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Home / Equine Research Bank / Equine Vet J / Continuous measurement of arterial oxygenation in mechanical...
Equine veterinary journal2021; 54(6); 1144-1152; doi: 10.1111/evj.13542

Continuous measurement of arterial oxygenation in mechanically ventilated horses.

Abstract: The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. Objective: The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO2 (PaO2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. Methods: In vivo experimental study. Methods: Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteries through a catheter to continuously measure and record PaO2Sensor . After an alveolar recruitment manoeuvre, a decremental positive end-expiratory pressure (PEEP) titration using 20-minute steps of 5 cm H2 O from 20 to 0 cm H2 O was performed. An arterial blood sample was collected at 15 minutes of ventilation at each PEEP level for PaO2 measurement using an automated blood gas machine (PaO2Ref ). The agreement between PaO2Sensor and PaO2Ref was assessed by Pearson's correlation, Bland-Altman plot and four-quadrant plot analysis. In the last minute of ventilation at each PEEP level, a slow tidal inflation/deflation manoeuvre was performed. Results: The mean relative bias between PaO2Sensor and PaO2Ref was 4% with limits of agreement between -17% and 29%. The correlation coefficient between PaO2Sensor and PaO2Ref was 0.98 (P < .001). The PaO2Sensor and PaO2Ref concordance rate for changes was 95%. Measurements of PaO2Sensor during the slow inflation/deflation manoeuvre at PEEP 15 and 10 cm H2 O were not possible because of significant noise on the PaO2 signal generated by a small blood clot. Conclusions: Small sample size. Conclusions: The tested fibreoptic probe was able to accurately and continuously measure PaO2Sensor in anaesthetised horses undergoing ventilatory manoeuvres. A heparinised system in the catheter used by the fibreoptic sensor should be used to avoid blood clots and artefacts in the PaO2 measurements.
© 2021 EVJ Ltd.
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Publication Date: 2021-12-22 PubMed ID: 34797580DOI: 10.1111/evj.13542Google Scholar: Lookup
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Summary

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The study evaluates the effectiveness of a novel fibreoptic sensor in continuously and accurately measuring arterial oxygen partial pressure in anaesthetised horses during ventilatory manoeuvres. The fibreoptic probe showed significant accuracy, despite being occasionally hindered by small blood clots.

Objective and Significance of the Study

  • The main focus of the research was to assess the ability of a fibreoptic sensor to continuously measure the partial pressure of oxygen in the arteries (PaO) in real-time in anesthetized horses.
  • Arterial oxygen measurement is an important aspect in the management of hypoxaemia (abnormally low level of oxygen in the blood) in horses undergoing general anaesthesia.

Methods Used

  • In this experimental study, six healthy adult horses were anaesthetised and mechanically ventilated while lying on their back.
  • A fibreoptic sensor was placed in one of the facial arteries via a catheter to continuously measure and record PaO.
  • After an alveolar recruitment manoeuvre, decremental positive end-expiratory pressure (PEEP) titration was carried out in 20-minute steps from 20 to 0 cm H2O.
  • Arterial blood samples were collected at 15-minute intervals at each level of PEEP, which were then analyzed by an automated blood gas machine.
  • The correlation between the two PaO measurements, taken through the fibreoptic sensor and the automated blood gas machine, was ascertained using statistical methods including Pearson’s correlation and Bland-Altman plot analysis.

Results and Conclusion

  • The results indicated a significant correlation between the readings of arterial oxygenation from the fibreoptic sensor and the automated blood gas machine, making the sensor a reliable tool to measure arterial blood oxygen in real-time.
  • The mean relative bias between the two measurements was only 4% and the correlation coefficient was extremely high at 0.98.
  • The concordance rate of changes between the two methods of PaO measurement was an impressive 95%.
  • However, monitoring at PEEP levels of 15 and 10 cm H2O was not feasible due to significant noise in the PaO signal induced by a small blood clot.
  • This suggests that a heparinized system should be used in conjunction with the fibreoptic sensor in the catheter to avert blood clots and artifacts in the PaO measurements.
  • Overall, despite the small sample size, the study concludes that the fibreoptic probe is capable of accurately and continuously measuring arterial oxygen levels in horses under general anesthesia in real-time.

Cite This Article

APA
Hummer EV, Soares JHN, Crockett DC, Aguiar AJA, Tran MC, Cronin JN, Brosnan RJ, Braun C, Formenti F. (2021). Continuous measurement of arterial oxygenation in mechanically ventilated horses. Equine Vet J, 54(6), 1144-1152. https://doi.org/10.1111/evj.13542

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 6
Pages: 1144-1152

Researcher Affiliations

Hummer, Emma V
  • William Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, California, USA.
Soares, Joao H N
  • Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
Crockett, Douglas C
  • Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.
Aguiar, Antonio J A
  • Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
  • Departamento de Cirurgia e Anestesiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo, Brazil.
Tran, Minh C
  • Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.
  • Department of Engineering Science, University of Oxford, Oxford, UK.
Cronin, John N
  • Centre for Human and Applied Physiological Sciences, King's College London, London, UK.
  • Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Brosnan, Robert J
  • Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
Braun, Christina
  • Anaesthesiology and Perioperative Intensive Care, Vetmeduni Vienna, Vienna, Austria.
Formenti, Federico
  • Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.
  • Centre for Human and Applied Physiological Sciences, King's College London, London, UK.

MeSH Terms

  • Animals
  • Arteries
  • Blood Gas Analysis / veterinary
  • Horses
  • Oxygen
  • Positive-Pressure Respiration / veterinary
  • Respiration, Artificial / veterinary

Grant Funding

  • 18-31 / Center for Equine Health, University of California, Davis

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