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Viterbo L, Hughes J, Milner PI, Bardell D. Arterial Blood Gas, Electrolyte and Acid-Base Values as Diagnostic and Prognostic Indicators in Equine Colic. Animals (Basel) 2023; 13:3241. [PMID: 37893965 PMCID: PMC10603645 DOI: 10.3390/ani13203241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
The study aimed to investigate if arterial blood analysis in conscious horses presenting with signs of colic and breathing ambient air had diagnostic or prognostic value. Arterial blood samples from 352 horses presenting with colic at a university equine referral hospital were analysed for pH, partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), concentrations of sodium (Na+), potassium (K+), ionised calcium (Ca2+) and chloride (Cl-), actual and standardised plasma bicarbonate concentration (HCO3- (P) and HCO3- (P, st)), blood and extracellular fluid base excess (Base (B) and Base (ecf)) and anion gap (AG). Results were compared to previously reported values for healthy horses, and comparisons were made between final diagnosis, treatment and survival to hospital discharge. Significant differences were found between colic cases and healthy reference values between some primary aetiologies. Overall, surgical and non-surgical colic cases differed in Ca2+ and Cl- concentrations and Ca2+ differed between cases that survived to discharge and those that did not. PaO2 differed between small intestinal surgical cases that survived and those that did not. From these results, we developed regression models that demonstrated excellent or good predictive value in identifying the likelihood of surgical versus medical management and survival to hospital discharge.
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Affiliation(s)
- Luisa Viterbo
- North Downs Specialist Referrals, Part of Linnaeus Veterinary Limited, The Fresian Buildings 3–4, Dairy Business Park, Brewer Street, Bletchingley RH1 4QP, UK;
| | - Jodie Hughes
- North Downs Specialist Referrals, Part of Linnaeus Veterinary Limited, The Fresian Buildings 3–4, Dairy Business Park, Brewer Street, Bletchingley RH1 4QP, UK;
| | - Peter I. Milner
- Department of Equine Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK; (P.I.M.); (D.B.)
| | - David Bardell
- Department of Equine Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK; (P.I.M.); (D.B.)
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2
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Portela DA, Di Franco C, Chiavaccini L, Araos J, Romano M, Otero PE, Biedrzycki AH, Schramel JP. Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses. Vet Anaesth Analg 2023:S1467-2987(23)00050-8. [PMID: 37055259 DOI: 10.1016/j.vaa.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (VTalv), airway (VDaw) and physiological (VDphys) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO2) elimination per breath (Vco2br-1), PaCO2, and the ratio of PaO2-to-fractional inspired oxygen (PaO2:FiO2). STUDY DESIGN Prospective research study. ANIMALS A group of eight healthy research horses undergoing laparotomy. METHODS Anesthetized horses were mechanically ventilated as follows: 6 breaths minute-1, tidal volume (VT) 13 mL kg-1, inspiratory-to-expiratory time ratio 1:2, positive end-expiratory pressure 5 cmH2O and EIP 0%. Vco2br-1 and expired tidal volume (VTE) of 10 consecutive breaths were recorded 30 minutes after induction, after adding 30% EIP and upon EIP removal to construct volumetric capnograms. A stabilization period of 15 minutes was allowed between phases. Data were analyzed using a mixed-effect linear model. Significance was set at p < 0.05. RESULTS The EIP decreased VDaw from 6.6 (6.1-6.7) to 5.5 (5.3-6.1) mL kg-1 (p < 0.001) and increased VTalv from 7.7 ± 0.7 to 8.6 ± 0.6 mL kg-1 (p = 0.002) without changing the VTE. The VDphys to VTE ratio decreased from 51.0% to 45.5% (p < 0.001) with EIP. The EIP also increased PaO2:FiO2 from 393.3 ± 160.7 to 450.5 ± 182.5 mmHg (52.5 ± 21.4 to 60.0 ± 24.3 kPa; p < 0.001) and Vco2br-1 from 0.49 (0.45-0.50) to 0.59 (0.45-0.61) mL kg-1 (p = 0.008) without reducing PaCO2. CONCLUSIONS AND CLINICAL RELEVANCE The EIP improved oxygenation and reduced VDaw and VDphys, without reductions in PaCO2. Future studies should evaluate the impact of different EIP in healthy and pathological equine populations under anesthesia.
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O'Donovan KA, Aarnes TK, Hubbell JA, Parker EM, Mollenkopf D, Lerche P, Ricco Pereira CH, Bini G, Bednarski RM. Risk of anesthesia-related complications in draft horses: a retrospective, single-center analysis. Vet Anaesth Analg 2023; 50:157-162. [PMID: 36577561 DOI: 10.1016/j.vaa.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To report anesthetic-related complications and determine risks associated with anesthesia in draft horses. STUDY DESIGN Retrospective study. ANIMALS A total of 401 anesthetic records for draft horse breeds that underwent general anesthesia from January 2010 through December 2020 were reviewed; horses euthanized during general anesthesia were excluded. METHODS Demographics, perioperative drugs used, procedure type and duration, time to extubation, number of attempts to stand, use of sling in recovery and perioperative morbidity and mortality were investigated. Morbidity and mortality statistical evaluation included univariable logistic regression analysis and ordinal regression analysis. RESULTS American Society of Anesthesiologists (ASA) status I-II, ASA III-V and total mortality rate for all cases was 0.69% (2/288), 6.19% (7/113) and 2.24% (9/401), respectively, with Belgian horses being overrepresented (6/9). Cardiac arrest occurred in six out of nine horses that died without euthanasia, and five out of six of these horses underwent colic surgery. Factors associated with increased mortality risk included ASA status of III-V, increased body weight, emergency status and horses presenting for colic. Hypotension, hypercarbia and hypoxemia occurred in 56% (224/401), 46% (186/401) and 14% (58/401) of horses, respectively. During recovery from anesthesia, lighter horses and horses undergoing shorter anesthetic procedures were more likely to be successful on the first or second attempt to stand and were less likely to require a sling in recovery. CONCLUSIONS AND CLINICAL RELEVANCE Draft horses undergoing general anesthesia had a higher mortality rate than previously reported for all types and breeds of horses.
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Affiliation(s)
- Kathrin A O'Donovan
- The Ohio State University Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA
| | - Turi K Aarnes
- The Ohio State University Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA.
| | | | - Elizabeth M Parker
- The Ohio State University Department of Preventive Medicine, College of Veterinary Medicine, Columbus, OH, USA
| | - Dixie Mollenkopf
- The Ohio State University Department of Preventive Medicine, College of Veterinary Medicine, Columbus, OH, USA
| | - Phillip Lerche
- The Ohio State University Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA
| | - Carolina H Ricco Pereira
- The Ohio State University Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA
| | - Gianluca Bini
- The Ohio State University Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA
| | - Richard M Bednarski
- The Ohio State University Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Columbus, OH, USA
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4
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Fisher K, Dodam J, Bailey J, Thombs L, Hodgson D, Bukoski A. Arterial blood gas tensions during recovery in horses anesthetized with apneustic anesthesia ventilation compared with conventional mechanical ventilation. Vet Anaesth Analg 2023; 50:238-244. [PMID: 36781322 DOI: 10.1016/j.vaa.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To compare PaO2 and PaCO2 in horses recovering from general anesthesia maintained with either apneustic anesthesia ventilation (AAV) or conventional mechanical ventilation (CMV). STUDY DESIGN Randomized, crossover design. ANIMALS A total of 10 healthy adult horses from a university-owned herd. METHODS Dorsally recumbent horses were anesthetized with isoflurane in oxygen [inspired oxygen fraction = 0.3 initially, with subsequent titration to maintain PaO2 ≥ 85 mmHg (11.3 kPa)] and ventilated with AAV or CMV according to predefined criteria [10 mL kg-1 tidal volume, PaCO2 40-45 mmHg (5.3-6.0 kPa) during CMV and < 60 mmHg (8.0 kPa) during AAV]. Horses were weaned from ventilation using a predefined protocol and transferred to a stall for unassisted recovery. Arterial blood samples were collected and analyzed at predefined time points. Tracheal oxygen insufflation at 15 L minute-1 was provided if PaO2 < 60 mmHg (8.0 kPa) on any analysis. Time to oxygen insufflation, first movement, sternal recumbency and standing were recorded. Data were analyzed using repeated measures anova, paired t tests and Fisher's exact test with significance defined as p < 0.05. RESULTS Data from 10 horses were analyzed. Between modes, PaO2 was significantly higher immediately after weaning from ventilation and lower at sternal recumbency for AAV than for CMV. No PaCO2 differences were noted between ventilation modes. All horses ventilated with CMV required supplemental oxygen, whereas three horses ventilated with AAV did not. Time to first movement was shorter with AAV. Time to oxygen insufflation was not different between ventilation modes. CONCLUSIONS Although horses ventilated with AAV entered the recovery period with higher PaO2, this advantage was not sustained during recovery. Whereas fewer horses required supplemental oxygen after AAV, the use of AAV does not preclude the need for routine supplemental oxygen administration in horses recovering from general anesthesia.
