The H9N2 strains of avian influenza viruses (AIVs) circulate worldwide in poultry and cause sporadic infection in humans. To better understand the evolution of these viruses while circulating in poultry, an H9N2 chicken isolate was passaged 19 times in chickens via aerosol inoculation. Whole-genome sequencing showed that the viruses from the initial stock and those after the 8th and 19th passages (P0, P8, and P19) all had the same monobasic cleavage site in the hemagglutinin (HA), typical for viruses of low pathogenicity. However, at position 226 of the HA protein the ratio of glutamine (which favors avian-type receptor binding) to leucine (which favors mammalian-type receptor binding) decreased from 54:46 in P0, to 87:13 in P8, and then 0:100 in P19. In chickens exposed to aerosols of P0, P8, or P19, replication of the viruses was similar and mainly limited to the respiratory tract. None of the infected chickens showed any clinical signs. Over the 19 passages the viruses maintained relatively stable infectivity but gradually lost lethality to chicken embryos. According to the hemagglutination inactivation assay, P8 was slightly and P19 significantly (P < 0.05) less thermostable than P0. Collectively, after 19 passages in chickens the H9N2 AIVs retained low pathogenicity with a positive selection of L226 in the HA. These findings suggest that H9N2 viruses might acquire mammalian specificity after asymptomatic circulation in avian species.

OBJECTIVE To evaluate efficacy of an alveolar recruitment maneuver (ARM) with positive end-expiratory pressures (PEEPs) in anesthetized horses ventilated with oxygen or heliox (70% helium and 30% oxygen). ANIMALS 6 healthy adult horses. PROCEDURES In a randomized crossover study, horses were anesthetized and positioned in dorsal recumbency. Volume-controlled ventilation was performed with heliox or oxygen (fraction of inspired oxygen [Fio2] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm H2O in steps of 5 cm H2O every 5 minutes, followed by incremental steps back to 0 cm H2O) was performed. Peak inspiratory pressure, dynamic lung compliance (Cdyn), and Pao2 were measured during each PEEP. Indices of pulmonary oxygen exchange and alveolar dead space were calculated. Variables were compared with baseline values (PEEP, 0 cm H2O) and between ventilation gases by use of repeated-measures ANOVAs. RESULTS For both ventilation gases, ARM significantly increased pulmonary oxygen exchange indices and Cdyn. Mean ± SD Cdyn (506 ± 35 mL/cm H2O) and Pao2-to-Fio2 ratio (439 ± 36) were significantly higher and alveolar-arterial difference in Pao2 (38 ± 11 mm Hg) was significantly lower for heliox, compared with values for oxygen (357 ± 50 mL/cm H2O, 380 ± 92, and 266 ± 88 mm Hg, respectively). CONCLUSIONS AND CLINICAL RELEVANCE An ARM in isoflurane-anesthetized horses ventilated with heliox significantly improved pulmonary oxygen exchange and respiratory mechanics by decreasing resistive properties of the respiratory system and reducing turbulent gas flow in small airways.