Mechanical ventilation in horses is a medical procedure used to assist or replace spontaneous breathing in equine patients experiencing respiratory failure or undergoing anesthesia. This technique involves the use of a mechanical ventilator to deliver controlled breaths to the horse's lungs, ensuring adequate oxygenation and carbon dioxide removal. Mechanical ventilation can be utilized in various clinical scenarios, including surgical procedures that require general anesthesia, severe respiratory distress, or conditions that impair normal breathing. This page compiles peer-reviewed research studies and scholarly articles that explore the application, methodologies, and physiological effects of mechanical ventilation in equine medicine.
Fisher K, Dodam J, Bailey J, Thombs L, Hodgson D, Bukoski A.To compare PaO2 and PaCO2 in horses recovering from general anesthesia maintained with either apneustic anesthesia ventilation (AAV) or conventional mechanical ventilation (CMV). Methods: Randomized, crossover design. Methods: 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 kP...
Hopster K, Hurcombe SD, Simpson K, VanderBroek AR, Driessen B.Mechanical ventilation is usually achieved by active lung inflation during inspiration and passive lung emptying during expiration. By contrast, flow-controlled expiration (FLEX) ventilation actively reduces the rate of lung emptying by causing linear gas flow throughout the expiratory phase. Our aim was to evaluate the effects of FLEX on lung compliance and gas exchange in anesthetized horses in dorsal recumbency. Methods: 8 healthy horses. Methods: All animals were anesthetized twice and either ventilated beginning with FLEX or conventional volume-controlled ventilation in a randomized, cros...
Scardia A, Mariani Pimenta EL, Ross Russell RI, Jones GJ, Staffieri F.The aim of this study was to evaluate the validity of the SpO/FiO diagram in estimating gas exchange in horses under general anaesthesia. In this prospective, controlled clinical study were included 10 horses under general anaesthesia. FiO was progressively reduced with the following steps: 0.6, 0.4, 0.3 and 0.21; SpO was recorded at each step. An arterial blood sample was collected at the steps of 1.0 and 0.21, to calculate intrapulmonary shunt with the Fshunt formula. The Fshunt value calculated at 0.21 FiO was defined as "Fshunt 0.21", the one calculated at 1.0 FiO as "Fshunt 1.0". The FiO ...
Auckburally A, Nyman G, Wiklund MK, Straube AK, Perchiazzi G, Beda A, Ley CJ, Lord PF.To develop a method based on CT angiography and the maximum slope model (MSM) to measure regional lung perfusion in anesthetized ponies. Methods: 6 ponies. Methods: Anesthetized ponies were positioned in dorsal recumbency in the CT gantry. Contrast was injected, and the lungs were imaged while ponies were breathing spontaneously and while they were mechanically ventilated. Two observers delineated regions of interest in aerated and atelectatic lung, and perfusion in those regions was calculated with the MSM. Measurements obtained with a computerized method were compared with manual measurement...
Calero Rodriguez A, de Grauw JC, van Loon JPAM.To determine the effect of fraction of inspired oxygen (FiO) on intrapulmonary shunt fraction as measured by F-shunt in ponies during isoflurane anaesthesia. Methods: Prospective, randomized clinical study. Methods: 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) and either morphine (0.1 mg kg) or butorphanol (0.02 mg kg). Anaesthesia was induced with ketamine (2.2 mg kg) and midazolam (0.07 mg kg) administered IV. Ponies were randomly allocated to maintenance of anaesthesia w...
Trenholme HN, Barletta M, Quandt JE, Reed RA, Kleine SA, Hofmeister EH.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 (PaO) 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 α-adrenoceptor agonist, ± acepromazine and induced with ketamine combined with a benzodiazepine, propofol, or guaifenesin...
Wiklund M, Kellgren M, Wulcan S, Grubb T, Nyman G.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. Objective: To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. Methods: Prospective nonblinded clinical trial. Methods: Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing coli...