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Affiliation(s)
- Kelsey Fisher
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - John Dodam
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - James Bailey
- Innovative Veterinary Medicine, Ponte Vedra, FL, USA
| | - Lori Thombs
- Department of Statistics, College of Arts and Science, University of Missouri, Columbia, MO, USA
| | - David Hodgson
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Alex Bukoski
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.
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5
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Marchese GA, Calvo Carrasco D, Pascal M. Multimodal analgesic technique in a peacock (
Pavo cristatus
) anaesthetised for orthopaedic surgery. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pittman E, Martin-Flores M, Mosing M, Lorenzutti M, Retamal J, Staffieri F, Adler A, Campbell M, Araos J. Preliminary evaluation of the effects of a 1:1 inspiratory-to-expiratory ratio in anesthetized and ventilated horses. Vet Anaesth Analg 2022; 49:645-649. [DOI: 10.1016/j.vaa.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 10/15/2022]
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Marchese GA, Crystal J, Louro LF. Incidence of severe hypoxaemia in anaesthetised horses undergoing emergency exploratory laparotomy. J Equine Vet Sci 2022; 116:104026. [PMID: 35659514 DOI: 10.1016/j.jevs.2022.104026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/29/2022] [Accepted: 05/26/2022] [Indexed: 11/19/2022]
Abstract
Prevalence and risk factors of severe hypoxaemia in anaesthetised horses undergoing emergency exploratory laparotomy are sparsely documented. The aim of this study was to report incidence of severe hypoxaemia ( PaO 2 < 60 mmHg) in horses undergoing emergency exploratory laparotomy and identify potential risk factors for this complication. A single centre retrospective cross sectional designed was used. Clinical data of 714 horses undergoing general anaesthesia for emergency explorative laparotomy were reviewed. A backward stepwise elimination procedure was used to determine the final multivariable logistic regression model; all covariables with univariable P-values <0.25 were incorporated, with retention of covariables with Wald P-values <0.05 at each step, in order to determine which explanatory variables would be included in the final model. The overall incidence of severe hypoxaemia in our population was 15.3%. Multivariable logistic regression analysis showed that increasing body weight (OR 1.01, 95% CI 1.0-1.01, P = .002), colon torsion (OR 3.0, 95% CI 1.3-6.8, P = .006), increased dead space ventilation (OR 1.06, 95% CI 1.04-1.09, P = <0.001), shorter time between induction of anaesthesia and collection of arterial blood gas samples (OR 0.98, 95% CI 0.98-0.99, P = <0.001) and intra-tracheal aerosolised salbutamol (OR 13.5, 95% CI 7.6-24, P = <0.001) were associated with the outcome. The incidence of hypoxaemia found in our study was in line with previous literature. Increasing body weight, colon torsion and shorter time between the time of induction of anaesthesia and collection of arterial blood gas samples represented risk factors for hypoxaemia.
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Affiliation(s)
- Giorgia Anna Marchese
- School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK; Willows Veterinary Centre and Referral Service, Solihull, UK.
| | - Joanna Crystal
- School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK
| | - Luís Filipe Louro
- School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK; ChesterGates Veterinary Specialists, Wirral, UK
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8
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Clark-Price SC, Lascola KM, Auckburally A, Boone LH, Caldwell FJ, Weatherall KM, Hanson RR. The effect of inhaled albuterol on PaO2 in anesthetized horses receiving a FiO2 of 0.5 or > 0.95. J Equine Vet Sci 2022; 113:103944. [DOI: 10.1016/j.jevs.2022.103944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
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9
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Ribonnet C, Palmers K, Saegerman C, Vanderperren K, van Galen G. Perioperative lung ultrasonography in healthy horses undergoing general anesthesia for elective surgery. J Vet Intern Med 2022; 36:1160-1172. [PMID: 35322893 PMCID: PMC9151480 DOI: 10.1111/jvim.16408] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 01/03/2023] Open
Abstract
Background Lung ultrasound (LUS) is poorly evaluated in horses, especially perioperatively. Objectives (1) Describe LUS findings in healthy horses before and after general anesthesia (GA), (2) evaluate if GA induces ultrasonographic changes in healthy horses, (3) suggest a LUS scoring system, (4) identify horse variables that are associated to LUS changes after anesthesia. Animals Twenty‐five healthy adult horses undergoing elective surgery. Methods Prospective hypothesis‐driven observational study. LUS findings were recorded before anesthesia, 5 minutes in recovery, 15 minutes, 2H, 3H, 4H, 6H, and 24H after anesthesia in 8 lung regions. Clinical data were collected perioperatively. Results There was a significant increase in amount of I‐lines (10.8 ± 8.7 vs 15.28 ± 8.19), B‐lines (3.2 ± 3.5 vs 8.72 ± 4.86), and coalescent B‐lines (0.04 ± 0.2 vs 1.12 ± 1.45) after anesthesia compared to before anesthesia, and a significantly higher LUS score 2H after anesthesia (4.92 ± 8.40) compared to before anesthesia (0.9 ± 1.8; P = .02). The maximal LUS score after anesthesia was correlated to total procedure time (Pearson r = 0.4, P = .05; Spearman r = 0.44, P = .03) and was significantly higher in horses with abnormal cardiorespiratory values during anesthesia (P = .005). Conclusions LUS changes can be induced by GA in healthy horses. This study did not investigate if and which LUS findings indicate lesions, however, this information can aid clinicians to identify pulmonary complications after anesthesia.
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Affiliation(s)
| | | | - Claude Saegerman
- Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiege), Fundamental and Applied Research for Animal Health (FARAH) Center, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Katrien Vanderperren
- Department of Medical Imaging of Domestic Animals and Orthopaedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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10
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Bennell AJ, Wright RJH, Malalana F, Senior JM. An analysis of risk factors for a fracture or luxation in recovery from general anaesthesia in horses: a single centre study. J Equine Vet Sci 2022; 112:103914. [PMID: 35218904 DOI: 10.1016/j.jevs.2022.103914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/12/2022] [Accepted: 02/18/2022] [Indexed: 11/28/2022]
Abstract
Catastrophic fractures or luxations (FoL) sustained during recovery from general anaesthesia are a significant cause of mortality during equine anaesthesia. There is a lack of evidence regarding potential risk factors for a FoL occurring in the immediate anaesthetic recovery period. A single centre, retrospective, case-matched study was performed to identify risk factors for sustaining a catastrophic FoL during recovery from general anaesthesia. Clinical data were obtained for horses which sustained a catastrophic FoL when recovering from general anaesthesia from January 2011- June 2020 in a single centre referral population. Multivariable logistical regression analysis was performed to identify risk factors which were significant in horses where a FoL occurred. Statistically significant risk factors in our population of horses of sustaining a FoL in recovery included intra-operative administration of intra-tracheal salbutamol, intra-operative administration of ketamine and increasing age. Further research in this area, particularly with regards to salbutamol administration, is required.
