Cardiopulmonary effects of pleural insufflation with CO2 during two-lung ventilation in dorsally recumbent anesthetized horses.
Abstract: To record the cardiopulmonary effects of pleural CO2 positive pressure insufflation in anesthetized horses. Methods: Prospective study. Methods: Seven horses (mean ± standard deviation, 530.9 ± 68.1 kg) undergoing terminal surgery. Methods: Horses were sedated with xylazine. Anesthesia was induced with ketamine-propofol and maintained with isoflurane, positive pressure ventilation, detomidine infusion, and butorphanol with the horses in dorsal recumbency. Baseline measurements were cardiac output, heart rate, pulmonary and systemic arterial and right atrial blood pressures, body temperature, expired and inspired gas concentrations, and arterial and mixed venous blood gases, electrolytes, glucose, and lactate concentrations. An 18 gauge 6.6 cm needle was inserted into the right pleural cavity midway between the sternum and dorsal midline in the sixth or seventh intercostal space for pleural pressure (PP) measurement. A 14 gauge 18 cm needle placed 5 cm below the previous needle allowed CO2 insufflation into the pleural cavity. All measurements were repeated after: needle insertion, at 2, 5, and 8 mmHg PPs, and after pleural gas removal (GR). Data were compared with baseline using one-way analysis of variance with repeated measures. p < 0.05 was considered significant. Results: Actual PPs were within 1.1 mmHg of the targeted PP. Pulmonary systolic and mean arterial pressures, alveolar dead space to tidal volume ratio, and isoflurane requirements increased at 8 mmHg PP and GR. Cardiac index decreased at 5 mmHg PP. Stroke index decreased at 2 mmHg PP to GR. PaO2 decreased at 5 mmHg PP to GR. PaCO2 increased at 8 mmHg PP and GR. Oxygen delivery decreased at 5 and 8 mmHg PP. Intrapulmonary shunt fraction and lactate concentration increased with GR. Conclusions: Severe adverse cardiopulmonary effects arise from CO2 positive pressure insufflation into the right hemithorax in dorsally recumbent isoflurane-anesthetized horses. PP should be ≤2 mmHg.
Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
Publication Date: 2017-01-10 PubMed ID: 28599888DOI: 10.1016/j.vaa.2016.07.004Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
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.
This study investigates the cardiopulmonary effects of CO2 positive pressure insufflation into the right hemithorax in anesthetized, recumbent horses. The results show severe adverse effects that recommend a pleural pressure ≤2 mmHg.
Study Design and Procedures
- The research is a prospective study involving seven horses undergoing terminal surgery.
- Horses were sedated and anesthetized using xylazine, ketamine-propofol, isoflurane, detomidine, and butorphanol.
- Various baseline measurements, such as cardiac output, heart rate, blood pressures, body temperature, gas concentrations, and blood gases, were recorded.
- An 18-gauge and a 14-gauge needle were inserted into the right pleural cavity of the horses to measure pleural pressure and allow CO2 insufflation respectively.
- Measurements were again taken after the needle insertion, at 2, 5, and 8 mmHg pleural pressures, and after the removal of pleural gas. The statistics were analyzed with one-way analysis of variance.
Cardiopulmonary Measurements and Results
- The actual pleural pressures recorded were very close to the targeted pressure.
- At 8 mmHg pleural pressure and after gas removal, there were increases in pulmonary systolic and mean arterial pressures, the alveolar dead space to tidal volume ratio, and isoflurane requirements.
- A decrease in cardiac index was recorded at 5 mmHg pleural pressure. Stroke index decreased from 2 mmHg pleural pressure to the point of gas removal.
- Decreases in arterial oxygen levels were observed from 5 mmHg pleural pressure till gas removal.
- Increases in arterial carbon dioxide levels were seen at 8 mmHg pleural pressure and after gas removal.
- Oxygen delivery decreased at both 5 mmHg and 8 mmHg pleural pressures.
- Lactate concentration and intrapulmonary shunt fraction increased after gas removal.
Conclusions and Recommendations
- The study found severe adverse cardiopulmonary effects from the CO2 positive pressure insufflation into the right hemithorax in anesthetized, recumbent horses.
- Based on the study results and observed adverse effects, the researchers recommended that pleural pressure should be kept at or below 2 mmHg.
Cite This Article
APA
Bohaychuk-Preuss KS, Carrozzo MV, Duke-Novakovski T.
(2017).
Cardiopulmonary effects of pleural insufflation with CO2 during two-lung ventilation in dorsally recumbent anesthetized horses.
Vet Anaesth Analg, 44(3), 483-491.
https://doi.org/10.1016/j.vaa.2016.07.004 Publication
Researcher Affiliations
- Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK, Canada.
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada. Electronic address: tad551@mail.usask.ca.
MeSH Terms
- Anesthesia / veterinary
- Anesthetics
- Animals
- Blood Gas Analysis / veterinary
- Blood Pressure
- Body Temperature
- Carbon Dioxide
- Cardiac Output
- Female
- Heart Rate
- Horses
- Insufflation / adverse effects
- Insufflation / methods
- Insufflation / veterinary
- Isoflurane
- Ketamine
- Lactic Acid / blood
- Male
- Patient Positioning / methods
- Patient Positioning / veterinary
- Pleura
- Positive-Pressure Respiration / veterinary
- Propofol
- Prospective Studies
- Respiration, Artificial / methods
- Respiration, Artificial / veterinary
- Respiratory Dead Space
- Stroke Volume
- Xylazine
Citations
This article has been cited 2 times.- Asami M, Kanai E, Yamauchi Y, Saito Y, Matsutani N, Kawamura M, Sakao Y. Positive Intrapleural Pressure with Carbon Dioxide May Limit Intraoperative Pulmonary Arterial Bleeding: Verification by Animal Model. Ann Thorac Cardiovasc Surg 2022 Dec 20;28(6):403-410.
- Aertsens A, Humphreys E, Takaesu T, Rancilio N. Evaluation of a chest wall lift technique in feline cadaveric specimens. Vet Surg 2025 Nov;54(8):1599-1607.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
