FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Canadian journal of veterinary research = Revue canadienne de recherche veterinaire2020; 84(3); 205-211;

Effect of position on transdiaphragmatic pressure and hemodynamic variables in anesthetized horses.

Abstract: Recumbency affects respiratory mechanics and oxygenation in anesthetized horses. Changes in pleural and abdominal pressures that can impair ventilation have not been described in all recumbencies. The objective of this study was to determine the effects of patient positioning on transdiaphragmatic pressure and selected hemodynamic variables. Horses were maintained under total intravenous general anesthesia with nasal oxygen supplementation. Transnasal balloon catheters in the stomach and thoracic esophagus were used to measure intrathoracic and gastric pressures in standing horses and in anesthetized horses positioned in right and left lateral recumbency, dorsal recumbency, reverse Trendelenburg position, and Trendelenburg position. Transdiaphragmatic pressure was calculated as the difference between gastric and intrathoracic pressures. Measurements of oxygen saturation (SpO2), heart rate, systolic, diastolic and mean arterial pressures, and respiratory rate were obtained every 5 minutes. When compared to dorsal recumbency, gastric expiratory pressure is decreased in the standing position. Thoracic expiratory pressure is decreased in standing and reverse Trendelenburg. Transdiaphragmatic expiratory pressure and SpO2 are decreased in Trendelenburg. Heart rate is increased in reverse Trendelenburg. Systolic, diastolic, and mean arterial pressures are decreased in reverse Trendelenburg and increased in left lateral and right lateral recumbency. We found that there is wide variation in respiratory pressures between horses and positions and they are not predictive of associated changes in hemodynamic variables. Le décubitus affecte la mécanique respiratoire et l’oxygénation chez les chevaux anesthésiés. Les changements dans les pressions pleurales et abdominales qui peuvent affecter la ventilation n’ont pas été décrites dans tous les décubitus. L’objectif de la présente étude était de déterminer les effets du positionnement du patient sur la pression trans-diaphragmatique et une sélection de variables hémodynamiques. Des chevaux furent maintenus sous anesthésie intraveineuse générale totale avec supplémentation en oxygène par voie nasale. Des cathéters à ballon intra-nasal placés dans l’estomac et l’oesophage thoracique furent utilisés pour mesurer les pressions intrathoracique et gastrique chez des chevaux en position debout et des chevaux anesthésiés positionnés en décubitus latéral droit et gauche, en décubitus dorsal, en position renversée de Trendelenburg et en position de Trendelenburg. La pression trans-diaphragmatique fut calculée comme étant la différence entre les pressions gastrique et intrathoracique. Les mesures de saturation en oxygène (SpO2), du rythme cardiaque, des pressions artérielles systolique, diastolique et moyenne, ainsi que le rythme respiratoire furent obtenues à toutes les 5 minutes. Lors de la comparaison avec le décubitus dorsal, la pression expiratoire gastrique est diminuée dans la position debout. La pression thoracique expiratoire est diminuée en position debout et en position renversée de Trendelenburg. La pression expiratoire trans-diaphragmatique et la SpO2 sont diminuées en position Trendelenburg. Le rythme cardiaque est augmenté en position renversée de Trendelenburg. Les pressions artérielles systolique, diastolique et moyenne sont diminuées en position renversée de Trendelenburg et augmentées en décubitus latéral gauche et droit. Nous avons trouvé qu’il y avait de grandes variations dans les pressions respiratoires entre les chevaux et les positions et qu’elles ne sont pas prédictives de changements associés dans les variables hémodynamiques.(Traduit par Docteur Serge Messier).
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Get Full Text
Publication Date: 2020-08-18 PubMed ID: 32801455PubMed Central: PMC7301668
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.
LinkedInCopy
  • 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 research seeks to analyze how a horse’s position affects its breathing and certain heart-related variables when under general anesthesia. The study shows that different positions and horse-to-horse variables cause a wide range of respiratory pressures that do not necessarily indicate changes in heart-related factors.

Research Aim

  • The main objective of this study was to determine the effects of different physical positions on transdiaphragmatic pressure and selected heart-related (hemodynamic) variables in anesthetized horses.