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11
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Auckburally A, Wiklund MK, Lord PF, Hedenstierna G, Nyman G. Effects of pulsed inhaled nitric oxide delivery on the distribution of pulmonary perfusion in spontaneously breathing and mechanically ventilated anesthetized ponies. Am J Vet Res 2022; 83:171-179. [PMID: 34851855 DOI: 10.2460/ajvr.21.03.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To measure changes in pulmonary perfusion during pulsed inhaled nitric oxide (PiNO) delivery in anesthetized, spontaneously breathing and mechanically ventilated ponies positioned in dorsal recumbency. ANIMALS 6 adult ponies. PROCEDURES Ponies were anesthetized, positioned in dorsal recumbency in a CT gantry, and allowed to breathe spontaneously. Pulmonary artery, right atrial, and facial artery catheters were placed. Analysis time points were baseline, after 30 minutes of PiNO, and 30 minutes after discontinuation of PiNO. At each time point, iodinated contrast medium was injected, and CT angiography was used to measure pulmonary perfusion. Thermodilution was used to measure cardiac output, and arterial and mixed venous blood samples were collected simultaneously and analyzed. Analyses were repeated while ponies were mechanically ventilated. RESULTS During PiNO delivery, perfusion to aerated lung regions increased, perfusion to atelectatic lung regions decreased, arterial partial pressure of oxygen increased, and venous admixture and the alveolar-arterial difference in partial pressure of oxygen decreased. Changes in regional perfusion during PiNO delivery were more pronounced when ponies were spontaneously breathing than when they were mechanically ventilated. CLINICAL RELEVANCE In anesthetized, dorsally recumbent ponies, PiNO delivery resulted in redistribution of pulmonary perfusion from dependent, atelectatic lung regions to nondependent aerated lung regions, leading to improvements in oxygenation. PiNO may offer a treatment option for impaired oxygenation induced by recumbency.
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Affiliation(s)
- Adam Auckburally
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Maja K Wiklund
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Peter F Lord
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Görel Nyman
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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12
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Sage AM, Ambrisko TD, Martins FDC, Dantino SC, Keating SCJ, Strahl‐Heldreth DE, Wilkins PA. Evaluation of fingertip pulse oximeters for monitoring haemoglobin oxygen saturation in arterial blood and pulse rate in isoflurane‐anaesthetised horses breathing greater than 90 percent oxygen. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. M. Sage
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - T. D. Ambrisko
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - F. D. C. Martins
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - S. C. Dantino
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - S. C. J. Keating
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - D. E. Strahl‐Heldreth
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
| | - P. A. Wilkins
- Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois at Urbana‐Champaign Urbana Illinois USA
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13
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Hummer EV, Soares JHN, Crockett DC, Aguiar AJA, Tran MC, Cronin JN, Brosnan RJ, Braun C, Formenti F. Continuous measurement of arterial oxygenation in mechanically ventilated horses. Equine Vet J 2021; 54:1144-1152. [PMID: 34797580 DOI: 10.1111/evj.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. OBJECTIVES The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO2 (PaO2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. STUDY DESIGN In vivo experimental study. METHODS Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteries through a catheter to continuously measure and record PaO2Sensor . After an alveolar recruitment manoeuvre, a decremental positive end-expiratory pressure (PEEP) titration using 20-minute steps of 5 cm H2 O from 20 to 0 cm H2 O was performed. An arterial blood sample was collected at 15 minutes of ventilation at each PEEP level for PaO2 measurement using an automated blood gas machine (PaO2Ref ). The agreement between PaO2Sensor and PaO2Ref was assessed by Pearson's correlation, Bland-Altman plot and four-quadrant plot analysis. In the last minute of ventilation at each PEEP level, a slow tidal inflation/deflation manoeuvre was performed. RESULTS The mean relative bias between PaO2Sensor and PaO2Ref was 4% with limits of agreement between -17% and 29%. The correlation coefficient between PaO2Sensor and PaO2Ref was 0.98 (P < .001). The PaO2Sensor and PaO2Ref concordance rate for changes was 95%. Measurements of PaO2Sensor during the slow inflation/deflation manoeuvre at PEEP 15 and 10 cm H2 O were not possible because of significant noise on the PaO2 signal generated by a small blood clot. MAIN LIMITATIONS Small sample size. CONCLUSION The tested fibreoptic probe was able to accurately and continuously measure PaO2Sensor in anaesthetised horses undergoing ventilatory manoeuvres. A heparinised system in the catheter used by the fibreoptic sensor should be used to avoid blood clots and artefacts in the PaO2 measurements.
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Affiliation(s)
- Emma V Hummer
- William Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, California, USA
| | - Joao H N Soares
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | | | - Antonio J A Aguiar
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA.,Departamento de Cirurgia e Anestesiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Minh C Tran
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.,Department of Engineering Science, University of Oxford, Oxford, UK
| | - John N Cronin
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK.,Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Robert J Brosnan
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Christina Braun
- Anaesthesiology and Perioperative Intensive Care, Vetmeduni Vienna, Vienna, Austria
| | - Federico Formenti
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.,Centre for Human and Applied Physiological Sciences, King's College London, London, UK
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14
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Dupont J, Gougnard A, Salciccia A, Detilleux J, Serteyn D, Sandersen C. Comparison of single-breath continuous positive airway pressure manoeuvre with inhaled salbutamol to improve oxygenation in horses anaesthetized for laparotomy. Vet Anaesth Analg 2021; 49:85-94. [PMID: 34872855 DOI: 10.1016/j.vaa.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/30/2021] [Accepted: 06/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the efficacy of single-breath continuous positive airway pressure manoeuvre (CPAP-M) with inhaled salbutamol, and a combination of both. STUDY DESIGN Randomized, clinical study. ANIMALS A total of 62 client-owned horses (American Society of Anesthesiologists status III-V) anaesthetized for laparotomy. METHODS Horses were premedicated with intravenous (IV) xylazine (0.4-0.6 mg kg-1), anaesthesia was induced with midazolam (0.06 mg kg-1 IV) and ketamine (2.2 mg kg-1 IV) and maintained with isoflurane in oxygen using volume-controlled ventilation without positive end-expiratory pressure. If PaO2 was < 100 mmHg (13.3 kPa), either a CPAP-M (50 cmH2O for 45 seconds) or salbutamol (0.002 mg kg-1) was administered. The intervention was considered successful if PaO2 reached 100 mmHg (13.3 kPa). If PaO2 remained < 100 mmHg (13.3 kPa), treatments were switched. PaO2/FiO2 ratio and estimated shunt fraction (F-shunt) were derived from data obtained from arterial blood gas measurements. Dynamic compliance (Cdyn) was calculated from variables recorded at the moment of arterial blood analysis. Fisher's exact tests compared success rates between treatments, and linear models were performed to test whether the treatment modified the values of the measurements; p < 0.05. RESULTS Salbutamol was the first intervention in 28 horses and was effective in 22 horses. CPAP-M was the first intervention in 34 horses and was effective in 26 horses. CPAP-M after salbutamol was performed in six horses, with four responders, and salbutamol after CPAP-M was administered to eight horses, with one responder. Salbutamol, but not CPAP-M, significantly decreased F-shunt. Both salbutamol and CPAP-M significantly increased Cdyn. CONCLUSIONS AND CLINICAL RELEVANCE Salbutamol and CPAP-M were comparably effective in improving oxygenation and Cdyn in anaesthetized horses with PaO2 < 100 mmHg (13.3 kPa). Whether combining both treatments might be beneficial needs to be confirmed on a larger number of horses.
