{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T18:23:45Z","timestamp":1787336625788,"version":"build-2736575974"},"reference-count":31,"publisher":"American Veterinary Medical Association (AVMA)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate whether laparoscopic-induced pneumoperitoneum (8 to 10 mm Hg) in reverse Trendelenburg (RT) impairs ventilation and oxygenation, and whether pressure-controlled ventilation (PCV) with low positive end-expiratory pressure (PEEP; 3 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O [PEEP-3] or 5 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O [PEEP-5]) improves these variables in sevoflurane-anesthetized large-breed dogs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cardiopulmonary variables were recorded before (T0) and 15 minutes after insufflation in RT (T1) during spontaneous ventilation (SV) and again 45 minutes after initiating PCV (T2) using 20 breaths\/min, an inspiratory-to-expiratory ratio of 1:2, PEEP-3 or PEEP-5, and peak inspiratory pressure (PIP) starting at 10 or 12 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O, respectively, with 2\u2013cm H\n                      <jats:sub>2<\/jats:sub>\n                      O increments every 5 minutes until end-tidal CO\n                      <jats:sub>2<\/jats:sub>\n                      reached 35 to 40 mm Hg or PIP reached 20 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O. The final dataset was collected 5 minutes after desufflation on PCV (T3).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During SV, pneumoperitoneum worsened Pa\n                      <jats:sc>co<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      (median [range]; PEEP-3, 70.0 mm Hg [62.0 to 86.1 mm Hg]; PEEP-5, 72.0 mm Hg [61.0 to 81.9 mm Hg]) and plasma pH (mean \u00b1 SD; PEEP-3, 7.18 \u00b1 0.04; PEEP-5, 7.18 \u00b1 0.02). During PCV, after titrating PIP (median, 16 and 18 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O, respectively), these variables improved, but in PEEP-5, pH remained lower (mean \u00b1 SD; 7.36 \u00b1 0.03 vs 7.32 \u00b1 0.04), and dead space-to-tidal volume higher (median [range]; 9.4% [2.2% to 16.1%] vs 16.2% [7.0% to 34.0%]). Oxygenation was unaffected, and cardiovascular changes and interventions were similar between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>During SV, pneumoperitoneum in RT worsened hypercapnia and acidemia without impairing oxygenation. During PCV, PEEP-3 provided the best respiratory outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Low PEEP-3 PCV improves pneumoperitoneum-induced hypoventilation in large-breed dogs without oxygenation impairment, whereas PEEP-5 may be limited by PIP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.25.12.0797","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T16:51:22Z","timestamp":1779468682000},"page":"1-10","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic-induced pneumoperitoneum does not impair oxygenation in large-breed dogs but worsens hypercapnia, which is improved by low positive end-expiratory pressure ventilation"],"prefix":"10.2460","volume":"264","author":[{"given":"Francisco Jongwoo","family":"Park","sequence":"first","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio Loria","family":"Lepiz","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Baetge","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0096-9942","authenticated-orcid":true,"given":"Vanna","family":"Dickerson","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelley","family":"Thieman","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2200-4355","authenticated-orcid":true,"given":"Keila K.","family":"Ida","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"6","key":"ref1","series-title":"J Am Vet Med Assoc","first-page":"921","article-title":"Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs","volume":"227","author":"Devitt CM","year":"2005","unstructured":"Devitt CM, Cox RE, Hailey JJ. 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