Perfusion in horses refers to the process of delivering blood to the capillary bed in the biological tissue, ensuring adequate oxygen and nutrient supply to cells. It is a critical aspect of maintaining cellular function and overall health in equine physiology. Proper perfusion is necessary for tissue viability and function, and it can be influenced by various factors, including cardiovascular health, hydration status, and systemic conditions. In horses, perfusion is often assessed to evaluate circulatory efficiency and detect potential issues such as laminitis or colic. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, assessment techniques, and clinical implications of perfusion in equine medicine.
Saldinger LK, Kilcoyne I, Nieto J.To evaluate if a difference in synovial amikacin concentrations exists in the radiocarpal joint (RCJ) following different durations of instillation of an IV regional limb perfusion (IVRLP) perfusate. Methods: 7 healthy horses. Methods: Horses received 2 IVRLPs with 2 g amikacin diluted to 60 mL with 0.9% NaCl via the cephalic vein in a crossover study design with a wash-out period between procedures. Instillation of the perfusate was administered over a 1-minute (technique 1) and 5-minute (technique 5) period. Concentrations of amikacin within the RCJ were measured at time (T) 5, 10, 15, 20, 2...
Duysens J, Graide H, Niesten A, Mouithys-Mickalad A, Ceusters J, Serteyn D.The main causes of mortality in horses are the gastrointestinal pathologies associated with septic shock. Stem cells have shown, through systemic injection, a capacity to decrease inflammation and to regenerate injured tissue faster. Nevertheless, to achieve this rapid and total regeneration, systemic injections of 1 to 2 million cells per kilogram of body weight must be considered. Here, we demonstrate for the first time the feasibility and expansion capacity of equine muscle-derived mesenchymal stromal cells (mdMSCs) in a functionally closed, automated, perfusion-based, hollow-fiber bioreact...
Kieffer PJ, Williams JM, Shepard MK, Giguère S, Epstein KL.Horses undergoing abdominal exploratory surgery are at risk of hypotension and hypoperfusion. Normal mean arterial pressure is used as a surrogate for adequate tissue perfusion. However, measures of systemic circulation may not be reflective of microcirculation. This study measured the mean arterial pressure, cardiac index, lactate, and four microcirculatory indices in six healthy, anesthetized adult horses undergoing elective laparotomies. The microcirculatory parameters were measured at three different sites along the gastrointestinal tract (oral mucosa, colonic serosa, and rectal mucosa) wi...
Araos J, Driessen B, Brandly J, Gorenberg E, Heerdt P, Bruhn A, Martin-Flores M, Adler A, Hopster K.To investigate the mechanisms underlying the improved arterial oxygenation described with flow-limited expiration (FLEX) ventilation in anesthetized horses. Methods: 5 healthy adult research horses. Methods: Horses underwent volume-controlled ventilation for 60 minutes (VCV1), followed by 60 minutes of FLEX, and 30 minutes of VCV (VCV2). Main outcomes included the arterial partial pressure of oxygen-to-Fio2 (PF) ratio and electrical impedance tomography (EIT)-derived functional indices at the end of each phase. The EIT data were used to create regional maps of relative lung ventilation and per...
Valverde A, Cribb N, Arroyo L.Twelve adult horses were randomly assigned to 2 groups in a prospective experimental trial. A pneumatic tourniquet (425 mmHg) was placed, under sedation, proximal to the carpus on one randomly chosen thoracic limb. A cephalic vein catheter was placed distal to the tourniquet to establish an intravenous regional limb perfusion technique (IVRLP) with morphine (0.1 mg/kg) diluted with saline 0.9% to 0.1 mL/kg, and the tourniquet left in place for 30 minutes. Horses were euthanized at 1 h (Group I) or 6 h (Group II) following the IVRLP and synovial fluid from the radiocarpal, intercarpal, metacarp...
O'Brien M, Mochel JP, Kersh K, Wang C, Troy J.Pain management is critical to equine welfare with non-steroidal anti-inflammatory drugs (NSAID) commonly used in horses. However, systemic NSAID use is limited by harmful gastrointestinal and renal side effects. Intravenous regional limb perfusion (IVRLP) is a technique used in horses that produces high, local antibiotic concentrations while limiting systemic circulation. NSAID-IVRLP would be a novel method of local pain management while limiting systemic NSAID side effects. To date, NSAID-IVRLP administration has not been reported in horses. This study aimed to identify the pharmacokinetics ...