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Affiliation(s)
- Julien Dupont
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.
| | - Alexandra Gougnard
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Alexandra Salciccia
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Johann Detilleux
- Quantitative Genetics Group, Department of Veterinary Management of Animal Resources, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Didier Serteyn
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Charlotte Sandersen
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
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Dagnall C, Khenissi L, Love E. Monitoring techniques for equine anaesthesia. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Dagnall
- Faculty of Health Sciences The University of Bristol Bristol UK
| | | | - E. Love
- Faculty of Health Sciences The University of Bristol Bristol UK
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16
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Calero Rodriguez A, de Grauw JC, van Loon JPAM. Effect of different inspired fractions of oxygen on F-shunt and arterial partial pressure of oxygen in isoflurane-anaesthetized and mechanically ventilated Shetland ponies. Vet Anaesth Analg 2021; 48:930-934. [PMID: 34544618 DOI: 10.1016/j.vaa.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/10/2021] [Accepted: 05/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the effect of fraction of inspired oxygen (FiO2) on intrapulmonary shunt fraction as measured by F-shunt in ponies during isoflurane anaesthesia. STUDY DESIGN Prospective, randomized clinical study. ANIMALS A group of 23 adult Shetland ponies undergoing a total of 32 anaesthetic procedures. METHODS Ponies were premedicated intravenously (IV) with detomidine (0.01 mg kg-1) and either morphine (0.1 mg kg-1) or butorphanol (0.02 mg kg-1). Anaesthesia was induced with ketamine (2.2 mg kg-1) and midazolam (0.07 mg kg-1) administered IV. Ponies were randomly allocated to maintenance of anaesthesia with isoflurane in oxygen (group TH; FiO2 = 0.95) or a mixture of oxygen and medical air (group TL; FiO2 = 0.65); all ponies were given a constant rate of infusion of detomidine. Animals were mechanically ventilated to maintain PaCO2 between 40 and 50 mmHg. Arterial blood gas analysis was performed every 30 minutes. The F-shunt equation was calculated for each time point T0, T30, T60 and T90. Data were analysed using linear mixed model analysis and presented as mean ± standard deviation (p < 0.05). RESULTS PaO2 was greater in group TH than in group TL (TH: 406 ± 90, 438 ± 83, 441 ± 69 and 464 ± 53 mmHg versus TL: 202 ± 90, 186 ± 84, 172 ± 85 and 191 ± 98 mmHg at T0, T30, T60 and T90, respectively; p < 0.0001). In TH, F-shunt was < TL. Significant differences were found at T60 (TH: 13.2% ± 4.3 versus TL: 19.4% ± 8.3; p = 0.016) and T90 (TH: 11.7% ± 3.5 versus TL: 18.6% ± 9.5; p = 0.036). CONCLUSIONS AND CLINICAL RELEVANCE Our findings do not support a beneficial effect of using a reduced FiO2 to improve oxygenation in anaesthetized and mechanically ventilated Shetland ponies.
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Affiliation(s)
- Abraham Calero Rodriguez
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
| | - Janny C de Grauw
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Johannes P A M van Loon
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Cowling N, Woldeyohannes S, Sole Guitart A, Goodwin W. Measurement of Tissue Oximetry in Standing Unsedated and Sedated Horses. Vet Sci 2021; 8:vetsci8100202. [PMID: 34679032 PMCID: PMC8537620 DOI: 10.3390/vetsci8100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
Near infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO2) and may be useful to detect early changes in StO2 in anaesthetized and critically ill horses. This study aimed to identify the muscle belly that provided the highest percentage of successful StO2 readings and the highest mean StO2 value. Fifty adult horses were enrolled in a prospective controlled study. StO2 was measured at six different muscles in each horse, for each intervention: hair overlying the muscle was clipped (post clipping: PC), clipped skin was cleaned with chlorhexidine (post-surgical prepping: PP) and medetomidine was administered intravenously (post medetomidine: PM). Mean StO2 values were calculated for each muscle, and a linear effects model was used to assess the effect of muscle group and intervention on StO2. The sartorius muscle gave the highest percentage of successful StO2 values (p < 0.001) and the highest mean (90% CI) StO2 values for the PC, PP and PM interventions. Surgical prepping of the skin increased the success for measurement of StO2 values. For all muscles, administration of medetomidine was associated with lower StO2 values (p < 0.001). In conclusion, of the muscles examined, the sartorius muscle may be the preferred muscle to measure StO2 in horses, and clipping and cleaning of the probe placement site is recommended.
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Loomes K, Louro LF. Recovery of horses from general anaesthesia: A systematic review (2000-2020) of risk factors and influence of interventions during the recovery period. Equine Vet J 2021; 54:201-218. [PMID: 34537994 DOI: 10.1111/evj.13517] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 07/19/2021] [Accepted: 09/03/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND In equine anaesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research. Risk factors, including age, type and duration of procedure or temperament may influence recovery quality. Unfortunately, the anaesthetist is unable to control for these factors, therefore various pharmacological interventions and recovery methods have been developed with the objective of improving recovery quality. However, no consensus among anaesthetists has been reached for many of these interventions and their implications for recovery-related mortality and morbidity. OBJECTIVES To conduct a systematic review of the published evidence relating to risk factors and interventions in the recovery period which may influence recovery quality from equine general anaesthesia (GA). STUDY DESIGN A systematic evaluation of the equine veterinary literature using the GRADE framework. METHODS A literature search was performed and studies were assessed for eligibility by both authors utilising PRISMA guidelines. Studies meeting inclusion criteria were evaluated by both authors, categorically summarised and the quality of evidence for each sub-topic was assessed using the GRADE framework. RESULTS Thirty-nine studies were identified which directly assessed the impact of risk factors and recovery interventions on recovery quality after equine GA. There was evidence to support that peri-anaesthetic risk factors such as anaesthesia duration, American Society of Anesthesiologists (ASA) physical status and surgical procedure influenced recovery quality. We also identified sufficient evidence that administration of α-2 adrenoreceptor agonists immediately prior to recovery, improves recovery quality. MAIN LIMITATIONS The validity of the results of some studies may have been compromised by missing data and small sample sizes. CONCLUSIONS Recovery quality is influenced by factors including: anaesthesia duration, ASA physical status and surgical procedure. Recovery quality can be improved by the administration of an α-2 adrenoreceptor agonist immediately prior to recovery.
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Affiliation(s)
| | - Luís Filipe Louro
- School of Veterinary Science, Leahurst Campus, University of Liverpool, Wirral, UK
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Savvas I, Pavlidou K, Braun C, Schauvliege S, Staffieri F, Moens Y. Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis. Animals (Basel) 2021; 11:ani11082245. [PMID: 34438703 PMCID: PMC8388394 DOI: 10.3390/ani11082245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023] Open
Abstract
In anaesthetized horses, pronounced ventilation/perfusion mismatching often occurs. Several authors have investigated the effect of lower inspired oxygen fractions (FiO2) to reduce formation of absorption atelectasis. This systematic review compared the effects of low (<0.6) and high (>0.8) FiO2 on the arterial oxygen tension (PaO2), the alveolar-to-arterial oxygen tension difference (P(A-a)O2), and the PaO2/FiO2 ratio in horses during inhalation anaesthesia. Using the Systematic Review Protocol for Animal Intervention Studies, four experimental and one clinical investigations were deemed suitable for inclusion. A meta-analysis was performed on the four experimental studies. The PaO2 was significantly lower (p = 0.0007, mean difference -23.54 kPa, 95% CI -37.18, -9.90) with a lower FiO2. However, the P(A-a)O2 was also significantly lower (p < 0.00001, mean difference -20.80 kPa, 95% CI -26.28, -15.32) when using a low FiO2. For the PaO2/FiO2 ratio, only one study fitted the inclusion criteria, so no meta-analysis was performed. It is concluded that, while only a limited number of studies are available, the use of a higher FiO2 in horses during inhalation anaesthesia will result in higher levels of PaO2, but also a larger P(A-a)O2 difference. Further studies are needed to increase the level of evidence on this subject.
