Effects of tourniquet number and exsanguination on amikacin concentrations in the radiocarpal and distal interphalangeal joints after low volume intravenous regional limb perfusion in horses.

The research investigates how different tourniquet application techniques and limb exsanguination (drawing out of blood) affects the concentration of Amikacin, a type of antibiotic, in two different joints of horses. Four different techniques were tested and results showed that the concentration of Amikacin varied depending on the technique used and the joint being observed. The study concluded that the use of two tourniquets could lead to optimum Amikacin concentration in one of the joints, and that exsanguination prior to the procedure did not have an impact on Amikacin concentration.

Experimental Design

• The experiment involved the use of six healthy adult horses. The experiment was structured as a randomized cross-over design, which means each horse received all four treatments in a random order to minimize bias.
• Each horse was administered one gram of Amikacin mixed in with 6 mL of 0.9% NaCl (Salt solution).
• Four techniques were tested: proximal pneumatic tourniquet (P), proximal pneumatic tourniquet with exsanguination (PE), proximal pneumatic and distal Esmarch tourniquet (PD), and proximal pneumatic with distal Esmarch tourniquet and exsanguination (PDE).

Results

• The concentrations of Amikacin in the radiocarpal joint (RCJ) were found to be higher when the PD and PDE techniques were used, as compared to the P and PE.
• However, in the distal interphalangeal joint (DIPJ), the highest Amikacin concentrations were recorded with the P and PE methods, noticeably higher than methods PD and PDE.
• These results show that the method of tourniquet application and the joint being targeted lead to varying antibiotic concentrations.

Conclusion

• The researchers concluded that the placement of two tourniquets, specifically a proximal and a distal to the carpus, could lead to the delivery of therapeutic Amikacin concentrations in the RCJ joint of horses.
• They also found that performing exsanguination prior to the intravenous regional limb perfusion (IVRLP) does not alter the synovial fluid Amikacin concentrations, which means it does not have a significant impact on Amikacin delivery to the joints.

These findings are valuable in veterinary medicine, specifically in ensuring the effectiveness of antibiotic treatments in horses. They could contribute to developing best practices for IVRLP in horses.