Garcia Filho SG, de Andrade FSRM, Dos Santos RST, Gonçalves LA, Pereira MAA, de Souza AF, Ambrósio AM, Fantoni DT.The objective of this study was to compare the hemodynamic effects of dobutamine and ephedrine during the management of anesthesia-related hypotension in healthy horses. Thirteen horses underwent general anesthesia with isoflurane and were randomly divided into two different groups, one of which received a dobutamine constant rate infusion (CRI) (1 µg/kg bwt/min) and the other received an ephedrine CRI (20 µg/kg bwt/min) when hypotension (<60 mmHg) was identified, following up to 15 min after the blood pressure reached 70 mmHg. All horses were equipped with a pulmonary artery catheter and a ...
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...
Blohm KO, Tichy A, Nell B.To determine efficacy of contrast-enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Methods: Ocular B-mode and contrast-enhanced ultrasonography were performed bilaterally in nine sedated university-owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different ...
Neudeck S, Kästner SBR, Wittenberg-Voges L, Rohn K, Hopster K.OBJECTIVE To determine global and peripheral perfusion and oxygenation during anesthesia with equipotent doses of desflurane and propofol combined with a constant rate infusion of dexmedetomidine in horses. ANIMALS 6 warmblood horses. PROCEDURES Horses were premedicated with dexmedetomidine (3.5 μg•kg, IV). Anesthesia was induced with propofol or ketamine and maintained with desflurane or propofol (complete crossover design) combined with a constant rate infusion of dexmedetomidine (7 μg•kg •h). Microperfusion and oxygenation of the rectal, oral, and esophageal mucosa were measured bef...
Hopster K, Wittenberg-Voges L, Geburek F, Hopster-Iversen C, Kästner SBR.Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia. During part A arterial oxygen saturation (SaO) was reduced by reducing inspiratory oxygen fraction in steps...
Wittenberg-Voges L, Kästner SB, Raekallio M, Vainio OM, Rohn K, Hopster K.To compare the effects of MK-467 during isoflurane anaesthesia combined with xylazine or dexmedetomidine on global and gastrointestinal perfusion parameters. Methods: Prospective, randomized experimental trial. Methods: A total of 15 warmblood horses. Methods: Horses were divided into two groups for administration of either dexmedetomidine (D) or xylazine (X) for premedication (D: 3.5 μg kg; X: 0.5 mg kg) and as constant rate infusion during isoflurane anaesthesia (D: 7 μg kg hour; X: 1 mg kg hour). During anaesthesia, heart rate, mean arterial blood pressure (MAP), systemic vascular resista...
Hopster K, Hopster-Iversen C, Geburek F, Rohn K, Kästner SB.The aim of this study was to assess the effect of duration of anaesthesia and concentration of isoflurane on global perfusion as well as intestinal microperfusion and oxygenation. Nine Warmblood horses were premedicated with xylazine; anaesthesia was induced with midazolam and ketamine, and maintained with isoflurane. Horses were ventilated to normocapnia. During 7 h of anaesthesia, mean arterial blood pressures (MAP), heart rate, central venous pressure, pulmonary artery pressure, expiratory isoflurane concentration (ETIso) and cardiac output using lithium dilution were measured; cardiac in...
Esteller-Vico A, Liu IK, Vaughan B, Steffey EP, Brosnan RJ.In the uterus of the mare, data obtained using transrectal Doppler ultrasonography indicate that uterine blood flow (UBF) is dynamic and changes throughout the estrous cycle. Degenerative lesions in the uterus are associated with subfertility and infertility. Among these lesions, vascular elastosis has been reported in aged, multiparous, and infertile mares. Angiosis of the uterine vasculature could potentially compromise UBF. The objectives of this experiment are to determine levels of UBF and perfusion of reproductively healthy mares and compare them to levels of subfertile/infertile mares a...
