The Use of Bi-Nasal Prongs for Delivery of Non-Invasive Ventilation to Foals.
Authors: van Diggelen Michael, Quinn Chris T, Catanchin Chee Sum M, Lehmann Heidi S, Raidal Sharanne L
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: Bi-Nasal Prongs for Non-Invasive Ventilation in Foals Non-invasive ventilation (NIV) offers respiratory support without endotracheal intubation, yet equipment suitable for foals remains limited. Van Diggelen and colleagues assessed tolerance to bi-nasal prongs in healthy foals, finding that devices remained in place throughout five-minute trials in most animals, with tolerance improving when light sedation was used (5/6 foals sedated versus 4/6 unsedated). Although all foals tolerated the NIV delivery method, increasing airway pressures triggered physiological responses—elevated inspiratory volumes, prolonged inspiration times and increased circuit leakage—that preceded behavioural signs of discomfort and ventilator discontinuation. Circuit leakage proved particularly problematic, reducing exhaled air return to the ventilator and creating mismatches between inspiratory and expiratory times and tidal volumes delivered versus those measured. The findings indicate bi-nasal prongs hold clinical promise for non-invasive respiratory support in foals, but practitioners should expect to optimise interface design and fitting, whilst monitoring both behavioural cues and ventilator parameters—particularly pressure thresholds, leakage rates and tidal volume accuracy—to ensure patient tolerance during treatment.
Read the full abstract on PubMed
Practical Takeaways
- •Bi-nasal prongs show promise as a non-invasive ventilation delivery method for foals, but current design requires optimization before clinical adoption
- •Light sedation improves tolerance compared to unsedated foals; careful monitoring of patient behaviour and ventilator variables is essential to detect discomfort early
- •Circuit leakage significantly impacts ventilation efficacy; ensure proper fitting and seal to maintain adequate gas exchange and reduce airway pressure requirements
Key Findings
- •Bi-nasal prongs remained in place for five minutes in 4/6 unsedated foals and 5/6 lightly sedated foals
- •All foals tolerated NIV through bi-nasal prongs despite increasing airway pressures causing increases in inspiratory volume and air leakage
- •Increased circuit leakage was associated with reduced expired air return to ventilator and increasing disparity between inspiratory and expiratory times
- •Behaviour changes consistent with discomfort preceded discontinuation of NIV in foals with higher airway pressures