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Affiliation(s)
- Ioannis Savvas
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 546 27 Thessaloniki, Greece;
- Correspondence:
| | - Kiriaki Pavlidou
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 546 27 Thessaloniki, Greece;
| | - Christina Braun
- Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, 1210 Vienna, Austria; (C.B.); (Y.M.)
| | - Stijn Schauvliege
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari Aldo Moro, 70010 Bari, Italy;
| | - Yves Moens
- Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, 1210 Vienna, Austria; (C.B.); (Y.M.)
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20
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Stefanik E, Drewnowska O, Lisowska B, Turek B. Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia. Animals (Basel) 2021; 11:2049. [PMID: 34359177 PMCID: PMC8300395 DOI: 10.3390/ani11072049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Horses, due to their unique anatomy and physiology, are particularly prone to intraoperative cardiopulmonary disorders. In dorsally recumbent horses, chest wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the collapse of the alveoli. This results in hypoventilation, leading to hypercapnia and respiratory acidosis as well as impaired tissue oxygen supply (hypoxia). The most common mechanisms disturbing gas exchange are hypoventilation, atelectasis, ventilation-perfusion (V/Q) mismatch and shunt. Gas exchange disturbances are considered to be an important factor contributing to the high anaesthetic mortality rate and numerous post-anaesthetic side effects. Current monitoring methods, such as a pulse oximetry, capnography, arterial blood gas measurements and spirometry, may not be sufficient by themselves, and only in combination with each other can they provide extensive information about the condition of the patient. A new, promising, complementary method is near-infrared spectroscopy (NIRS). The purpose of this article is to review the negative effect of general anaesthesia on the gas exchange in horses and describe the post-operative complications resulting from it. Understanding the changes that occur during general anaesthesia and the factors that affect them, as well as improving gas monitoring techniques, can improve the post-aesthetic survival rate and minimize post-operative complications.
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Affiliation(s)
- Elżbieta Stefanik
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 100, 02-797 Warsaw, Poland;
| | - Olga Drewnowska
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 100, 02-797 Warsaw, Poland;
| | - Barbara Lisowska
- National Geriatrics, Rheumatology and Rehabilitation Institute, Spartańska 1, 02-637 Warsaw, Poland;
| | - Bernard Turek
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 100, 02-797 Warsaw, Poland;
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21
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Moreno‐Martinez F, Senior JM, Mosing M. Controlled mechanical ventilation in equine anaesthesia: Classification of ventilators and practical considerations (Part 2). EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- F. Moreno‐Martinez
- School of Veterinary and Life Sciences Murdoch University Perth Western Australia Australia
| | - J. M. Senior
- Department of Equine Clinical Science Institute of Veterinary Science University of Liverpool Neston UK
| | - M. Mosing
- School of Veterinary and Life Sciences Murdoch University Perth Western Australia Australia
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COMPARISON OF ISOFLURANE GAS VERSUS A GUAIFENESIN, KETAMINE, AND MEDETOMIDINE CONSTANT-RATE INFUSION FOR MAINTENANCE ANESTHESIA IN AMERICAN BLACK BEARS ( URSUS AMERICANUS). J Zoo Wildl Med 2021; 50:570-578. [PMID: 33517625 DOI: 10.1638/2018-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2019] [Indexed: 11/21/2022] Open
Abstract
Published anesthetic protocols for captive and free-ranging bears are limited to injectable inductions with maintenance via inhalants or additional injectable boluses. Though common in other species, intravenous (IV) continuous-rate infusions (CRI) using guaifenesin combinations have not been evaluated in ursids. This study evaluated the use of a CRI compared to an inhalant for maintenance anesthesia. Seven healthy American black bears (Ursus americanus) were anesthetized in a crossover design with two different anesthetic maintenance protocols. Bears were immobilized with ketamine (2.02 ± 0.14 mg/kg) and medetomidine (0.04 ± 0.003 mg/kg) for both protocols. The anesthetic maintenance control protocol consisted of isoflurane gas (ISO) started at 2% delivered by endotracheal tube; the experimental protocol consisted of guaifenesin, medetomidine, ketamine (GMK) IV CRI started at 50 mg/kg/hr guaifenesin, 0.01 mg/kg/hr medetomidine, and 1 mg/kg/hr ketamine. Induction and recovery parameters including time to first effect, recumbency, and hands on; duration of maintenance protocol; and time from reversals administered to head up, standing on all four feet, no ataxia, and to fully recovered were recorded and compared between protocols. Heart rate, respiratory rate, rectal temperature, blood pressure, end tidal carbon dioxide, and hemoglobin oxygen saturation were recorded at 5-min intervals and compared between protocols. Venous blood gases were obtained at the start, middle, and end of the maintenance anesthesia and compared between protocols. All bears exhibited hypertension with mild respiratory acidosis throughout procedures. Measured physiologic parameters did not differ significantly between the isoflurane and the GMK CRI maintenance protocols, with the exception of higher endpoint (ISO) pCO2 measurements. No adverse events were recorded with either protocol, and adequate depth of anesthesia was maintained with both protocols. GMK CRI provides a safe, effective, and more portable alternative to inhalant anesthetics for maintenance anesthesia in bears in captivity or in the field.
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Moreno‐Martinez F, Mosing M, Senior M. Controlled mechanical ventilation in equine anaesthesia: Physiological background and basic considerations (Part 1). EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- F. Moreno‐Martinez
- School of Veterinary and Life Sciences Murdoch University Perth Western Australia Australia
| | - M. Mosing
- School of Veterinary and Life Sciences Murdoch University Perth Western Australia Australia
| | - M. Senior
- Department of Equine Clinical Science Institute of Veterinary Science University of Liverpool Neston, Cheshire UK
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Kadwa AR, Brown GJ, Buck R. Anaesthetic management of a bovine for ventral midline coeliotomy approach to hysterotomy. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Abdur Rahmaan Kadwa
- Department of Companion Animal Clinical Studies Faculty of Veterinary Science, University of Pretoria South Africa
| | - Geoffrey James Brown
- Department of Companion Animal Clinical Studies Faculty of Veterinary Science, University of Pretoria South Africa
| | - Roxanne Buck
- Department of Companion Animal Clinical Studies Faculty of Veterinary Science, University of Pretoria South Africa
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Petruccione I, Levionnois O, Pawson P. Hypoxaemia and bradyarrhythmia in a foal undergoing surgical bladder repair. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ilaria Petruccione
- Anaesthesia and Pain Management Division VetSuisse Fakultät Langasstrassse 124 Bern 3012 Switzerland
| | - Olivier Levionnois
- Anaesthesia and Pain Management Division VetSuisse Fakultät Langasstrassse 124 Bern 3012 Switzerland
| | - Patricia Pawson
- Anaesthesia Department, College of Medical Veterinary and Life Sciences University of Glasgow 464, Bearsden Road Glasgow G61 1QH UK
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Bellini L, Dzikiti BT, De Benedictis GM, Algarin Sepulveda FR, Maney JK. Oxygen reserve index as a noninvasive indicator of arterial partial pressure of oxygen in anaesthetized donkeys: a preliminary study. Vet Anaesth Analg 2021; 48:388-392. [PMID: 33632615 DOI: 10.1016/j.vaa.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/02/2020] [Accepted: 01/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the oxygen reserve index (ORI) as a noninvasive estimate of the PaO2 during moderate hyperoxaemia [100-200 mmHg (13.3-26.6 kPa)], and to determine ORI values identifying PaO2 > 100, > 150 (20.0 kPa) and > 200 mmHg in anaesthetized donkeys with an inspired fraction of oxygen (FiO2) > 0.95. STUDY DESIGN Prospective observational study. ANIMALS A group of 28 adult standard donkeys aged (mean ± standard deviation) 4 ± 2 years and weighing 135 ± 15 kg. METHODS Donkeys were sedated intramuscularly with xylazine and butorphanol; anaesthesia was induced with ketamine and diazepam and maintained with isoflurane in oxygen. An adhesive sensor probe was applied to the donkey's tongue and connected to a Masimo pulse co-oximeter to determine ORI values. An arterial catheter was inserted into an auricular artery. After ORI signal stabilization, the value was noted and PaO2 determined by blood gas analysis. The Pearson correlation coefficient was used to assess the relationship between ORI and PaO2 for oxygen tension < 200 mmHg (< 26.6 kPa). The Youden index was used to identify the value of ORI that detected PaO2 > 150 and 200 mmHg (20.0 and 26.6 kPa) with the highest sensitivity and specificity. RESULTS A total of 106 paired measurements were collected. A mild positive correlation was observed between ORI and PaO2 for values < 200 mmHg (26.6 kPa; r = 0.52). An ORI > 0.0, > 0.1 and > 0.3 indicated a PaO2 > 100, > 150 and > 200 mmHg (13.3, 20.0 and 26.6 kPa) with negative predictive values > 94%. CONCLUSIONS AND CLINICAL RELEVANCE ORI may provide a noninvasive indication of PaO2 > 100, > 150 and > 200 mmHg (13.3, 20.0 and 26.6 kPa) in anaesthetized donkeys with an FiO2 > 0.95, although it does not replace blood gas analysis for assessment of oxygenation.
