Effects of pulse-delivered inhaled nitric oxide administration on pulmonary perfusion and arterial oxygenation in dorsally recumbent isoflurane-anesthetized horses.
Abstract: To image the spatial distribution of pulmonary blood flow by means of scintigraphy, evaluate ventilation-perfusion (VA/Q) matching and pulmonary blood shunting (Qs/Qt) by means of the multiple inert gas elimination technique (MIGET), and measure arterial oxygenation and plasma endothelin-1 concentrations before, during, and after pulse-delivered inhaled nitric oxide (PiNO) administration to isoflurane-anesthetized horses in dorsal recumbency. Methods: 3 healthy adult Standardbreds. Methods: Nitric oxide was pulsed into the inspired gases in dorsally recumbent isoflurane-anesthetized horses. Assessment of VA/Q matching, Qs/Qt, and Pao2 content was performed by use of the MIGET, and spatial distribution of pulmonary blood flow was measured by perfusion scintigraphy following IV injection of technetium Tc 99m-labeled macroaggregated human albumin before, during, and 30 minutes after cessation of PiNO administration. Results: During PiNO administration, significant redistribution of blood flow from the dependent regions to the nondependent regions of the lungs was found and was reflected by improvements in VA/Q matching, decreases in Qs/Qt, and increases in Pao2 content, all of which reverted to baseline values at 30 minutes after PiNO administration. Conclusions: Administration of PiNO in anesthetized dorsally recumbent horses resulted in redistribution of pulmonary blood flow from dependent atelectatic lung regions to nondependent aerated lung regions. Because hypoxemia is commonly the result of atelectasis in anesthetized dorsally recumbent horses, the addition of nitric oxide to inhaled gases could be used clinically to alleviate hypoxemia in horses during anesthesia.
Publication Date: 2014-10-29 PubMed ID: 25350084DOI: 10.2460/ajvr.75.11.949Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research investigates the effects of pulse-delivered inhaled nitric oxide on blood flow and oxygen levels in horses under anesthesia. The findings suggest that the introduction of nitric oxide significantly reconfigures blood flow in the lungs, improving oxygen levels and potentially offering a solution for hypoxemia, a common condition in anesthetized horses.
Objective and Methodology
- The aim of this research was to analyze the rearrangement of blood flow in the lungs and its effects on oxygen levels in horses undergoing anesthesia.
- The methodology involved the usage of the multiple inert gas elimination technique (MIGET) and perfusion scintigraphy as imaging techniques to map pulmonary blood flow.
- Furthermore, plasma endothelin-1 concentrations, an indicator of lung function, were measured before, during and after the delivery of pulse-delivered inhaled nitric oxide (PiNO).
- The subjects were three healthy adult Standardbreds, anesthetized and placed in a dorsal recumbency position.
- Nitric oxide was introduced into the inspired gases during the experiment.
Results
- The results demonstrated a significant redistribution of blood flow from the dependent (gravity-affected) region to the nondependent areas of the lungs.
- This redirection of blood flow resulted in improvements in ventilation-perfusion (VA/Q) matching, decreases in pulmonary blood shunting (Qs/Qt), and increases in arterial oxygen content (Pao2).
- However, it was noted that these changes reverted to baseline levels 30 minutes after the cessation of PiNO delivery.
Conclusions
- The introduction of PiNO in anesthetized, dorsally recumbent horses resulted in a redirection of pulmonary blood flow away from dependent, collapsed lung areas (atelectasis) towards nondependent, ventilated lung areas.
- The findings point that hypoxemia, a common issue in anesthetized horses lying on their backs, can be alleviated by introducing nitric oxide to inhaled gases.
- Overall, the addition of nitric oxide during anesthesia could offer a clinical solution for improving oxygenation in horses.
Cite This Article
APA
Grubb TL, Lord PF, Berger M, Larsson C, Rydén A, Frendin J, Funkquist P, Edner A, Nyman G.
(2014).
Effects of pulse-delivered inhaled nitric oxide administration on pulmonary perfusion and arterial oxygenation in dorsally recumbent isoflurane-anesthetized horses.
Am J Vet Res, 75(11), 949-955.
https://doi.org/10.2460/ajvr.75.11.949 Publication
Researcher Affiliations
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, 53223 Skara, Sweden., Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
MeSH Terms
- Administration, Inhalation
- Adult
- Anesthetics, Inhalation / pharmacology
- Animals
- Arteries / drug effects
- Blood Gas Analysis / veterinary
- Female
- Heart Rate / drug effects
- Hemodynamics / drug effects
- Horses / physiology
- Humans
- Hypoxia / etiology
- Hypoxia / therapy
- Hypoxia / veterinary
- Isoflurane / pharmacology
- Lung / blood supply
- Lung / diagnostic imaging
- Male
- Nitric Oxide / administration & dosage
- Perfusion / veterinary
- Pulmonary Atelectasis / physiopathology
- Pulmonary Atelectasis / veterinary
- Radionuclide Imaging
- Respiration / drug effects
Citations
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