Methods

  • Horses were kept under total general anesthesia with nasal oxygen supplementation, a technique used to ensure breathing.
  • Transnasal balloon catheters placed in the stomach and thoracic esophagus were used to measure pressures within the chest and stomach. These measurements were taken for both standing and anesthetized horses in various positions: right and left lateral recumbency, dorsal recumbency, reverse Trendelenburg (head-down tilt), and Trendelenburg position (head-up tilt).
  • Transdiaphragmatic pressure, which is the difference between gastric and thoracic pressures, was also calculated. This pressure indicates how well the diaphragm— the main muscle used for breathing — is working.
  • Measurements, including oxygen saturation (SpO), heart rate, and systolic, diastolic and mean arterial pressures, and respiratory rate were collected every 5 minutes.

Findings

  • Results showed that there is a decrease in gastric expiratory pressure (pressure in the stomach at the end of expiration or breathing out) in the standing position when compared to dorsal recumbency (lying on the back).
  • In standing and reverse Trendelenburg positions, thoracic expiratory pressure (pressure within the chest at the end of expiration) decreased.
  • The transdiaphragmatic expiratory pressure and oxygen saturation decreased in the Trendelenburg position.
  • Heart rate increased in the reverse Trendelenburg position.
  • Meanwhile, systolic, diastolic, and mean arterial pressures dropped in reverse Trendelenburg position, but rose in both left and right lateral recumbency (lying on side).
  • The findings revealed significant variation in respiratory pressures (breathing-related pressures) between horses and positions which did not predict associated changes in heart-related variables.

Cite This Article

APA
Youngblood CD, Hodgson DS, Beard WL, Song Y, Prakash P, Heflin LV. (2020). Effect of position on transdiaphragmatic pressure and hemodynamic variables in anesthetized horses. Can J Vet Res, 84(3), 205-211.

Publication

Canadian journal of veterinary research = Revue canadienne de recherche veterinaire
ISSN: 1928-9022
NlmUniqueID: 8607793
Country: Canada
Language: English
Volume: 84
Issue: 3
Pages: 205-211

Researcher Affiliations

Youngblood, Cori D
  • Department of Clinical Sciences, Kansas State University Veterinary Health Center, Manhattan, Kansas 66506, USA (Youngblood, Hodgson, Beard, Heflin); Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506, USA (Song, Prakash).
Hodgson, David S
  • Department of Clinical Sciences, Kansas State University Veterinary Health Center, Manhattan, Kansas 66506, USA (Youngblood, Hodgson, Beard, Heflin); Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506, USA (Song, Prakash).
Beard, Warren L
  • Department of Clinical Sciences, Kansas State University Veterinary Health Center, Manhattan, Kansas 66506, USA (Youngblood, Hodgson, Beard, Heflin); Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506, USA (Song, Prakash).
Song, Yuqi
  • Department of Clinical Sciences, Kansas State University Veterinary Health Center, Manhattan, Kansas 66506, USA (Youngblood, Hodgson, Beard, Heflin); Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506, USA (Song, Prakash).
Prakash, Punit
  • Department of Clinical Sciences, Kansas State University Veterinary Health Center, Manhattan, Kansas 66506, USA (Youngblood, Hodgson, Beard, Heflin); Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506, USA (Song, Prakash).
Heflin, Lindsay V
  • Department of Clinical Sciences, Kansas State University Veterinary Health Center, Manhattan, Kansas 66506, USA (Youngblood, Hodgson, Beard, Heflin); Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506, USA (Song, Prakash).