Jones T, Bracamonte JL, Ambros B, Duke-Novakovski T.To evaluate effects of anesthesia induced with alfaxalone and maintained with alfaxalone, dexmedetomidine and remifentanil infusions in foals. Methods: Prospective, experimental study. Methods: A group of six healthy foals [median (range) 11 (8-33) days] undergoing abdominal surgery. Methods: Intravenous (IV) dexmedetomidine (3-7μgkg) provided sedation for insertion of a pulmonary artery catheter. IV anesthesia was induced with alfaxalone (2mgkg) and maintained with alfaxalone (6mgkghour), dexmedetomidine (1μgkghour) and remifentanil (3μgkghour). Foals were endotracheally intubated and lung...
Hopster K, D￮ LR, Hopster-Iversen CCS, Driessen B.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 [Fio] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm HO in steps of 5 cm HO every 5 minutes, followed by incremental s...
Sacks M, Ringer SK, Bischofberger AS, Berchtold SM, Bettschart-Wolfensberger R.To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. Methods: Prospective, blinded, randomized clinical study. Methods: Sixty healthy adult warm blood horses undergoing elective surgery. Methods: Thirty horses each were sedated with dexmedetomidine 3.5 μg kg (group DEX) or medetomidine 7 μg kg (group MED) intravenously. After assessing and supplementing sedation if necessary, anaesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and ...
Wright BD, Hildebrand SV.To compare arterial oxygen and carbon dioxide tensions in apneic and spontaneously ventilating horses recovering from anesthesia. Methods: Randomized clinical trial. Methods: Forty-two healthy horses averaging 466 ± 106 kg and 6 ± 5 years of age. Methods: Anesthetized horses undergoing a variety of surgical procedures and receiving positive pressure ventilation (IPPV) were divided into two equal groups. One group was allowed to return to spontaneous ventilation prior to disconnection from the anesthetic circuit (weaned). The other group remained apneic during transport to a recovery stall. A...
Estell KE, Young A, Kozikowski T, Swain EA, Byrne BA, Reilly CM, Kass PH, Aleman M.Klebsiella spp. are implicated as a common cause of bacterial pneumonia in horses, but few reports describe clinical presentation and disease progression. Objective: To describe the signalment, clinicopathologic data, radiographic and ultrasonographic findings, antimicrobial susceptibility, outcome, and pathologic lesions associated with Klebsiella spp. pneumonia in horses. Methods: Forty-six horses from which Klebsiella spp. was isolated from the lower respiratory tract. Methods: Retrospective study. Medical records from 1993 to 2013 at the William R. Pritchard Veterinary Medical Teaching Hos...
Taylor SD, Toth B, Townsend WM, Bentley RT.To describe the clinical course, management, and outcome of a horse with a presumptive diagnosis of botulism treated with long-term mechanical ventilation. Methods: A 6-year-old Quarter Horse gelding with a history of esophageal obstruction was evaluated for progressive tetraparesis. Generalized and progressive skeletal muscle weakness characterized by recumbency, decreased tongue, tail, eyelid, and anal tone, and respiratory failure was observed. Anticholinergic signs including decreased salivation, xerophthalmia, and ileus were also noted. A presumptive diagnosis of botulism was made, althou...
Gregson R, Clutton RE.A 7-year-old gelded Irish sports horse weighing 650 kg was anesthetized on 2 consecutive days for lavage of a septic right radio-carpal joint. On both occasions the endotracheal tube connector, which had been bound in medical tape to produce an airtight seal, functioned as a unidirectional valve during mechanical ventilation, retarding expiration, imposing positive end expiratory pressure (PEEP), and probably continuous positive airway pressure (CPAP). The equipment dysfunction was not identified on either occasion despite close inspection prompted by progressive increases in airway pressure a...
