Between 2008 and 2014, mechanical positive pressure ventilation (PPV) was used to manage 48 critically ill, cold-stunned sea turtles during their first week of treatment. Twenty-nine turtles had complete records for analysis and no ventilator complications, including 21 Kemp's ridley turtles (Lepidochelys kempii), four loggerhead turtles (Caretta caretta), and four green turtles (Chelonia mydas). Indications for PPV included poor responsiveness, bradypnea or apnea, bradycardia, and respiratory acidosis. Twenty (68.9%) turtles were successfully extubated, seven (24.1%) turtles died naturally during PPV, and two (7.0%) turtles were euthanized during PPV. Of the 20 turtles that were extubated, 11 (55%) survived over 24 h after extubation and were considered successfully weaned from the ventilator, but only four (20%) turtles survived to eventual release. Throughout PPV, improvements in respiratory, cardiovascular, and clinicopathologic status were variable, likely related to the degree of illness at presentation. On average, however, ventilation resulted in expected physical and physiologic improvements between the beginning and end of ventilation, including significant increases in activity, heart rate, venous pH and partial pressure of oxygen and decreases in venous partial pressure of carbon dioxide, potassium, and mortality prediction index score. Results of this study indicate that mechanical PPV is effective in improving the respiratory status of some moribund cold-stunned sea turtles; however, further refinement of the ventilation methods is recommended, and the prognosis remains poor to guarded for the most severely debilitated turtles.
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Vol. 27 • No. 1-2