Intermittent positive pressure ventilation with constant positive end-expiratory pressure and alveolar recruitment manoeuvre during inhalation anaesthesia in horses undergoing surgery for colic, and its influence on the early recovery period.
Abstract: To compare, ventilation using intermittent positive pressure ventilation (IPPV) with constant positive end-expiratory pressure (PEEP) and alveolar recruitment manoeuvres (RM) to classical IPPV without PEEP on gas exchange during anaesthesia and early recovery. Methods: Prospective randomized study. Methods: Twenty-four warm-blood horses, weight mean 548 ± SD 49 kg undergoing surgery for colic. Methods: Premedication, induction and maintenance (isoflurane in oxygen) were identical in all horses. Group C (n = 12) was ventilated using conventional IPPV, inspiratory pressure (PIP) 35-45 cmH2O; group RM (n = 12) using similar IPPV with constant PEEP (10 cmH2O) and intermittent RMs (three consecutive breaths PIP 60, 80 then 60 cmH2O, held for 10-12 seconds). RMs were applied as required to maintain arterial oxygen tension (PaO2) at >400 mmHg (53.3 kPa). Physiological parameters were recorded intraoperatively. Arterial blood gases were measured intra- and postoperatively. Recovery times and quality of recovery were measured or scored. Results: Statistically significant findings were that horses in group RM had an overall higher PaO2 (432 ± 101 mmHg) than those in group C (187 ± 112 mmHg) at all time points including during the early recovery period. Recovery time to standing position was significantly shorter in group RM (49.6 ± 20.7 minutes) than group C (70.7 ± 24.9). Other measured parameters did not differ significantly. The median (range) of number of RMs required to maintain PaO2 above 400 mmHg per anaesthetic was 3 (1-8). Conclusions: Ventilation using IPPV with constant PEEP and RM improved arterial oxygenation lasting into the early recovery period in conjunction with faster recovery of similar quality. However this ventilation mode was not able to open up the lung completely and to keep it open without repeated recruitment. Conclusions: This mode of ventilation may provide a clinically practicable method of improving oxygenation in anaesthetized horses.
© 2011 The Authors. Veterinary Anaesthesia and Analgesia © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.
Publication Date: 2011-04-16 PubMed ID: 21492381DOI: 10.1111/j.1467-2995.2011.00606.xGoogle Scholar: Lookup
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- Comparative Study
- Journal Article
- Randomized Controlled Trial
Summary
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The article presents findings from a comparative study where the use of Intermittent Positive Pressure Ventilation (IPPV) with Constant Positive End-Expiratory Pressure (PEEP) and alveolar recruitment manoeuvres (RM) was evaluated against a conventional IPPV method during anaesthesia for horses undergoing colic surgery. The study found that using IPPV with PEEP and RM results in better oxygenation during and post-operation and quicker recovery times compared to the traditional IPPV method without PEEP.
Methods
- The research involved two groups of warm-blood horses, with both groups consisting of 12 horses. All horses weighed an average of 548 ± 49 kg and were undergoing surgery for colic.
- Premedication, induction and maintenance were kept constant across all horses.
- One group, named Group C, was ventilated using conventional IPPV while the other group, named Group RM, was ventilated using IPPV integrated with constant PEEP and intermittent RMs.
- Physiological parameters of the horses were recorded during surgery.
- In order to compare the methods, arterial blood gases were measured both during and after surgery, and recovery times and recovery quality were tracked.
Findings
- The study found that horses ventilated using IPPV with constant PEEP and RM (Group RM) had higher arterial oxygen tension (PaO2) throughout the surgery and the recovery period than those ventilated using conventional IPPV (Group C).
- It was also found that the recovery time to a standing position was significantly shorter in group RM than in group C.
- Other parameters, however, did not show significant difference between the two groups.
- Also of note, to maintain PaO2 above 400 mmHg per anaesthetic, the median number of RMs required was 3, ranging from 1 to 8.
Conclusions
- The study concluded that using IPPV with constant PEEP and RM resulted in improved arterial oxygenation and faster recovery times, though it was not able to completely open up the lung and maintain it open without repeated recruitment.
- It was proposed that this ventilation method could be a clinically useful way of improving oxygenation in anaesthetized horses.
Cite This Article
APA
Hopster K, Kästner SB, Rohn K, Ohnesorge B.
(2011).
Intermittent positive pressure ventilation with constant positive end-expiratory pressure and alveolar recruitment manoeuvre during inhalation anaesthesia in horses undergoing surgery for colic, and its influence on the early recovery period.
Vet Anaesth Analg, 38(3), 169-177.
https://doi.org/10.1111/j.1467-2995.2011.00606.x Publication
Researcher Affiliations
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany. klaus.hopster@tiho-hannover.de
MeSH Terms
- Acute Disease
- Anesthesia Recovery Period
- Anesthesia, Inhalation / methods
- Anesthesia, Inhalation / veterinary
- Animals
- Blood Gas Analysis / veterinary
- Colic / blood
- Colic / surgery
- Colic / veterinary
- Horse Diseases / surgery
- Horses
- Intermittent Positive-Pressure Ventilation / methods
- Intermittent Positive-Pressure Ventilation / veterinary
- Positive-Pressure Respiration / methods
- Positive-Pressure Respiration / veterinary
- Prospective Studies
- Pulmonary Gas Exchange
Citations
This article has been cited 7 times.- Brandly JE, Midon M, Douglas HF, Hopster K. Flow-controlled expiration reduces positive end-expiratory pressure requirement in dorsally recumbent, anesthetized horses.. Front Vet Sci 2023;10:1135452.
- Andrade FSRM, Ambrósio AM, Rodrigues RR, Faccó LL, Gonçalves LA, Garcia Filho SG, Dos Santos RT, Rossetto TC, Pereira MAA, Fantoni DT. The optimal PEEP after alveolar recruitment maneuver assessed by electrical impedance tomography in healthy horses.. Front Vet Sci 2022;9:1024088.
- Ambrósio AM, Sanchez AF, Pereira MAA, Andrade FSRM, Rodrigues RR, Vitorasso RL, Moriya HT, Fantoni DT. Assessment of Regional Ventilation During Recruitment Maneuver by Electrical Impedance Tomography in Dogs.. Front Vet Sci 2021;8:815048.
- Tucker L, Almeida D, Wendt-Hornickle E, Baldo CF, Allweiler S, Guedes AGP. Effect of 15° Reverse Trendelenburg Position on Arterial Oxygen Tension during Isoflurane Anesthesia in Horses.. Animals (Basel) 2022 Feb 1;12(3).
- Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature.. Animals (Basel) 2021 Jun 14;11(6).
- Dupont J, Serteyn D, Sandersen C. Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse.. Front Vet Sci 2018;5:235.
- Hopster K, Wittenberg-Voges L, Geburek F, Hopster-Iversen C, Kästner SBR. Effects of controlled hypoxemia or hypovolemia on global and intestinal oxygenation and perfusion in isoflurane anesthetized horses receiving an alpha-2-agonist infusion.. BMC Vet Res 2017 Nov 28;13(1):361.
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