MeSH Terms

  • Anesthesia, General / veterinary
  • Anesthetics, Intravenous / administration & dosage
  • Animals
  • Body Weight
  • Diaphragm
  • Female
  • Heart Rate / drug effects
  • Hemodynamics
  • Horses
  • Male
  • Oxygen / blood
  • Pressure

References

This article includes 33 references
  1. Nyman G, Hedenstierna G. Ventilation-perfusion relationships in the anaesthetised horse. Equine Vet J 1989;21:274–281.
    pubmed: 2670542
  2. Nyman G, Funkquist B, Kvart C. Atelectasis causes gas exchange impairment in the anaesthetised horse. Equine Vet J 1990;22:317–324.
    pubmed: 2226395
  3. Dobson A, Gleed RD, Meyer RE, Stewart BJ. Changes in blood flow distribution in equine lungs induced by anaesthesia. Q J Exp Physiol 1985;70:283–297.
    pubmed: 3925493
  4. Hall LW. Cardiovascular and pulmonary effects of recumbency in two conscious ponies. Equine Vet J 1984;16:89–92.
    pubmed: 6714220
  5. Day TK, Gaynor JS, Muir WW 3rd, Bednarski RM, Mason DE. Blood gas values during intermittent positive pressure ventilation and spontaneous ventilation in 160 anesthetized horses positioned in lateral or dorsal recumbency. Vet Surg 1995;24:266–276.
    pubmed: 7653042
  6. Sorenson PR, Robinson NE. Postural effects on lung volumes and asynchronous ventilation in anesthetized horses. J Appl Physiol Respir Environ Exerc Physiol 1980;48:97–103.
    pubmed: 7353982
  7. McDonell WN, Hall LW, Jeffcott LB. Radiographic evidence of impaired pulmonary function in laterally recumbent anaesthetised horses. Equine Vet J 1979;11:24–32.
    pubmed: 428360
  8. Moens Y, Lagerweij E, Gootjes P, Poortman J. Distribution of inspired gas to each lung in the anaesthetised horse and influence of body shape. Equine Vet J 1995;27:110–116.
    pubmed: 7607142
  9. Runck H, Schumann S, Tacke S, Haberstroh J, Guttmann J. Effects of intra-abdominal pressure on respiratory system mechanics in mechanically ventilated rats. Respir Physiol Neurobiol 2012;180:204–210.
    pubmed: 22138515
  10. Mutoh T, Lamm WJ, Embree LJ, Hildebrandt J, Albert RK. Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo. J Appl Physiol 1991;70:2611–2618.
    pubmed: 1885456
  11. Pelosi P, Quintel M, Malbrain ML. Effect of intra-abdominal pressure on respiratory mechanics. Acta Clin Belg 2007;62:78–88.
    pubmed: 24881704
  12. McBeth PB, Zygun DA, Widder S. Effect of patient positioning on intra-abdominal pressure monitoring. Am J Surg 2007;193:644–647.
    pubmed: 17434374
  13. De Keulenaer BL, De Waele JJ, Powell B, Malbrain ML. What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end-expiratory pressure?. Intensive Care Med 2009;35:969–976.
    pubmed: 19242675
  14. Safran DB, Orlando R 3rd. Physiologic effects of pneumoperitoneum. Am J Surg 1994;167:281–286.
    pubmed: 8135322
  15. Scott VH, Williams JM, Mudge MC, Hurcombe SD. Effect of body position on intra-abdominal pressures and abdominal perfusion pressures measured at three sites in horses anesthetized with short-term total intravenous anesthesia. Am J Vet Res 2014;75:301–308.
    pubmed: 24564317
  16. Canola PA, Johnson PJ. Intra-abdominal hypertension in horses. Equine Vet Educ 2013;25:189–195.
  17. Perilli V, Sollazzi L, Bozza P. The effects of the reverse Trendelenburg position on respiratory mechanics and blood gases in morbidly obese patients during bariatric surgery. Anesth Analg 2000;91:1520–1525.
    pubmed: 11094011
  18. Binetti A, Mosing M, Sacks M, Duchateau L, Gasthuys F, Schauvliege S. Impact of Trendelenburg (head down) and reverse Trendelenburg (head up) position on respiratory and cardiovascular function in anaesthetized horses. Vet Anaesth Analg 2018;45:760–771.
    pubmed: 30257797