Vatistas NJ, Nieto JE, Van Hoogmoed L, Gardner I, Snyder JR.To evaluate the efficacy of an isolated perfusion circuit and the effect of ischemia-reperfusion on mucosal permeability of the jejunum. Methods: In vitro study of intestinal mucosal permeability. Methods: Twelve healthy adult horses. Methods: A control segment of jejunum was placed in an isolated perfusion circuit for 240 minutes and mucosal permeability was measured. After detecting no deleterious effects of the isolated system on the control intestine, low flow ischemia was created in experimental segments for 20, 40, 60 and 90 minutes followed by 60 minutes of reperfusion and mucosal perme...
Dyson S, Lakhani K, Wood J.It was hypothesised that exercise may promote perfusion of the distal part of the limbs and enhance uptake of radiopharmaceutical into bone, but bandaging and lameness would have no effect. Two hundred and two horses undergoing routine nuclear scintigraphic examination for assessment of lameness or poor performance between November 1998 and November 1999 were assigned randomly to one of 4 groups: no bandages and no exercise (NB/NE); bandages and no exercise (B/NE); no bandages and exercise (NB/E); bandages and exercise (B/E). In the bandage groups, the distal forelimbs were bandaged for at lea...
Hlastala MP, Bernard SL, Erickson HH, Fedde MR, Gaughan EM, McMurphy R, Emery MJ, Polissar N, Glenny RW.Recent studies using microspheres in dogs, pigs and goats have demonstrated considerable heterogeneity of pulmonary perfusion within isogravitational planes. These studies demonstrate a minimal role of gravity in determining pulmonary blood flow distribution. To test whether a gravitational gradient would be more apparent in an animal with large vertical lung height, we measured perfusion heterogeneity in horses (vertical lung height = approximately 55 cm). Four unanesthetized Thoroughbred geldings (422-500 kg) were studied awake in the standing position with fluorescent microspheres injected ...
Maier FP, Wintzer HJ.In this paper the measurement technique pulse oximetry is examined in 25 halothane-anaesthetized horses. Furthermore measures are presented which lead to a successful sensor placement at the tongue of the horse. The hemoglobin saturation determined by the pulse oximeter (SaO2) correlated very well with the hemoglobin saturation calculated by blood gas analysis (sO2). Nevertheless in the range of low saturation the pulse oximeter increasingly overestimates sO2. Pulse oximetry is an important progress in equine patient monitoring. A decline of oxygen saturation in the blood is detected immediate...
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...
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...
Hlastala MP, Bernard SL, Erickson HH, Fedde MR, Gaughan EM, McMurphy R, Emery MJ, Polissar N, Glenny RW.Recent studies using microspheres in dogs, pigs and goats have demonstrated considerable heterogeneity of pulmonary perfusion within isogravitational planes. These studies demonstrate a minimal role of gravity in determining pulmonary blood flow distribution. To test whether a gravitational gradient would be more apparent in an animal with large vertical lung height, we measured perfusion heterogeneity in horses (vertical lung height = approximately 55 cm). Four unanesthetized Thoroughbred geldings (422-500 kg) were studied awake in the standing position with fluorescent microspheres injected ...
Hopster K, Hopster-Iversen C, Geburek F, Rohn K, Kästner SB.The aim of this study was to assess the effect of duration of anaesthesia and concentration of isoflurane on global perfusion as well as intestinal microperfusion and oxygenation. Nine Warmblood horses were premedicated with xylazine; anaesthesia was induced with midazolam and ketamine, and maintained with isoflurane. Horses were ventilated to normocapnia. During 7 h of anaesthesia, mean arterial blood pressures (MAP), heart rate, central venous pressure, pulmonary artery pressure, expiratory isoflurane concentration (ETIso) and cardiac output using lithium dilution were measured; cardiac in...
Hopster K, Wittenberg-Voges L, Geburek F, Hopster-Iversen C, Kästner SBR.Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia. During part A arterial oxygen saturation (SaO) was reduced by reducing inspiratory oxygen fraction in steps...
Blohm KO, Tichy A, Nell B.To determine efficacy of contrast-enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Methods: Ocular B-mode and contrast-enhanced ultrasonography were performed bilaterally in nine sedated university-owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different ...