Crumley MN, Hodgson DS, Kreider SE.To measure the effects of tidal volume, ventilatory frequency, and oxygen insufflation flow on the fraction of inspired oxygen in cadaveric horse heads attached to a lung model. Methods: 8 heads of equine cadavers. Methods: Each cadaveric horse head was intubated with a nasotracheal tube that extended into the proximal portion of the trachea. Oxygen was delivered through an oxygen catheter contained within and extending to the tip of the nasotracheal tube. The trachea was connected to the lung model by use of a spiral-wound hose with a sampling adaptor. Eight treatment combinations involving 2...
Franci P, Bertamini A, Bertamini O, Pilla T, Busetto R.A new volatile anaesthetic agent delivery system was tested in 15 horses undergoing scheduled surgical procedures. The delivery system consisted of a laptop computer (with dedicated software), a computer-controlled syringe driver (loaded with liquid isoflurane) connected to the inspiratory arm of a large-animal circle breathing system and a respiratory gas monitor, providing isoflurane end-tidal concentrations (ET(measured)) every 20 s to the computer. Following induction and connection to the breathing system, mechanical ventilation was started. The bodyweight (BW), fresh gas flow, breathing ...
Wagner AE, Mama KR, Steffey EP, Ferreira TH, Rezende ML.To compare cardiovascular effects of sevoflurane alone and sevoflurane plus an IV infusion of lidocaine in horses. Animals-8 adult horses. Methods: Each horse was anesthetized twice via IV administration of xylazine, diazepam, and ketamine. During 1 anesthetic episode, anesthesia was maintained by administration of sevoflurane in oxygen at 1.0 and 1.5 times the minimum alveolar concentration (MAC). During the other episode, anesthesia was maintained at the same MAC multiples via a reduced concentration of sevoflurane plus an IV infusion of lidocaine. Heart rate, arterial blood pressures, blood...
Clark L, Clutton RE, Blissitt KJ, Chase-Topping ME.To study the effects of morphine on haemodynamic variables, blood gas values and the requirement for additional anaesthetic drugs in horses undergoing surgery. Methods: Prospective randomized study. Methods: Thirty-eight client-owned horses, ASA(American Society of Anesthesiologists) category I or II, undergoing elective surgical procedures, were studied. Horses were divided between two groups, and were paired according to operation, anaesthetist, body position during surgery, mass and breed. Group M+ received morphine by intravenous (IV) injection (0.15 mg kg(-1)) before induction of anaesthe...
Wilkins PA, Palmer JE."Shaker foal" disease, toxicoinfectious botulism of foals, was 1st described as a clinical entity in 1967. The reported mortality rate was 90%, with death occurring within 24-72 hours of the onset of the characteristic clinical signs. The mortality rate decreased when equine-origin botulism antitoxin became available; however, a certain percentage of foals continued to die of respiratory failure. Mechanical ventilation is an important part of the treatment of infant botulism and is essential to the survival of many affected infants. We report a retrospective study of 9 foals with toxicoinfecti...
Wilson DV.Heavily pregnant mares requiring anesthesia present special problems and challenges. The use of short-acting anesthetic agents, combined with inhalational anesthesia, mechanical ventilation, and blood pressure support, will ensure an optimal outcome by maintaining both maternal and fetal homeostasis. The provision of oxygen during recovery to the still gravid mare also is important for fetal survival.
Palmer JE.Many sick neonatal foals have respiratory failure secondary to perinatal hypoxia, sepsis, or pneumonia. These foals require ventilatory support to prevent respiratory embarrassment and other complications associated with chronic hypoxia and hypercapnia. This article discusses practical aspects of ventilatory therapy, such as choosing a candidate for mechanical ventilation, choosing the proper ventilatory mode, placing a foal on a ventilator, maintaining a foal on mechanical ventilation, and weaning from mechanical ventilation. This article details some of the techniques that have been develope...