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Affiliation(s)
- Luca Bellini
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy.
| | - Brighton T Dzikiti
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | | | - Felix R Algarin Sepulveda
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Jill K Maney
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
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28
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Cerullo M, Driessen B, Douglas H, Hopster K. Changes in Arterial Blood Pressure and Oxygen Tension as a Result of Hoisting in Isoflurane Anesthetized Healthy Adult Horses. Front Vet Sci 2020; 7:601326. [PMID: 33324704 PMCID: PMC7723898 DOI: 10.3389/fvets.2020.601326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background: In anesthetized adult horses, changes in recumbency can influence the cardiovascular system but how arterial blood pressures and oxygen tension change in isoflurane anesthetized animals as a direct result of hoisting has not been investigated. Objective: To evaluate effects of hoisting on hemodynamic function and pulmonary gas exchange in isoflurane-anesthetized horses. Study Design: Prospective, experimental study. Methods: Six adult horses were anesthetized three times using isoflurane in pure oxygen (inspired fraction 0.9-1.0), and allowed breathing spontaneously in lateral recumbency. After 45 min horses were hoisted using a single hoist-hobble system for 5 min and returned into left lateral recumbency. Heart rate (HR), respiratory rate (RR), and systolic (SAP), diastolic (DAP), and mean arterial blood pressures (MAP) were measured every minute starting from 5 min before to 5 min after hoisting. Arterial blood gas samples were collected before, during, and after hoisting. Results: Significant changes in hemodynamic parameters and PaO2 but not PaCO2 were found between baseline recordings and measurements obtained during and early after hoisting. The MAP decreased within the 1st min of hoisting from a mean of 74 ± 17 mmHg at baseline to 57 ± 20 mmHg (p < 0.05). Thereafter, it rapidly recovered to baseline before continuing to rise to higher than baseline values and then remaining elevated for 5 min after horses were returned into lateral recumbency. Simultaneously, the HR increased by 6-9 beats per min during the initial 3 min of hoisting before returning close to baseline values (p < 0.05). The PaO2 decreased significantly from a mean of 324.9 ±137.0 mmHg at baseline to a mean of 141.3 ± 104.2 mmHg during hoisting (p < 0.001) without recovering any more to baseline values. Clinical significance: Hoisting an adult horse during or at the end of isoflurane anesthesia carries the risk of a precipitous, though short-lived (1-2 min), drop in arterial blood pressures and a persistent decrease in arterial oxygenation. While in systemically healthy animals the observed functional impairments were not life-threatening, they may be more severe in systemically compromised horses.Therefore, arterial blood pressures and oxygenation must be carefully monitored when hoisting sick equine patients during or at the end of inhalant anesthesia.
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Affiliation(s)
- Michelle Cerullo
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
| | - Bernd Driessen
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
| | - Hope Douglas
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
| | - Klaus Hopster
- Department of Clinical Sciences, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, United States
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Trenholme HN, Barletta M, Quandt JE, Reed RA, Kleine SA, Hofmeister EH. Arterial oxygenation in anesthetized horses placed in a 5-degree reverse Trendelenburg position. Res Vet Sci 2020; 135:304-309. [PMID: 33066990 DOI: 10.1016/j.rvsc.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 11/17/2022]
Abstract
Low arterial oxygen is a common complication in anesthetized horses and placing the animal in reverse Trendelenburg (RT) position may treat hypoxemia. The objective of this study was to assess the arterial partial pressure of oxygen (PaO2) in horses placed in a 5-degree RT compared to horizontal (H) position. Client-owned healthy horses (n = 60) undergoing elective surgeries were enrolled in a randomized controlled clinical study. Horses were sedated with butorphanol, an α2-adrenoceptor agonist, ± acepromazine and induced with ketamine combined with a benzodiazepine, propofol, or guaifenesin. Anesthesia was maintained with isoflurane in oxygen with mechanical ventilation. Each group (RT and H) included 30 horses, 10 in each recumbency (dorsal, right and left lateral). Arterial blood gas analyses (aBG) were performed following arterial catheter placement then hourly. Time first-to-last aBG, changes in PaO2, dynamic compliance (Cdyn), estimated pulmonary shunt fraction (F-shunt), and alveolar dead space to tidal volume ratio (VD/VT) were evaluated with a 2-way analysis of variance. Statistical significance was set at p < .05. Overall, PaO2 increased in all groups; however no significant difference was found between recumbencies (dorsal, right and left lateral) and RT versus H in changes over time for PaO2 (p = .064 and p = .070, respectively), Cdyn (p = .721 and p = .672, respectively), F-shunt (p = .055 and p = .054, respectively), or VD/VT (p = .616 and p = .064, respectively). In healthy anesthetized horses, 5-degree RT did not affect changes in PaO2 as compared to H position.
