• Felipe Srm Andrade, Lara L Facó, Keila K Ida, Luis Clc Silva, Denise T Fantoni, and Aline M Ambrósio.
• Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil. Electronic address: fesandrade@usp.br.
• Vet Anaesth Analg. 2019 Jan 1; 46 (1): 64-73.

ObjectiveTo compare static compliance (Cst) and alveolar-arterial oxygen tension difference [P(a-a)O2] between positive end-expiratory pressures (PEEP) of 7, 12 and 17 cmH2O applied after an alveolar recruitment maneuver (RM) in isoflurane-anesthetized horses.Study DesignProspective, randomized, clinical study.AnimalsA group of 30 healthy adult horses undergoing arthroscopic surgery.MethodsAnimals in dorsal recumbency and mechanically ventilated with a tidal volume of 14 mL kg-1 and 7 cmH2O PEEP (control; n = 6) were subjected to an RM by increasing PEEP from 7 to 22 cmH2O in 5 cmH2O increments at 5 minute intervals, and then decreased similarly to PEEP of 17 (RM17; n = 8), 12 (RM12; n = 8) or 7 cmH2O (RM7; n = 8). Cst and P(a-a)O2 were assessed prior to (baseline) and after the RM at 5, 10, 15, 20, 40, 60 and 80 minutes after achieving each target PEEP, and during recovery from anesthesia.ResultsPost-RM improvements on P(a-a)O2 were maintained (baseline versus 80 minutes) in RM12 [216 ± 77 mmHg (28.8 ± 10.3 kPa) versus 194 ± 39 mmHg (25.9 ± 5.2 kPa)] and RM17 [180 ± 86 mmHg (24.0 ± 11.6 kPa) versus 136 ± 75 mmHg [18.2 ± 10.0 kPa]). The improvements on Cst were maintained only in RM12 (0.80 ± 0.13 versus 0.98 ± 0.13 mL cmH2O-1 kg-1). No such improvements were observed in RM7 and control. No significant differences were observed between groups during recovery from anesthesia.Conclusionsand clinical relevance The 12 and 17 cmH2O PEEP can be used to maintain the improvements on P(a-a)O2 obtained after an RM. Only 12 cmH2O PEEP maintained the post-RM increase on Cst. Such variables were not influenced by the 7 cmH2O PEEP.Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

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