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Animals : an open access journal from MDPI2021; 11(8); 2245; doi: 10.3390/ani11082245

Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis.

Abstract: In anaesthetized horses, pronounced ventilation/perfusion mismatching often occurs. Several authors have investigated the effect of lower inspired oxygen fractions (FiO) to reduce formation of absorption atelectasis. This systematic review compared the effects of low (0.8) FiO on the arterial oxygen tension (PaO), the alveolar-to-arterial oxygen tension difference (P(A-a)O), and the PaO/FiO ratio in horses during inhalation anaesthesia. Using the Systematic Review Protocol for Animal Intervention Studies, four experimental and one clinical investigations were deemed suitable for inclusion. A meta-analysis was performed on the four experimental studies. The PaO was significantly lower ( = 0.0007, mean difference -23.54 kPa, 95% CI -37.18, -9.90) with a lower FiO. However, the P(A-a)O was also significantly lower ( < 0.00001, mean difference -20.80 kPa, 95% CI -26.28, -15.32) when using a low FiO. For the PaO/FiO ratio, only one study fitted the inclusion criteria, so no meta-analysis was performed. It is concluded that, while only a limited number of studies are available, the use of a higher FiO in horses during inhalation anaesthesia will result in higher levels of PaO, but also a larger P(A-a)O difference. Further studies are needed to increase the level of evidence on this subject.
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Publication Date: 2021-07-30 PubMed ID: 34438703PubMed Central: PMC8388394DOI: 10.3390/ani11082245Google Scholar: Lookup
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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 research examines the impact of varying levels of inspired oxygen (FiO) on blood oxygenation during horse anesthesia, determining that higher levels of FiO result in more oxygen in the blood but a larger alveolar-to-arterial oxygen tension difference.

Introduction and Methodology

  • The paper commences by addressing the frequently observed ventilation and blood flow mismatch in anaesthetized horses.
  • Several authors have suggested lowering the fraction of inspired oxygen (FiO) to limit the formation of absorption atelectasis (collapse of lung segments).
  • This systematic review aims to compare the effects of low and high FiO on arterial oxygen tension (PaO), the alveolar-to-arterial oxygen tension difference (P(A-a)O), and the PaO/FiO ratio in horses under inhalation anaesthesia.
  • Using the Systematic Review Protocol for Animal Intervention Studies framework, five studies (four experimental and one clinical) were found to be appropriate for inclusion in the review.
  • A meta-analysis of the four experimental studies was then performed.

Results of the Review and Meta-Analysis

  • The review found PaO to be noticeably lower with lower FiO (mean difference -23.54 kPa).
  • In contrast, P(A-a)O was also significantly lower when using a low FiO. This implies that while there is less oxygen in the arterial blood with a lower FiO, there is a smaller difference between the oxygen tension in the alveolus and the arterial blood.
  • As for the PaO/FiO ratio, only one out of the five studies met the inclusion criteria, so no meta-analysis was conducted on this aspect.

Conclusions

  • The study concludes that attritional data from limited studies recommend using a higher FiO in horses during inhalation anaesthesia for a higher amount of PaO in horses. However, this would also reflect a larger P(A-a)O difference, meaning that there is a greater difference in oxygen tension between the alveolus and the arterial blood.
  • Due to the inclusion of only a small number of studies in the analysis, the authors suggest additional studies in this area to increase the scientific evidence on this subject.

Cite This Article

APA
Savvas I, Pavlidou K, Braun C, Schauvliege S, Staffieri F, Moens Y. (2021). Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis. Animals (Basel), 11(8), 2245. https://doi.org/10.3390/ani11082245

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 11
Issue: 8
PII: 2245

Researcher Affiliations

Savvas, Ioannis
  • Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 546 27 Thessaloniki, Greece.
Pavlidou, Kiriaki
  • Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 546 27 Thessaloniki, Greece.
Braun, Christina
  • Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, 1210 Vienna, Austria.
Schauvliege, Stijn
  • Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
Staffieri, Francesco
  • Section of Veterinary Clinics and Animal Production, Department of Emergency and Organs Transplantation, University of Bari Aldo Moro, 70010 Bari, Italy.
Moens, Yves
  • Anaesthesiology and Perioperative Intensive Care Medicine, University of Veterinary Medicine, 1210 Vienna, Austria.

Conflict of Interest Statement

The authors declare no conflict of interest.

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Citations

This article has been cited 1 times.
  1. Bukoski A, Downs J, Hodgson DS, Le-Bert CR, Thomen R, Flors L, Thombs L, Bailey J. Cardiopulmonary effects of apneustic anesthesia ventilation in anesthetized pigs: a new mode of ventilation for anesthetized veterinary species. Front Vet Sci 2024;11:1378617.
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