  19. Schauvliege S, Binetti A, Duchateau L, van Dijk JJ, Gasthuys F. Cardiorespiratory effects of a 7° reverse Trendelenburg position in anaesthetized horses: A randomized clinical trial. Vet Anaesth Analg 2018;45:648–657.
    pubmed: 30082180
  20. Hofmeister E, Peroni JF, Fisher AT. Effects of carbon dioxide insufflation and body position on blood gas values in horses anesthetized for laparoscopy. J Equine Vet Sci 2008;28:549–553.
  21. Kowalczyk L, Steblaj B, Schauvliege S. Comparison of respiratory function during TIVA and isoflurane anaesthesia in ponies Part II: Breathing patterns and transdiaphragmatic pressure. Vet Anaesth Analg 2014;41:592–601.
    pubmed: 24986481
  22. Slocombe R, Brock K, Covelli G, Bayly W. Effect of treadmill exercise on intrapleural, transdiaphragmatic and intra-abdominal pressures in Standardbred horses. In: Persson SG, Jeffcott LB, editors. Equine Exercise Physiology 3. Davis, California: ICEEP Publications; 1991. pp. 83–91.
  23. Benditt JO. Esophageal and gastric pressure measurements. Respir Care 2005;50:68–75.
    pubmed: 15636646
  24. Perilli V, Sollazzi L, Modesti C. Comparison of positive end-expiratory pressure with reverse Trendelenburg position in morbidly obese patients undergoing bariatric surgery: Effects on hemodynamics and pulmonary gas exchange. Obes Surg 2003;13:605–609.
    pubmed: 12935363
  25. Mankikian B, Cantineau JP, Sartene R, Clergue F, Viars P. Ventilatory pattern and chest wall mechanics during ketamine anesthesia in humans. Anesthesiology 1986;65:492–499.
    pubmed: 3777478
  26. Tokics L, Strandberg A, Brismar B, Lundquist H, Hedenstierna G. Computerized tomography of the chest and gas exchange measurements during ketamine anaesthesia. Acta Anaesthesiol Scand 1987;31:684–692.
    pubmed: 3434162
  27. Matzen S, Perko G, Groth S, Friedman DB, Secher NH. Blood volume distribution during head-up tilt induced central hypovolaemia in man. Clin Physiol 1991;11:411–422.
    pubmed: 1934937
  28. Klopfenstein CE, Morel DR, Clergue F, Pastor CM. Effects of abdominal CO2 insufflation and changes of position on hepatic blood flow in anesthetized pigs. Am J Physiol 1998;275:H900–905.
    pubmed: 9724294
  29. Araújo MA, Deschk M, Wagatsuma JT. Cardiopulmonary effects of reverse Trendelenburg position at 5° and 10° in sevoflurane-anesthetized steers. Vet Anaesth Analg 2017;44:854–864.
    pubmed: 28778513
  30. Gasthuys F, de Moor A, Parmentier D. Haemodynamic effects of change in position and respiration mode during a standard halothane anaesthesia in ponies. Zentralbl Veterinarmed A 1991;38:203–211.
    pubmed: 1907066
  31. Derksen FJ, Robinson NE. Esophageal and intrapleural pressures in the healthy conscious pony. Am J Vet Res 1980;41:1756–1761.
    pubmed: 7212405
  32. Canola PA, Perotta JH, Laskoski LM. Use of gastric balloon manometry for estimation of intra-abdominal pressure in horses. Equine Vet J 2011;43:714–720.
    pubmed: 21668492
  33. Hurcombe SD, Scott VH. Direct intra-abdominal pressures and abdominal perfusion pressures in unsedated normal horses. J Vet Emerg Crit Care (San Antonio) 2012;22:441–446.
    pmc: PMC3960595pubmed: 22765021

Citations

This article has been cited 1 times.
  1. Schwartzman WE, Turner ME, Spiess JL, Jimenez M, Watanabe T, Hama R, Che J, Kelly GL, Yimit A, Baker PB, Arsuaga-Zorrilla C, Kelly J, Breuer CK, Best CA, Reinhardt JW. Dynamic Narrowing of the Diaphragmatic Vena Cava in Ovis aries. Anat Histol Embryol 2024 Nov;53(6):e13114.
    doi: 10.1111/ahe.13114pubmed: 39403062google scholar: lookup
Subscribe to our newsletter
Join 99,928 horse owners like you who receive our email updates on horse health and nutrition.