Matthews NS, Hartsfield SM, Sanders EA, Light GS, Slater MS.All 43 horses anaesthetised for colic surgery were premedicated with xylazine or diazepam. Anaesthesia was induced with guaifenesin and ketamine, horses were placed in dorsal recumbency and anaesthesia was maintained with isoflurane in oxygen and mechanical ventilation. Haemoglobin saturation readings (SpO2) were taken with a pulse oximeter and compared with computed haemoglobin saturation (SaO2) from arterial blood samples. Readings were taken over a range of SaO2 of 78-100%, mean arterial blood pressure ranged from 24 to 108 mmHg and PaO2 ranged from 53 to 490 mmHg. Analysis of 107 readings ...
Kähn W, Palmer J, Vaala W.Various techniques for support and control of respiration in neonatal foals are described. It is crucial to evaluate respiration through frequent arterial blood gas analysis. Details for blood sampling from the metatarsal arteries and interpretation of results are provided. Typical diseases in newborn foals, which cause hypoxemia and/or hypercapnia and can be indications for respiratory support are apnea, hypopnea, pulmonary atelectasis, surfactant deficiency, meconium-, fetal fluid- and milk aspiration, maladjustment syndrome, cardiovascular abnormalities, anemia, airway obstruction, compromi...
Hildebrand S.In summary, neuromuscular blocking agents can be used safely and to advantage in equine anesthesia. Muscle-relaxant use in equine anesthesia has been helped by the development of new relaxants such as atracurium, which has a reliable and reproducible duration of action. There are certain cases that benefit particularly by the use of relaxants but their use is not limited to these cases. These cases involve horses that experience persistent movement and hypotension during anesthesia, are undergoing ophthalmic or abdominal surgery or fracture repair, or are severely ill. Horses receiving muscle ...
Nyman G, Hedenstierna G.Ventilation-perfusion relationships were studied by the multiple inert gas elimination technique in seven horses while they were conscious and during inhalation anaesthesia with halothane. A generally good match between ventilation and perfusion was found in the conscious, standing horse. During anaesthesia a huge shunt developed, ie perfusion of completely unventilated lung regions, both in dorsal and left lateral recumbency and whether the horse was breathing spontaneously or mechanically ventilated. The shunt was significantly greater and the arterial oxygen tension (PaO2) significantly low...
Dudan F, Hirni H.Since 1980 techniques specifically designed to treat human neonatal diseases have also started to be applied to ill or premature equine newborns. These techniques will be described and their application to the most common equine neonatal disorders will be discussed. Such techniques include: post-natal cardiopulmonary resuscitation, exogenous thermal support, administration of broad spectrum antibiotics after diagnostic studies, supplemental oxygen therapy and mechanical ventilation, intravenous fluid and electrolyte therapy, blood component transfusion and total parenteral nutrition.
Lloyd KC, Kelly AB, Dunlop CI.A foal born 3 weeks prematurely was treated for respiratory distress, using a combination of oxygen therapy and mechanical ventilatory assistance. Clinical response and arterial blood gas tensions were monitored regularly. Continuous positive-airway pressure and intermittent positive-pressure ventilation administered via a nasotracheal tube were effective in improving arterial oxygenation and ventilatory function.
Benson GJ, Hartsfield SM, Smetzer DL, Thurmon JC.Succinylcholine chloride, administered to horses anesthetized with halothane in oxygen and mechanically ventilated, caused slight but significant (P less than 0.01) increases in heart rate. Significant alteration in mean arterial blood pressure did not occur, and there were clinically insignificant increases in serum K+ and C1- concentration. Cardiac dysrhythmia and myoglobinuria did not occur. Thus, effects of halothane anesthesia and mechanical ventilation prevented cardiac dysrhythmia and hypertension and greatly reduced the tachycardia generally associated with siccinylcholine administrati...
