CMV (PIP 8 cmH2O), can be used to predict a cardiovascular response (>10% increase in mean arterial BP and/or >10% decrease in heart rate)

A retrospective study of efficacy and side effects of intrathecal administration of hyperbaric bupivacaine and morphine solution in 39 dogs undergoing hind limb orthopaedic surgery.

Objective  To evaluate the intraoperative efficacy of intrathecal anaesthesia with hyperbaric bupivacaine 0.5% and morphine 1% solution (HIA) in dogs undergoing hind limb orthopaedic surgery, using the cardiovascular response to surgical stimulation and to report the perioperative side effects. Study design  Retrospective clinical study. Animals  Forty-three dogs that underwent general anaesthesia for hind limb orthopaedic surgery between 2010 and 2011. Methods  The anaesthesia records of dogs that received HIA were reviewed. The bupivacaine and morphine doses were calculated based on body mass (BM) and spinal cord length (SCL). Cardiovascular response (CR) to surgical stimulation, the incidence of hypotension, bradycardia, urinary retention, pruritus and offset of motor block were all reported. The intraoperative time-to-event probability of CR was analyzed using Kaplan-Meier survival analysis. Results  The median (range) bupivacaine dose related to BM was 0.57 (0.40-0.78) mg kg(-1) , while that related to SCL was 0.13 (0.08-0.19) mg cm(-1) . A CR was observed in 3/39 (8%) dogs within the first hour after intrathecal injection (Ii) and in 9/39 (23%) dogs over the entire duration of surgery. At 70 minutes from Ii the event-free probability of CR fell below 80%. Hypotension was observed in 12/39 (31%), bradycardia in 6/39 (15%), pruritus in 3/39 (8%), and urinary retention in 3/39 (8%) dogs respectively. Five hours after Ii, 35/39 (89%) dogs were able to walk with only residual ataxia. Conclusions and clinical relevance  Intrathecal anaesthesia with hyperbaric bupivacaine 0.5% and morphine 1% solution provided effective intraoperative antinociception up to 70 minutes in dogs undergoing hind limb surgery. The technique of HIA can provide effective analgesia during short hind limb surgeries in dogs

Propofol Target Controlled Infusion (TCI) for assessment of laryngeal function in dogs: a preliminary investigation

Introduction: The aim of the study was to investigate the use of propofol TCI for visual examination of arytenoid motion in dogs. Materials and methods: Seven ASA I-II dogs scheduled for examination of laryngeal function were enrolled in a prospective study. Acepromazine (0.02mgkg1) and morphine (0.15mgkg1) were administered intramuscularly 60minutes prior to induction. Cardiorespiratory monitoring and flowby oxygen (0.2Lkg1 min1) were started before induction. Anesthesia was induced with propofol using a TCI system. A 3.1mcgmL1 plasma target was achieved, Loss-Of-Righting-Reflex (LORR) was assessed, and individual predicted ES concentration at LORR was recorded. After induction the individual ES concentration at LORR was targeted, and the target increased or decreased by 0.2mcgmL1 steps until laryngoscopy was impossible or arytenoid motion disappeared. The median (range) ES concentration at LORR and at \u2018best arytenoid motion\u2019 were calculated. Results: Five males and 2 females, 48 (12\u201372) months old, weighing 17.7 (5.4\u201328) kg entered the study. The median (range) propofol ES concentration was 1.65 (1.60\u20132.59)mcgmL1 at LORR, and 2.1 (1.4\u20132.8)mcgmL1 at \u2018best arytenoid motion\u2019. Two dogs were diagnosed with bilateral laryngeal paralysis and elongated soft palate, respectively. Although all dogs had some spontaneous movements of the tongue and jaw, and held their breath intermittently in response to laryngoscopy, on no occasion there was any risk of trauma to the examiner, the dog or the equipment. At the propofol concentration providing the best assessment no dogs lifted the head or showed a transient Return-Of- Righting-Reflex (RORR) after end of assessment. Hemoglobin oxygen saturation exceeded 94%in all dogs. Heart rate lower than 60 beats-per-minute and Mean Arterial Pressure lower than 60mmHg were not detected. Conclusions: Propofol ES-TCI represents a useful tool for visual examination of arytenoid motion in dogs. It provides a stable anesthetic depth, and can be titrated according to individual response. Required propofol ES concentration seems to be higher for laryngeal assessment than for LOR