Vatistas NJ, Nieto JE, Van Hoogmoed L, Gardner I, Snyder JR.To evaluate the efficacy of an isolated perfusion circuit and the effect of ischemia-reperfusion on mucosal permeability of the jejunum. Methods: In vitro study of intestinal mucosal permeability. Methods: Twelve healthy adult horses. Methods: A control segment of jejunum was placed in an isolated perfusion circuit for 240 minutes and mucosal permeability was measured. After detecting no deleterious effects of the isolated system on the control intestine, low flow ischemia was created in experimental segments for 20, 40, 60 and 90 minutes followed by 60 minutes of reperfusion and mucosal perme...
Wittenberg-Voges L, Kästner SB, Raekallio M, Vainio OM, Rohn K, Hopster K.To compare the effects of MK-467 during isoflurane anaesthesia combined with xylazine or dexmedetomidine on global and gastrointestinal perfusion parameters. Methods: Prospective, randomized experimental trial. Methods: A total of 15 warmblood horses. Methods: Horses were divided into two groups for administration of either dexmedetomidine (D) or xylazine (X) for premedication (D: 3.5 μg kg; X: 0.5 mg kg) and as constant rate infusion during isoflurane anaesthesia (D: 7 μg kg hour; X: 1 mg kg hour). During anaesthesia, heart rate, mean arterial blood pressure (MAP), systemic vascular resista...
Esteller-Vico A, Liu IK, Vaughan B, Steffey EP, Brosnan RJ.In the uterus of the mare, data obtained using transrectal Doppler ultrasonography indicate that uterine blood flow (UBF) is dynamic and changes throughout the estrous cycle. Degenerative lesions in the uterus are associated with subfertility and infertility. Among these lesions, vascular elastosis has been reported in aged, multiparous, and infertile mares. Angiosis of the uterine vasculature could potentially compromise UBF. The objectives of this experiment are to determine levels of UBF and perfusion of reproductively healthy mares and compare them to levels of subfertile/infertile mares a...
Dyson S, Lakhani K, Wood J.It was hypothesised that exercise may promote perfusion of the distal part of the limbs and enhance uptake of radiopharmaceutical into bone, but bandaging and lameness would have no effect. Two hundred and two horses undergoing routine nuclear scintigraphic examination for assessment of lameness or poor performance between November 1998 and November 1999 were assigned randomly to one of 4 groups: no bandages and no exercise (NB/NE); bandages and no exercise (B/NE); no bandages and exercise (NB/E); bandages and exercise (B/E). In the bandage groups, the distal forelimbs were bandaged for at lea...
Neudeck S, Kästner SBR, Wittenberg-Voges L, Rohn K, Hopster K.OBJECTIVE To determine global and peripheral perfusion and oxygenation during anesthesia with equipotent doses of desflurane and propofol combined with a constant rate infusion of dexmedetomidine in horses. ANIMALS 6 warmblood horses. PROCEDURES Horses were premedicated with dexmedetomidine (3.5 μg•kg, IV). Anesthesia was induced with propofol or ketamine and maintained with desflurane or propofol (complete crossover design) combined with a constant rate infusion of dexmedetomidine (7 μg•kg •h). Microperfusion and oxygenation of the rectal, oral, and esophageal mucosa were measured bef...
Maier FP, Wintzer HJ.In this paper the measurement technique pulse oximetry is examined in 25 halothane-anaesthetized horses. Furthermore measures are presented which lead to a successful sensor placement at the tongue of the horse. The hemoglobin saturation determined by the pulse oximeter (SaO2) correlated very well with the hemoglobin saturation calculated by blood gas analysis (sO2). Nevertheless in the range of low saturation the pulse oximeter increasingly overestimates sO2. Pulse oximetry is an important progress in equine patient monitoring. A decline of oxygen saturation in the blood is detected immediate...
Garcia Filho SG, de Andrade FSRM, Dos Santos RST, Gonçalves LA, Pereira MAA, de Souza AF, Ambrósio AM, Fantoni DT.The objective of this study was to compare the hemodynamic effects of dobutamine and ephedrine during the management of anesthesia-related hypotension in healthy horses. Thirteen horses underwent general anesthesia with isoflurane and were randomly divided into two different groups, one of which received a dobutamine constant rate infusion (CRI) (1 µg/kg bwt/min) and the other received an ephedrine CRI (20 µg/kg bwt/min) when hypotension (<60 mmHg) was identified, following up to 15 min after the blood pressure reached 70 mmHg. All horses were equipped with a pulmonary artery catheter and a ...