Weaver BM, Walley RV.Eleven out of 12 horses were underventilating while breathing spontaneously during halothane anaesthesia with high arterial carbon dioxide tensions. In addition, large alveolar to arterial oxygen tension gradients were found to be present. Mechanically, controlled ventilation with an intermittent positive pressure of 20-30 cm H2O reduced arterial carbon dioxide levels to normal. The alveolar to arterial oxygen gradients did not increase and in some cases decreased. These (A - a) Po2 gradients were due mainly to true shunt of the order of 30 per cent and not to ventilation perfusion inequality....
Nyman G, Hedenstierna G.Ventilation-perfusion relationships were studied by the multiple inert gas elimination technique in seven horses while they were conscious and during inhalation anaesthesia with halothane. A generally good match between ventilation and perfusion was found in the conscious, standing horse. During anaesthesia a huge shunt developed, ie perfusion of completely unventilated lung regions, both in dorsal and left lateral recumbency and whether the horse was breathing spontaneously or mechanically ventilated. The shunt was significantly greater and the arterial oxygen tension (PaO2) significantly low...
Estell KE, Young A, Kozikowski T, Swain EA, Byrne BA, Reilly CM, Kass PH, Aleman M.Klebsiella spp. are implicated as a common cause of bacterial pneumonia in horses, but few reports describe clinical presentation and disease progression. Objective: To describe the signalment, clinicopathologic data, radiographic and ultrasonographic findings, antimicrobial susceptibility, outcome, and pathologic lesions associated with Klebsiella spp. pneumonia in horses. Methods: Forty-six horses from which Klebsiella spp. was isolated from the lower respiratory tract. Methods: Retrospective study. Medical records from 1993 to 2013 at the William R. Pritchard Veterinary Medical Teaching Hos...
Sacks M, Ringer SK, Bischofberger AS, Berchtold SM, Bettschart-Wolfensberger R.To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. Methods: Prospective, blinded, randomized clinical study. Methods: Sixty healthy adult warm blood horses undergoing elective surgery. Methods: Thirty horses each were sedated with dexmedetomidine 3.5 μg kg (group DEX) or medetomidine 7 μg kg (group MED) intravenously. After assessing and supplementing sedation if necessary, anaesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and ...
Wagner AE, Mama KR, Steffey EP, Ferreira TH, Rezende ML.To compare cardiovascular effects of sevoflurane alone and sevoflurane plus an IV infusion of lidocaine in horses. Animals-8 adult horses. Methods: Each horse was anesthetized twice via IV administration of xylazine, diazepam, and ketamine. During 1 anesthetic episode, anesthesia was maintained by administration of sevoflurane in oxygen at 1.0 and 1.5 times the minimum alveolar concentration (MAC). During the other episode, anesthesia was maintained at the same MAC multiples via a reduced concentration of sevoflurane plus an IV infusion of lidocaine. Heart rate, arterial blood pressures, blood...
Clark L, Clutton RE, Blissitt KJ, Chase-Topping ME.To study the effects of morphine on haemodynamic variables, blood gas values and the requirement for additional anaesthetic drugs in horses undergoing surgery. Methods: Prospective randomized study. Methods: Thirty-eight client-owned horses, ASA(American Society of Anesthesiologists) category I or II, undergoing elective surgical procedures, were studied. Horses were divided between two groups, and were paired according to operation, anaesthetist, body position during surgery, mass and breed. Group M+ received morphine by intravenous (IV) injection (0.15 mg kg(-1)) before induction of anaesthe...
Wilkins PA, Palmer JE."Shaker foal" disease, toxicoinfectious botulism of foals, was 1st described as a clinical entity in 1967. The reported mortality rate was 90%, with death occurring within 24-72 hours of the onset of the characteristic clinical signs. The mortality rate decreased when equine-origin botulism antitoxin became available; however, a certain percentage of foals continued to die of respiratory failure. Mechanical ventilation is an important part of the treatment of infant botulism and is essential to the survival of many affected infants. We report a retrospective study of 9 foals with toxicoinfecti...
