Ventilatory Support

Ventilatory support (e.g., manual IPPV or mechanical ventilation) may be required for dogs that fail to respond to correction or stabilization of the primary respiratory problem and supplemental oxygen support.15 Ventilatory support requires a heavily sedated or anesthetized patient, even if a tracheostomy tube is in place (See CPG 16).

- Manual intermittent positive pressure ventilation (MIPPV) is feasible if personnel can be spared for this, and is ideal for short-term (i.e., <6 hours) of ventilator support.
- There may be instances in which mechanical ventilation (MV) is necessary to afford a chance for patient survival. MV may be necessary if MIPPV fails or duration of ventilator support is expected to be >6 hours. Providers must note that MV should be considered only if the provider has the necessary advanced MV training and experience, the provider feels there is a reasonable likelihood of success, and the provider has the necessary support staff, facilities, and monitoring and intensive care facilities to manage a MWD on MV without compromising human patient care. Thus, MV should be considered only in Level 2 or higher medical facilities and by trained specialists with adequate staff.
- Generally, it is best to induce general anesthesia and initially manage the ventilated dog using Controlled Ventilation or Assist-Control ventilator mode. Key ventilator settings are shown (See Table 7).

Table 7. Mechanical Ventilator Setting and Key Parameters

Table 7. Mechanical Ventilator Setting and Key Parameters