Use of prototype bi-nasal prongs for noninvasive ventilation in foals.
Authors: Raidal Sharanne L, van Diggelen Michael, Catanchin Chee Sum M, Lehmann Heidi S, Quinn Chris T
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Bi-nasal Prongs for Noninvasive Ventilation in Foals Noninvasive ventilation (NIV) offers valuable respiratory support for compromised foals, yet conventional face masks present practical challenges—poor tolerance by patients and a concerning tendency towards carbon dioxide retention (hypercapnia). Raidal and colleagues evaluated whether bi-nasal prongs might overcome these limitations by conducting a randomized cross-over trial in six healthy foals, comparing mask and prong delivery of NIV across various pressure settings (5–10 cmH₂O support and end-expiratory pressures) with and without supplementary oxygen. Bi-nasal prongs proved significantly easier to manage clinically, requiring minimal repositioning or constant monitoring, whilst maintaining equivalent improvements in oxygenation and respiratory mechanics to masks but critically eliminating the hypercapnia problem—arterial CO₂ levels remained stable with prongs and averaged 8.2 mmHg lower than with masks at comparable settings. For equine practitioners managing respiratory-compromised foals, these findings suggest bi-nasal prongs represent a superior interface that combines better patient tolerance, reduced labour intensity, and importantly, avoidance of the hypercapnic complications that have plagued mask-based NIV protocols historically.
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Practical Takeaways
- •Consider bi-nasal prongs as a superior alternative to face masks for noninvasive ventilation in foals, particularly for respiratory-compromised neonates requiring extended support
- •Bi-nasal prongs reduce the need for constant adjustment and monitoring, freeing clinician time during NIV treatment in foals
- •The elimination of hypercapnia with nasal prongs may improve clinical outcomes and tolerance of noninvasive ventilation protocols in foal respiratory disease cases
Key Findings
- •Bi-nasal prongs were better tolerated than face masks and required less manual positioning or monitoring during noninvasive ventilation in foals
- •Partial pressure of carbon dioxide did not increase with bi-nasal prongs and was 8.2 mmHg lower than with masks at T6 measurement point
- •Oxygenation and respiratory mechanics were improved with both device interfaces and showed no significant difference between them
- •Bi-nasal prongs ameliorated hypercapnia previously observed during mask-based noninvasive ventilation in foals