Hopster K, Hurcombe SD, Simpson K, VanderBroek AR, Driessen B.Mechanical ventilation is usually achieved by active lung inflation during inspiration and passive lung emptying during expiration. By contrast, flow-controlled expiration (FLEX) ventilation actively reduces the rate of lung emptying by causing linear gas flow throughout the expiratory phase. Our aim was to evaluate the effects of FLEX on lung compliance and gas exchange in anesthetized horses in dorsal recumbency. Methods: 8 healthy horses. Methods: All animals were anesthetized twice and either ventilated beginning with FLEX or conventional volume-controlled ventilation in a randomized, cros...
Hopster K, D￮ LR, Hopster-Iversen CCS, Driessen B.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 [Fio] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm HO in steps of 5 cm HO every 5 minutes, followed by incremental s...
Taylor SD, Toth B, Townsend WM, Bentley RT.To describe the clinical course, management, and outcome of a horse with a presumptive diagnosis of botulism treated with long-term mechanical ventilation. Methods: A 6-year-old Quarter Horse gelding with a history of esophageal obstruction was evaluated for progressive tetraparesis. Generalized and progressive skeletal muscle weakness characterized by recumbency, decreased tongue, tail, eyelid, and anal tone, and respiratory failure was observed. Anticholinergic signs including decreased salivation, xerophthalmia, and ileus were also noted. A presumptive diagnosis of botulism was made, althou...
Wright BD, Hildebrand SV.To compare arterial oxygen and carbon dioxide tensions in apneic and spontaneously ventilating horses recovering from anesthesia. Methods: Randomized clinical trial. Methods: Forty-two healthy horses averaging 466 ± 106 kg and 6 ± 5 years of age. Methods: Anesthetized horses undergoing a variety of surgical procedures and receiving positive pressure ventilation (IPPV) were divided into two equal groups. One group was allowed to return to spontaneous ventilation prior to disconnection from the anesthetic circuit (weaned). The other group remained apneic during transport to a recovery stall. A...
Weaver BM, Walley RV.Eleven out of 12 horses were underventilating while breathing spontaneously during halothane anaesthesia with high arterial carbon dioxide tensions. In addition, large alveolar to arterial oxygen tension gradients were found to be present. Mechanically, controlled ventilation with an intermittent positive pressure of 20-30 cm H2O reduced arterial carbon dioxide levels to normal. The alveolar to arterial oxygen gradients did not increase and in some cases decreased. These (A - a) Po2 gradients were due mainly to true shunt of the order of 30 per cent and not to ventilation perfusion inequality....
Benson GJ, Hartsfield SM, Smetzer DL, Thurmon JC.Succinylcholine chloride, administered to horses anesthetized with halothane in oxygen and mechanically ventilated, caused slight but significant (P less than 0.01) increases in heart rate. Significant alteration in mean arterial blood pressure did not occur, and there were clinically insignificant increases in serum K+ and C1- concentration. Cardiac dysrhythmia and myoglobinuria did not occur. Thus, effects of halothane anesthesia and mechanical ventilation prevented cardiac dysrhythmia and hypertension and greatly reduced the tachycardia generally associated with siccinylcholine administrati...
Wilson DV.Heavily pregnant mares requiring anesthesia present special problems and challenges. The use of short-acting anesthetic agents, combined with inhalational anesthesia, mechanical ventilation, and blood pressure support, will ensure an optimal outcome by maintaining both maternal and fetal homeostasis. The provision of oxygen during recovery to the still gravid mare also is important for fetal survival.
Matthews NS, Hartsfield SM, Sanders EA, Light GS, Slater MS.All 43 horses anaesthetised for colic surgery were premedicated with xylazine or diazepam. Anaesthesia was induced with guaifenesin and ketamine, horses were placed in dorsal recumbency and anaesthesia was maintained with isoflurane in oxygen and mechanical ventilation. Haemoglobin saturation readings (SpO2) were taken with a pulse oximeter and compared with computed haemoglobin saturation (SaO2) from arterial blood samples. Readings were taken over a range of SaO2 of 78-100%, mean arterial blood pressure ranged from 24 to 108 mmHg and PaO2 ranged from 53 to 490 mmHg. Analysis of 107 readings ...