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Affiliation(s)
- H Nicole Trenholme
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
| | - Jane E Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Rachel A Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Stephanie A Kleine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
| | - Erik H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
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La Rosa L, Schauvliege S. Transient radial paralysis occurring in a Belgian White Blue bull undergoing general anaesthesia for claw amputation. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lavinia La Rosa
- Large Animal Department of Surgery and AnaestesiologyGhent UniversityMerelbekeBelgium
| | - Stijn Schauvliege
- Large Animal Department of Surgery and AnaestesiologyGhent UniversityMerelbekeBelgium
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Boustead KJ, Steyl J, Joubert K. Fatal post‐anaesthetic pulmonary haemorrhage in a horse suffering from chronic‐active exercise‐induced pulmonary haemorrhage. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- K. J. Boustead
- Companion Animal Clinical Studies Faculty of Veterinary Sciences University of Pretoria Pretoria South Africa
- Anaesthesia and Critical Care Service Valley Farm Animal Hospital Pretoria South Africa
| | - J. Steyl
- Paraclinical Sciences Section of Pathology Faculty of Veterinary Sciences University of Pretoria Pretoria South Africa
| | - K. Joubert
- Companion Animal Clinical Studies Faculty of Veterinary Sciences University of Pretoria Pretoria South Africa
- Veterinary Anaesthesia Analgesia and Critical Care Service Johannesburg South Africa
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Ranninger E, Bettschart‐Wolfensberger R. Polymorphic tachycardia in an anaesthetised horse with an undiagnosed pheochromocytoma undergoing emergency coeliotomy. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Elisabeth Ranninger
- Department of Clinical Diagnostics and ServicesSection of AnaesthesiologyVetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Regula Bettschart‐Wolfensberger
- Department of Clinical Diagnostics and ServicesSection of AnaesthesiologyVetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Season's Effects on Some Clinical, Hematological Parameters and Blood Cortisol Level in Sedated Arabian Horses With Xylazine. J Equine Vet Sci 2019; 84:102835. [PMID: 31864466 DOI: 10.1016/j.jevs.2019.102835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/26/2019] [Accepted: 11/05/2019] [Indexed: 11/23/2022]
Abstract
Influence of heat or cold stress in sedated animals is unclear and requires further investigations. The present study aimed to evaluate the season's effects on some clinical, hematological parameters and blood cortisol level in sedated Arabian horses with xylazine. Therefore, seven Arabian horses were used to investigate heart and respiratory rates, and capillary refill time and serum cortisol level were recorded before (0) and at 5, 15, 60, and 180 minutes postsedation. Heparinized venous samples were collected before (0) and 3 hours postsedation for analysis of hematological analysis. Arterial blood samples were collected before and 1 hour postsedation for arterial blood gases and electrolytes analysis. Repeated analysis of variance was performed (P < .05). Significant decreases have been observed in heart and respiratory rates at 5, 15, and 60 minutes postsedation in summer and only at 5 minutes postsedation in winter. Arterial oxygen pressure and arterial carbon dioxide pressure showed a significant decrease and increase, respectively at 1 hour postsedation in summer and winter. The serum cortisol levels were significantly higher in summer than in winter at 5, 15, and 60 minutes postsedation. In summer, the postsedation concentrations of cortisol did not change significantly than its values before sedation. However, in winter, the cortisol concentration decreased significantly at 5, 15, and 60 minutes postsedation compared with their value before sedation. The present study suggests that these season's effects on the sedated Arabian horses could take into consideration in xylazine-sedated Arabian horses.
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Wiklund M, Kellgren M, Wulcan S, Grubb T, Nyman G. Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery. Equine Vet J 2019; 52:76-82. [PMID: 31009091 DOI: 10.1111/evj.13129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 04/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Administration of pulsed inhaled nitric oxide (PiNO) improves arterial oxygenation in spontaneously breathing anaesthetised healthy horses and in horses undergoing colic surgery. However, because hypoventilation commonly occurs, horses are often mechanically ventilated to prevent hypercarbia. OBJECTIVES To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. STUDY DESIGN Prospective nonblinded clinical trial. METHODS Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing colic surgery (Group C) in dorsal recumbency were included in the study. Every second horse in each group received PiNO (A-INO, C-INO), the others served as controls (A-CN, C-CN). All horses were mechanically ventilated and anaesthesia was maintained with isoflurane. PiNO was mechanically delivered at the proximal end of the endotracheal tube as a pulse during the first part of each inspiration. Data were collected at the start (baseline, before PiNO) and at the end of inhalation anaesthesia. The Tukey method was used to compare baseline and end values for each parameter. RESULTS Arterial oxygen tension (PaO2 ) increased from (median [IQR]) 13.6 (9.3, 30.1) at baseline to 24.2 (18.6, 37.0) kPa at the end of anaesthesia in A-INO (P = 0.005) and from 7.7 (6.4, 8.5) to 15.5 (9.9, 26.9) kPa in C-INO (P = 0.007). Mean (95% CI) difference in F-shunt between baseline and end were -6 (-10; -1) and -11 (-22; -1) % in A-INO (P = 0.005) and C-INO (P = 0.04) respectively. There was no change in PaO2 or F-shunt from baseline to end of anaesthesia in A-CN or C-CN. MAIN LIMITATIONS Cardiac output was not measured, thus O2 delivery could not be calculated. CONCLUSIONS The combination of mechanical ventilation and PiNO improved pulmonary gas exchange during anaesthesia by a simultaneous decrease in F-shunt and improved alveolar ventilation.
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Affiliation(s)
- M Wiklund
- Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - M Kellgren
- Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S Wulcan
- Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - T Grubb
- Washington State University's College of Veterinary Medicine, Pullman, Washington, USA
| | - G Nyman
- Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Total intravenous anesthesia with alfaxalone, dexmedetomidine and remifentanil in healthy foals undergoing abdominal surgery. Vet Anaesth Analg 2019; 46:315-324. [DOI: 10.1016/j.vaa.2019.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 11/18/2022]
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Tayari H, Cuypers C, Schäffler L, Proost K, Schauvliege S. Fatal cardiac arrest in a calf with uroperitoneum. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Charlotte Cuypers
- Department of Surgery and Anaesthesia of Domestic AnimalsUniversiteit Gent Faculteit DiergeneeskundeMerelbekeBelgium
| | - Lisa Schäffler
- Department of Large Animal Internal MedicineUniversiteit Gent Faculteit DiergeneeskundeMerelbekeBelgium
| | - Kirsten Proost
- Department of Surgery and AnaesthesiologyGhent UniversityMerelbekeBelgium
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Le Corre S, Thomas-Cancian A, Peyrecave X, Leblond A, Cadoré JL. Cor pulmonale secondary to pulmonary fibrosis in a 16-year-old mare. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S. Le Corre
- Equine Department; VetAgroSup; Veterinary School of Lyon; Université de Lyon; Marcy l'Etoile France
| | - A. Thomas-Cancian
- Equine Department; VetAgroSup; Veterinary School of Lyon; Université de Lyon; Marcy l'Etoile France
| | - X. Peyrecave
- Equine Department; VetAgroSup; Veterinary School of Lyon; Université de Lyon; Marcy l'Etoile France
| | - A. Leblond
- Equine Department; VetAgroSup; Veterinary School of Lyon; Université de Lyon; Marcy l'Etoile France
| | - J. L. Cadoré
- Equine Department; VetAgroSup; Veterinary School of Lyon; Université de Lyon; Marcy l'Etoile France
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38
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Kropf J, Hughes JML. Severe intraoperative hypoxaemia in a horse due to failure of an oxygen concentrator and auxiliary oxygen supply. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Josephine Kropf
- Department of AnaesthesiaUniversity of Glasgow School of Veterinary MedicineGlasgowUK
| | - J. M. Lynne Hughes
- Department of AnaesthesiaUniversity College Dublin College of Agriculture Food Science and Veterinary MedicineDublinIreland
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Dupont J, Serteyn D, Sandersen C. Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse. Front Vet Sci 2018; 5:235. [PMID: 30327770 PMCID: PMC6174201 DOI: 10.3389/fvets.2018.00235] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/10/2018] [Indexed: 01/26/2023] Open
Abstract
Horses are susceptible to developing large areas of pulmonary atelectasis during recumbency and anesthesia. The subsequent pulmonary shunt is responsible for significant impairment of oxygenation. Since ventilation perfusion mismatch persists into the post-operative period, hypoxemia remains an important concern in the recovery stall. This case report describes the diagnosis and supportive therapy of persistent hypoxemia in a 914 kg draft horse after isoflurane anesthesia. It highlights how challenging it can be to deal with hypoxemia after disconnection from the anesthesia machine and how life-threatening it can become if refractory to treatment. Furthermore, it stresses the point on the interactions between hypoxemia and other factors, such as residual drug effects and hypothermia, that should also be considered in the case of delayed recovery from general anesthesia.
