Clinical evaluation of an end-tidal target-controlled infusion closed-loop system for isoflurane administration in horses undergoing surgical procedures.
Abstract: 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 system and ventilator volume, and end-tidal isoflurane target (ET(target)) were entered into the computer. Using Lowe's equation, the software calculated the prime dose to be delivered by the syringe driver over 2 min. After this, the system delivered each minute the amount of isoflurane as determined by the following equation: Isoflurane (mL) = {2 × λ(B/G) × (200 × BW(0.75)) × (ET(target) - ET(measured)) + (fresh gas flow - (BW(0.75) × 0.07)) × (ET(measured))}/206. A fresh gas flow of 4 L oxygen min(-1) was administered until the inspired fraction of oxygen reached 0.7, and was then decreased. A target of 1.5% end-tidal isoflurane was initially used and subsequently adjusted to the clinical requirements. The system performance was evaluated using the median prediction error (MDPE) and the median absolute performance error (MDAPE), which were -3.6% and 5.29%, respectively. It was concluded that this system was useful to achieve end-tidal target-controlled infusion of isoflurane during equine anaesthesia.
Copyright © 2011 Elsevier Ltd. All rights reserved.
Publication Date: 2011-07-08 PubMed ID: 21741863DOI: 10.1016/j.tvjl.2011.06.001Google Scholar: Lookup
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- Evaluation Study
- Journal Article
Summary
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The study evaluates a new delivery system that accurately measures and controls the administration of isoflurane, a volatile anaesthetic agent, in horses during surgical procedures.
Introduction to the New Delivery System
- The focus of the study was a new system designed for administration of a volatile anaesthetic agent, isoflurane, to horses during surgical procedures.
- This system included a laptop with specialized software, a computer-controlled syringe driver containing liquid isoflurane, a large-animal circle breathing system, and a respiratory gas monitor.
- The gas monitor was used to provide the computer with isoflurane end-tidal concentrations every 20 seconds.
Procedure of the Study
- After the horse was sedated and connected to the breathing system, mechanical ventilation was started.
- Key parameters such as the horse’s body weight, fresh gas flow, breathing system and ventilator volume, and target end-tidal isoflurane (ET) levels were inputted into the computer system.
- Using Lowe’s equation, the software was then able to calculate the initial ‘prime’ dose of isoflurane.
- Subsequent doses were calculated every minute using a specific equation.
Results and Performance Evaluation
- During the experiment, a fresh gas flow of 4L oxygen per minute was administered until the inspired fraction of oxygen reached 0.7, at which point the flow was decreased.
- The target ET isoflurane was initially set at 1.5% and then further adjusted according to clinical requirements.
- The system performance was evaluated using median prediction error (MDPE) and median absolute performance error (MDAPE) measures. The MDPE and MDAPE were found to be -3.6% and 5.29%, respectively, demonstrating a fairly high level of accuracy.
Conclusion of the Study
- The results of this study indicate that the new system is a potentially useful tool for the administration of isoflurane during equine anaesthesia, enabling accurate and controlled delivery of the anaesthetic agent.
Cite This Article
APA
Franci P, Bertamini A, Bertamini O, Pilla T, Busetto R.
(2011).
Clinical evaluation of an end-tidal target-controlled infusion closed-loop system for isoflurane administration in horses undergoing surgical procedures.
Vet J, 192(2), 206-211.
https://doi.org/10.1016/j.tvjl.2011.06.001 Publication
Researcher Affiliations
- Department of Veterinary Clinical Science, Faculty of Veterinary Medicine, University of Padua, Legnaro 35020, Italy. paolo.franci@unipd.it
MeSH Terms
- Anesthesia, Closed-Circuit / instrumentation
- Anesthesia, Closed-Circuit / veterinary
- Anesthetics, Inhalation / administration & dosage
- Animals
- Drug Delivery Systems / veterinary
- Drug Therapy, Computer-Assisted / veterinary
- Female
- Horses / surgery
- Isoflurane / administration & dosage
- Male
- Tidal Volume
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