Calero Rodriguez A, de Grauw JC, van Loon JPAM.To determine the effect of fraction of inspired oxygen (FiO) on intrapulmonary shunt fraction as measured by F-shunt in ponies during isoflurane anaesthesia. Methods: Prospective, randomized clinical study. Methods: 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) and either morphine (0.1 mg kg) or butorphanol (0.02 mg kg). Anaesthesia was induced with ketamine (2.2 mg kg) and midazolam (0.07 mg kg) administered IV. Ponies were randomly allocated to maintenance of anaesthesia w...
Wiklund M, Kellgren M, Wulcan S, Grubb T, Nyman G.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. Objective: To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. Methods: Prospective nonblinded clinical trial. Methods: Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing coli...
Trenholme HN, Barletta M, Quandt JE, Reed RA, Kleine SA, Hofmeister EH.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 (PaO) 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 α-adrenoceptor agonist, ± acepromazine and induced with ketamine combined with a benzodiazepine, propofol, or guaifenesin...
Jones T, Bracamonte JL, Ambros B, Duke-Novakovski T.To evaluate effects of anesthesia induced with alfaxalone and maintained with alfaxalone, dexmedetomidine and remifentanil infusions in foals. Methods: Prospective, experimental study. Methods: A group of six healthy foals [median (range) 11 (8-33) days] undergoing abdominal surgery. Methods: Intravenous (IV) dexmedetomidine (3-7μgkg) provided sedation for insertion of a pulmonary artery catheter. IV anesthesia was induced with alfaxalone (2mgkg) and maintained with alfaxalone (6mgkghour), dexmedetomidine (1μgkghour) and remifentanil (3μgkghour). Foals were endotracheally intubated and lung...
Lloyd KC, Kelly AB, Dunlop CI.A foal born 3 weeks prematurely was treated for respiratory distress, using a combination of oxygen therapy and mechanical ventilatory assistance. Clinical response and arterial blood gas tensions were monitored regularly. Continuous positive-airway pressure and intermittent positive-pressure ventilation administered via a nasotracheal tube were effective in improving arterial oxygenation and ventilatory function.
Hildebrand S.In summary, neuromuscular blocking agents can be used safely and to advantage in equine anesthesia. Muscle-relaxant use in equine anesthesia has been helped by the development of new relaxants such as atracurium, which has a reliable and reproducible duration of action. There are certain cases that benefit particularly by the use of relaxants but their use is not limited to these cases. These cases involve horses that experience persistent movement and hypotension during anesthesia, are undergoing ophthalmic or abdominal surgery or fracture repair, or are severely ill. Horses receiving muscle ...
Franci P, Bertamini A, Bertamini O, Pilla T, Busetto R.A new volatile anaesthetic agent delivery system was tested in 15 horses undergoing scheduled surgical procedures. The delivery system consisted of a laptop computer (with dedicated software), a computer-controlled syringe driver (loaded with liquid isoflurane) connected to the inspiratory arm of a large-animal circle breathing system and a respiratory gas monitor, providing isoflurane end-tidal concentrations (ET(measured)) every 20 s to the computer. Following induction and connection to the breathing system, mechanical ventilation was started. The bodyweight (BW), fresh gas flow, breathing ...
Scardia A, Mariani Pimenta EL, Ross Russell RI, Jones GJ, Staffieri F.The aim of this study was to evaluate the validity of the SpO/FiO diagram in estimating gas exchange in horses under general anaesthesia. In this prospective, controlled clinical study were included 10 horses under general anaesthesia. FiO was progressively reduced with the following steps: 0.6, 0.4, 0.3 and 0.21; SpO was recorded at each step. An arterial blood sample was collected at the steps of 1.0 and 0.21, to calculate intrapulmonary shunt with the Fshunt formula. The Fshunt value calculated at 0.21 FiO was defined as "Fshunt 0.21", the one calculated at 1.0 FiO as "Fshunt 1.0". The FiO ...