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...
O'Brien M, Mochel JP, Kersh K, Wang C, Troy J.Pain management is critical to equine welfare with non-steroidal anti-inflammatory drugs (NSAID) commonly used in horses. However, systemic NSAID use is limited by harmful gastrointestinal and renal side effects. Intravenous regional limb perfusion (IVRLP) is a technique used in horses that produces high, local antibiotic concentrations while limiting systemic circulation. NSAID-IVRLP would be a novel method of local pain management while limiting systemic NSAID side effects. To date, NSAID-IVRLP administration has not been reported in horses. This study aimed to identify the pharmacokinetics ...
Valverde A, Cribb N, Arroyo L.Twelve adult horses were randomly assigned to 2 groups in a prospective experimental trial. A pneumatic tourniquet (425 mmHg) was placed, under sedation, proximal to the carpus on one randomly chosen thoracic limb. A cephalic vein catheter was placed distal to the tourniquet to establish an intravenous regional limb perfusion technique (IVRLP) with morphine (0.1 mg/kg) diluted with saline 0.9% to 0.1 mL/kg, and the tourniquet left in place for 30 minutes. Horses were euthanized at 1 h (Group I) or 6 h (Group II) following the IVRLP and synovial fluid from the radiocarpal, intercarpal, metacarp...
Araos J, Driessen B, Brandly J, Gorenberg E, Heerdt P, Bruhn A, Martin-Flores M, Adler A, Hopster K.To investigate the mechanisms underlying the improved arterial oxygenation described with flow-limited expiration (FLEX) ventilation in anesthetized horses. Methods: 5 healthy adult research horses. Methods: Horses underwent volume-controlled ventilation for 60 minutes (VCV1), followed by 60 minutes of FLEX, and 30 minutes of VCV (VCV2). Main outcomes included the arterial partial pressure of oxygen-to-Fio2 (PF) ratio and electrical impedance tomography (EIT)-derived functional indices at the end of each phase. The EIT data were used to create regional maps of relative lung ventilation and per...
Kieffer PJ, Williams JM, Shepard MK, Giguère S, Epstein KL.Horses undergoing abdominal exploratory surgery are at risk of hypotension and hypoperfusion. Normal mean arterial pressure is used as a surrogate for adequate tissue perfusion. However, measures of systemic circulation may not be reflective of microcirculation. This study measured the mean arterial pressure, cardiac index, lactate, and four microcirculatory indices in six healthy, anesthetized adult horses undergoing elective laparotomies. The microcirculatory parameters were measured at three different sites along the gastrointestinal tract (oral mucosa, colonic serosa, and rectal mucosa) wi...
Saldinger LK, Kilcoyne I, Nieto J.To evaluate if a difference in synovial amikacin concentrations exists in the radiocarpal joint (RCJ) following different durations of instillation of an IV regional limb perfusion (IVRLP) perfusate. Methods: 7 healthy horses. Methods: Horses received 2 IVRLPs with 2 g amikacin diluted to 60 mL with 0.9% NaCl via the cephalic vein in a crossover study design with a wash-out period between procedures. Instillation of the perfusate was administered over a 1-minute (technique 1) and 5-minute (technique 5) period. Concentrations of amikacin within the RCJ were measured at time (T) 5, 10, 15, 20, 2...
Duysens J, Graide H, Niesten A, Mouithys-Mickalad A, Ceusters J, Serteyn D.The main causes of mortality in horses are the gastrointestinal pathologies associated with septic shock. Stem cells have shown, through systemic injection, a capacity to decrease inflammation and to regenerate injured tissue faster. Nevertheless, to achieve this rapid and total regeneration, systemic injections of 1 to 2 million cells per kilogram of body weight must be considered. Here, we demonstrate for the first time the feasibility and expansion capacity of equine muscle-derived mesenchymal stromal cells (mdMSCs) in a functionally closed, automated, perfusion-based, hollow-fiber bioreact...
