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Canadian journal of veterinary research = Revue canadienne de recherche veterinaire2021; 85(4); 251-260;

Cardiopulmonary effects and recovery characteristics associated with 2 sedative protocols for assisted ventilation in healthy neonatal foals.

Abstract: Neonatal foals may require prolonged sedation to permit ventilatory support in the first few days of life. The objective of this study was to evaluate and compare the cardiopulmonary effects and clinical recovery characteristics of 2 sedative/analgesia protocols in healthy foals receiving assisted ventilation. Foals were randomized to receive dexmedetomidine, butorphanol, and propofol (DBP) or midazolam, butorphanol, and propofol (MBP) during a 24-hour period. Infusion rates of dexmedetomidine, midazolam, and propofol were adjusted and propofol boluses administered according to set protocols to maintain optimal sedation and muscle relaxation. Ventilatory support variables were adjusted to preset targets. Physiologic variables were recorded, cardiac output (CO) measured (thermodilution), and arterial and mixed venous blood collected for gas analysis at intervals up to 24 hours. Foals in group DBP received dexmedetomidine [2.4 ± 0.5 μg/kg body weight (BW) per hour], butorphanol (13 μg/kg BW per hour), and propofol (6.97 ± 0.86 mg/kg BW per hour), whereas foals in group MBP received midazolam (0.14 ± 0.04 mg/kg BW per hour), butorphanol (13 μg/kg BW per hour), and propofol (5.98 ± 1.33 mg/kg BW per hour). Foals in the DBP group received significantly more propofol boluses (9.0 ± 3.0) than those in the MBP group (4.0 ± 2.0). Although physiologic variables remained within acceptable limits, heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) were lower in foals in the DBP group than in the MBP group. Times to sternal recumbency, standing, and nursing were significantly shorter in the DBP than MBP group. We found that MBP and DBP protocols are suitable to assist ventilatory support in neonatal foals, although MBP results in a prolonged recovery compared to DBP. Les poulains nouveau-nés peuvent nécessiter une sédation prolongée pour permettre une assistance ventilatoire au cours des premiers jours de vie. L’objectif de cette étude était d’évaluer et de comparer les effets cardio-pulmonaires et les caractéristiques de récupération clinique de deux protocoles sédatifs/analgésiques chez des poulains sains recevant une ventilation assistée. Les poulains ont été randomisés pour recevoir de la dexmédétomidine, du butorphanol et du propofol (DBP) ou du midazolam, du butorphanol et du propofol (MBP) pendant une période de 24 heures. Les débits de perfusion de dexmédétomidine, de midazolam et de propofol ont été ajustés et des bolus de propofol ont été administrés selon des protocoles définis pour maintenir une sédation et une relaxation musculaire optimales. Les variables d’assistance ventilatoire ont été ajustées à des cibles prédéfinies. Les variables physiologiques ont été enregistrées, le débit cardiaque (CO) mesuré (thermodilution) et le sang artériel et veineux mixte prélevé pour analyse des gaz à des intervalles allant jusqu’à 24 h. Les poulains du groupe DBP ont reçu de la dexmédétomidine [2,4 ± 0,5 μg/kg de poids corporel (PC) par heure], du butorphanol (13 μg/kg de PC par heure) et du propofol (6,97 ± 0,86 mg/kg de PC par heure), tandis que les poulains du groupe MBP ont reçu du midazolam (0,14 ± 0,04 mg/kg de PC par heure), du butorphanol (13 μg/kg de PC par heure) et du propofol (5,98 ± 1,33 mg/kg de PC par heure). Les poulains du groupe DBP ont reçu significativement plus de bolus de propofol (9,0 ± 3,0) que ceux du groupe MBP (4,0 ± 2,0). Bien que les variables physiologiques soient restées dans des limites acceptables, la fréquence cardiaque (FC), la pression artérielle moyenne (MAP) et l’index cardiaque (IC) étaient plus faibles chez les poulains du groupe DBP que dans le groupe MBP. Les temps de décubitus sternal, de station debout et d’allaitement étaient significativement plus courts dans le groupe DBP que dans le groupe MBP. Nous avons constaté que les protocoles MBP et DBP sont adaptés pour assister l’assistance ventilatoire chez les poulains nouveau-nés, bien que le MBP entraîne une récupération prolongée par rapport au DBP.(Traduit par Docteur Serge Messier).
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Publication Date: 2021-10-05 PubMed ID: 34602729PubMed Central: PMC8451712
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research analyzes the effects and clinical recovery characteristics of two sedative protocols on neonatal foals requiring ventilatory support. Both methods used are found to be helpful, although the recovery time for one is noticeably longer.

Study and Objectives

  • The goal of the study was to evaluate and compare two different protocols for sedating neonatal foals that require assisted ventilation in their early days. These are vital procedures as foals may require prolonged sedation for ventilatory support soon after birth.

Methodology

  • The foals were randomized to receive one of two sedative protocols over a period of 24 hours. The first group received dexmedetomidine, butorphanol, and propofol (DBP), while the second group was treated with midazolam, butorphanol, and propofol (MBP).
  • The dexmedetomidine, midazolam, and propofol infusion rates were adjusted and extra propofol was given according to preset protocols to maintain good sedation and muscle relaxation. The ventilatory support variables were adjusted to pre-set targets.
  • Physiological variables, cardiac output (measured via thermodilution), and arterial and mixed venous blood were collected for gas analysis at different time intervals over the 24 hours.

Results

  • The foals in the DBP group received a consistent amount of dexmedetomidine, butorphanol, and propofol per hour, while the MBP group received variable amounts of midazolam, butorphanol, and propofol. Notably, the DBP group received significantly more propofol boluses than the MBP group.
  • Although the physiological variables stayed within acceptable ranges, heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) were lower in the DBP group foals than in the MBP group.
  • Additionally, much shorter time periods were observed in the DBP group for sternal recumbency, standing, and nursing compared to the foals in the MBP group. This indicates faster recovery characteristics for the DBP group.

Conclusion

  • The research concludes that both the MBP and DBP protocols are suitable for assisting ventilatory support in newborn foals. However, the MBP protocol results in a prolonged recovery period when compared to the DBP protocol.

Cite This Article

APA
Kerr CL, Keating SCJ, Arroyo LG, Viel L. (2021). Cardiopulmonary effects and recovery characteristics associated with 2 sedative protocols for assisted ventilation in healthy neonatal foals. Can J Vet Res, 85(4), 251-260.

Publication

Canadian journal of veterinary research = Revue canadienne de recherche veterinaire
ISSN: 1928-9022
NlmUniqueID: 8607793
Country: Canada
Language: English
Volume: 85
Issue: 4
Pages: 251-260

Researcher Affiliations

Kerr, Carolyn L
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Keating, Stephanie C J
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Arroyo, Luis G
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Viel, Laurent
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.

MeSH Terms

  • Anesthesia Recovery Period
  • Animals
  • Animals, Newborn / physiology
  • Butorphanol / administration & dosage
  • Butorphanol / pharmacology
  • Dexmedetomidine / administration & dosage
  • Dexmedetomidine / pharmacology
  • Drug Therapy, Combination
  • Female
  • Heart Rate / drug effects
  • Horses / physiology
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / pharmacology
  • Male
  • Midazolam / administration & dosage
  • Midazolam / pharmacology
  • Propofol / administration & dosage
  • Propofol / pharmacology
  • Respiration, Artificial
  • Respiratory Physiological Phenomena / drug effects

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