Dudan F, Hirni H.Since 1980 techniques specifically designed to treat human neonatal diseases have also started to be applied to ill or premature equine newborns. These techniques will be described and their application to the most common equine neonatal disorders will be discussed. Such techniques include: post-natal cardiopulmonary resuscitation, exogenous thermal support, administration of broad spectrum antibiotics after diagnostic studies, supplemental oxygen therapy and mechanical ventilation, intravenous fluid and electrolyte therapy, blood component transfusion and total parenteral nutrition.
Gregson R, Clutton RE.A 7-year-old gelded Irish sports horse weighing 650 kg was anesthetized on 2 consecutive days for lavage of a septic right radio-carpal joint. On both occasions the endotracheal tube connector, which had been bound in medical tape to produce an airtight seal, functioned as a unidirectional valve during mechanical ventilation, retarding expiration, imposing positive end expiratory pressure (PEEP), and probably continuous positive airway pressure (CPAP). The equipment dysfunction was not identified on either occasion despite close inspection prompted by progressive increases in airway pressure a...
Palmer JE.Many sick neonatal foals have respiratory failure secondary to perinatal hypoxia, sepsis, or pneumonia. These foals require ventilatory support to prevent respiratory embarrassment and other complications associated with chronic hypoxia and hypercapnia. This article discusses practical aspects of ventilatory therapy, such as choosing a candidate for mechanical ventilation, choosing the proper ventilatory mode, placing a foal on a ventilator, maintaining a foal on mechanical ventilation, and weaning from mechanical ventilation. This article details some of the techniques that have been develope...
Kähn W, Palmer J, Vaala W.Various techniques for support and control of respiration in neonatal foals are described. It is crucial to evaluate respiration through frequent arterial blood gas analysis. Details for blood sampling from the metatarsal arteries and interpretation of results are provided. Typical diseases in newborn foals, which cause hypoxemia and/or hypercapnia and can be indications for respiratory support are apnea, hypopnea, pulmonary atelectasis, surfactant deficiency, meconium-, fetal fluid- and milk aspiration, maladjustment syndrome, cardiovascular abnormalities, anemia, airway obstruction, compromi...
Auckburally A, Nyman G, Wiklund MK, Straube AK, Perchiazzi G, Beda A, Ley CJ, Lord PF.To develop a method based on CT angiography and the maximum slope model (MSM) to measure regional lung perfusion in anesthetized ponies. Methods: 6 ponies. Methods: Anesthetized ponies were positioned in dorsal recumbency in the CT gantry. Contrast was injected, and the lungs were imaged while ponies were breathing spontaneously and while they were mechanically ventilated. Two observers delineated regions of interest in aerated and atelectatic lung, and perfusion in those regions was calculated with the MSM. Measurements obtained with a computerized method were compared with manual measurement...
Crumley MN, Hodgson DS, Kreider SE.To measure the effects of tidal volume, ventilatory frequency, and oxygen insufflation flow on the fraction of inspired oxygen in cadaveric horse heads attached to a lung model. Methods: 8 heads of equine cadavers. Methods: Each cadaveric horse head was intubated with a nasotracheal tube that extended into the proximal portion of the trachea. Oxygen was delivered through an oxygen catheter contained within and extending to the tip of the nasotracheal tube. The trachea was connected to the lung model by use of a spiral-wound hose with a sampling adaptor. Eight treatment combinations involving 2...
Fisher K, Dodam J, Bailey J, Thombs L, Hodgson D, Bukoski A.To compare PaO2 and PaCO2 in horses recovering from general anesthesia maintained with either apneustic anesthesia ventilation (AAV) or conventional mechanical ventilation (CMV). Methods: Randomized, crossover design. Methods: 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 kP...