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Affiliation(s)
- Julien Dupont
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Didier Serteyn
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Charlotte Sandersen
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
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40
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Hopster K, Duffee LR, Hopster-Iversen CCS, Driessen B. Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture. Am J Vet Res 2018; 79:1021-1027. [DOI: 10.2460/ajvr.79.10.1021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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41
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Sage AM, Keating SC, Lascola KM, Schaeffer DJ, Clark-Price SC. Cardiopulmonary effects and recovery characteristics of horses anesthetized with xylazine-ketamine with midazolam or propofol. Vet Anaesth Analg 2018; 45:772-781. [PMID: 30262441 DOI: 10.1016/j.vaa.2018.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate cardiopulmonary and recovery characteristics of horses administered total intravenous anesthesia (TIVA) with xylazine and ketamine combined with midazolam or propofol. STUDY DESIGN Randomized crossover study. ANIMALS A group of eight adult horses, aged 7-22 years, weighing 493-740 kg. METHODS Horses were administered xylazine (1 mg kg-1) intravenously (IV), and anesthesia was induced with ketamine (2.2 mg kg-1) IV. Anesthesia was maintained for 45 minutes via IV infusion of xylazine (0.016 mg kg-1 minute-1) and ketamine (0.03 mg kg-1 minute-1) combined with midazolam at 0.002 mg kg-1 minute-1 (MKX), propofol at 0.05 mg kg-1 minute-1 (PKXlow) or propofol at 0.1 mg kg-1 minute-1 (PKXhigh). Additional ketamine was administered if a horse moved spontaneously. Cardiopulmonary variables, blood gases, lactate concentration, packed cell volume and total solids were recorded before sedation (baseline), at 10, 20, 30 and 45 minutes during TIVA and 10 minutes after standing. Recovery variables and quantitative recovery scores were compared. Significance was set at p < 0.05. RESULTS Additional ketamine was required for 50% of MKX horses. Systolic arterial pressure was elevated in MKX at 20 minutes compared with baseline (p = 0.043), at 10 and 20 minutes compared with PKXhigh (p = 0.007, p = 0.024) and at 20 and 30 minutes compared with PKXlow (p = 0.009, p = 0.02). MKX horses (5/8) were hypertensive compared with PKXlow (1/8; p = 0.017). All horses became hypoxemic (PaO2 ≤80 mmHg; 10.7 kPa) during TIVA. Recovery variables did not differ among treatments. CONCLUSIONS AND CLINICAL RELEVANCE PKXlow and PKXhigh had similar cardiopulmonary and recovery performance compared with MKX. PKX combinations provided superior quality of anesthesia to that of MKX. A combination of propofol, ketamine and xylazine administered as TIVA can be used in horses to provide anesthesia for short procedures. Supplemental oxygen is recommended.
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Affiliation(s)
- Adrianna M Sage
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Stephanie Cj Keating
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - Kara M Lascola
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - David J Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Stuart C Clark-Price
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
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Mosing M, Senior JM. Maintenance of equine anaesthesia over the last 50 years: Controlled inhalation of volatile anaesthetics and pulmonary ventilation. Equine Vet J 2018; 50:282-291. [DOI: 10.1111/evj.12793] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/24/2017] [Indexed: 01/06/2023]
Affiliation(s)
- M. Mosing
- Murdoch University School of Veterinary and Life Sciences; Murdoch Western Australia Australia
| | - J. M. Senior
- Department of Equine Clinical Science; Institute of Veterinary Science; University of Liverpool; Neston Cheshire UK
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EVALUATION OF BLOOD GAS VALUES IN ANESTHETIZED SOUTHERN WHITE RHINOCEROS ( CERATOTHERIUM SIMUM) VENTILATED WITH A NOVEL DEMAND VENTILATOR IN A ZOOLOGICAL PARK SETTING. J Zoo Wildl Med 2018; 48:1016-1025. [PMID: 29297798 DOI: 10.1638/2017-0048r1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Rhinoceros conservation efforts are essential to the survival of the species. One such effort is focused on using advanced reproductive technologies to produce viable northern white rhinoceros ( Ceratotherium simum cottoni) embryos for implantation into southern white rhinoceros ( Ceratotherium simum simum) surrogates. Anesthesia may be required to facilitate necessary procedures in these surrogate rhinoceros, but commonly reported side effects including hypercapnia and hypoxemia limit anesthetic recumbency time due to animal safety concerns. Although many interventions have been attempted, success in improving these physiologic parameters to date is mixed. The objective of this report is to describe arterial pH (pHa), blood gas (PaO2 and PaCO2), bicarbonate, base excess, lactate, and cardiovascular (heart rate, direct arterial blood pressure) values recorded in seven intubated and ventilated female southern white rhinoceros anesthetized for reproductive examinations in a zoological park setting. Anesthetic induction was accomplished using etorphine, medetomidine, butorphanol, and midazolam. The primary hypotheses were that PaO2 and PaCO2 would improve after intubation and mechanical ventilation. Induction and recovery observations were also summarized. Physiologic and laboratory data were analyzed using a mixed linear regression model using ranks. Statistical significance was set at P < 0.05. The PaO2 increased significantly ( P < 0.001) following ventilation from a median value of 58 (range, 38-67) to 123 (range, 42-184) mm Hg. The PaCO2 significantly ( P = 0.003) decreased from 63 (range, 55-73) to 52 (range, 30-75) mm Hg, with a corresponding improvement ( P = 0.068) in pHa from 7.33 (7.25-7.34) to 7.37 (7.24-7.58) units. Intubation and ventilation improve respiratory parameters and may facilitate safe prolongation of anesthetic duration in white rhinoceros.
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Santangelo B, Robin A, Simpson K, Potier J, Guichardant M, Portier K. The Modification and Performance of a Large Animal Anesthesia Machine (Tafonius ®) in Order to Deliver Xenon to a Horse. Front Vet Sci 2017; 4:162. [PMID: 29034250 PMCID: PMC5626812 DOI: 10.3389/fvets.2017.00162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/15/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction Xenon, due to its interesting anesthetic properties, could improve the quality of anesthesia protocols in horses despite its high price. This study aimed to modify and test an anesthesia machine capable of delivering xenon to a horse. Materials and methods An equine anesthesia machine (Tafonius, Vetronic Services Ltd., UK) was modified by including a T-connector in the valve block to introduce xenon, so that the xenon was pushed into the machine cylinder by the expired gases. A xenon analyzer was connected to the expiratory limb of the patient circuit. The operation of the machine was modeled and experimentally tested for denitrogenation, wash-in, and maintenance phases. The system was considered to consist of two compartments, one being the horse’s lungs, the other being the machine cylinder and circuit. A 15-year-old, 514-kg, healthy gelding horse was anesthetized for 70 min using acepromazine, romifidine, morphine, diazepam, and ketamine. Anesthesia was maintained with xenon and oxygen, co-administered with lidocaine. Ventilation was controlled. Cardiorespiratory variables, expired fraction of xenon (FeXe), blood gases were measured and xenon was detected in plasma. Recovery was unassisted and recorded. Results FeXe remained around 65%, using a xenon total volume of 250 L. Five additional boli of ketamine were required to maintain anesthesia. PaO2 was 45 ± 1 mmHg. The recovery was calm. Xenon was detected in blood during the entire administration time. Conclusion This pilot study describes how to deliver xenon to a horse. Although many technical problems were encountered, their correction could guide future endeavors to study the use of xenon in horses.
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Affiliation(s)
- Bruna Santangelo
- Section of Anesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Astrid Robin
- Section of Anesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | | | - Julie Potier
- Section of Anesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Michel Guichardant
- GREAT, Laboratoire Carmen, INSERM U1060, INRA U1235, INSA Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Karine Portier
- Section of Anesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France.,GREAT, Laboratoire Carmen, INSERM U1060, INRA U1235, INSA Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
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