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Home / Equine Research Bank / Equine Vet J / Effects of pulsed inhaled nitric oxide on arterial oxygenati...
Equine veterinary journal2019; 52(1); 76-82; doi: 10.1111/evj.13129

Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery.

Abstract: Administration of pulsed inhaled nitric oxide (PiNO) improves arterial oxygenation in spontaneously breathing anaesthetised healthy horses and in horses undergoing colic surgery. However, because hypoventilation commonly occurs, horses are often mechanically ventilated to prevent hypercarbia. Objective: To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. Methods: Prospective nonblinded clinical trial. Methods: Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing colic surgery (Group C) in dorsal recumbency were included in the study. Every second horse in each group received PiNO (A-INO, C-INO), the others served as controls (A-CN, C-CN). All horses were mechanically ventilated and anaesthesia was maintained with isoflurane. PiNO was mechanically delivered at the proximal end of the endotracheal tube as a pulse during the first part of each inspiration. Data were collected at the start (baseline, before PiNO) and at the end of inhalation anaesthesia. The Tukey method was used to compare baseline and end values for each parameter. Results: Arterial oxygen tension (PaO ) increased from (median [IQR]) 13.6 (9.3, 30.1) at baseline to 24.2 (18.6, 37.0) kPa at the end of anaesthesia in A-INO (P = 0.005) and from 7.7 (6.4, 8.5) to 15.5 (9.9, 26.9) kPa in C-INO (P = 0.007). Mean (95% CI) difference in F-shunt between baseline and end were -6 (-10; -1) and -11 (-22; -1) % in A-INO (P = 0.005) and C-INO (P = 0.04) respectively. There was no change in PaO or F-shunt from baseline to end of anaesthesia in A-CN or C-CN. Conclusions: Cardiac output was not measured, thus O delivery could not be calculated. Conclusions: The combination of mechanical ventilation and PiNO improved pulmonary gas exchange during anaesthesia by a simultaneous decrease in F-shunt and improved alveolar ventilation.
© 2019 EVJ Ltd.
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Publication Date: 2019-06-07 PubMed ID: 31009091DOI: 10.1111/evj.13129Google Scholar: Lookup
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  • Clinical Trial
  • Veterinary
  • 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.

The study demonstrates that the use of pulsed inhaled nitric oxide (PiNO) during anaesthesia improves oxygenation in horses undergoing arthroscopy or colic surgery who are mechanically ventilated. This is due to a combination of decreased shunting (diversion of blood) and improved ventilation within the lungs.

Objective and Method

  • The researchers aimed to understand the impacts of PiNO on arterial oxygenation, looking at mechanically ventilated horses undergoing anaesthesia for different surgical procedures. This builds on prior knowledge that PiNO enhances arterial oxygenation in anaesthetised horses.
  • This was a non-blinded prospective clinical trial, involving fifty horses scheduled for arthroscopic surgery and thirty horses set for colic surgery. The animals were randomly assigned to either receive PiNO or serve as a control group.
  • Anaesthesia was implemented using isoflurane and all the horses were mechanically ventilated. PiNO was inserted at the start of each breathing cycle. The researchers collected data at the start and end of the anaesthesia period.

Results

  • The results revealed a significant increase in arterial oxygen tension (PaO) from baseline to end of anaesthesia in those horses administered PiNO in both the arthroscopy (Group A-INO) and colic surgery (Group C-INO) groups.
  • There was also observed a notable decrease in the fraction of venous admixture (F-shunt), which indicates improved oxygenation, in the PiNO-treated horses when compared with the baseline figures.
  • In the control groups (A-CN, C-CN), no meaningful variations were observed in PaO or F-shunt values between the start and end of the anaesthesia.

Conclusions

  • The findings indicate that the combination of PiNO and mechanical ventilation enhances pulmonary gas exchange, leading to better oxygenation in anaesthetised horses under treatment. This, the researchers attribute to a decrease in F-shunt and improved alveolar ventilation.
  • However, the study does not provide a complete picture since cardiac output was not measured, making it impossible to compute oxygen delivery. Consequently, future studies should factor this in to provide a more comprehensive understanding of the impact of PiNO on oxygenation in anaesthetised horses.

Cite This Article

APA
Wiklund M, Kellgren M, Wulcan S, Grubb T, Nyman G. (2019). Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery. Equine Vet J, 52(1), 76-82. https://doi.org/10.1111/evj.13129

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 52
Issue: 1
Pages: 76-82

Researcher Affiliations

Wiklund, M
  • Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Kellgren, M
  • Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Wulcan, S
  • Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Grubb, T
  • Washington State University's College of Veterinary Medicine, Pullman, Washington, USA.
Nyman, G
  • Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.

MeSH Terms

  • Anesthesia / veterinary
  • Animals
  • Arthroscopy / veterinary
  • Colic / surgery
  • Colic / veterinary
  • Horse Diseases / surgery
  • Horses
  • Nitric Oxide / administration & dosage
  • Oxygen / blood
  • Respiration, Artificial / veterinary

Grant Funding

  • The Swedish-Norwegian Foundation for Equine Research

References

This article includes 35 references
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Citations

This article has been cited 1 times.
  1. Wilkens HL, Neudeck S, Kästner SBR. Nasal and tracheobronchial nitric oxide production and its influence on oxygenation in horses undergoing total intravenous anaesthesia. BMC Vet Res 2022 Apr 11;18(1):134.
    doi: 10.1186/s12917-022-03234-3pubmed: 35410207google scholar: lookup
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