Journal of equine veterinary science2023; 132; 104986; doi: 10.1016/j.jevs.2023.104986

Lower airway ultrasonographic, endoscopic, and cytological changes in horses undergoing inhalation anesthesia with controlled ventilation for minor elective surgeries.

Abstract: Effects of general anesthesia with controlled ventilation on the respiratory system have had limited evaluation in horses. A prospective observational study was performed with eleven client-owned horses undergoing elective surgery. Physical examination, auscultation with a rebreathing bag, complete blood cell count, lung ultrasound imaging, tracheal endoscopy imaging and transendoscopic tracheal wash were conducted before and 24 hours after anesthesia. Lung ultrasound imaging was also repeated just after recovery. A significant increase in blood neutrophil count between pre- and post-anesthesia (P=0.004) was observed. There was an increase in ultrasonographic score of the lungs at recovery (left P=0.007, right P=0.017). The score of the dependent lung was higher than the independent lung at recovery time (P=0.026) but no difference was observed 24 hours after anesthesia. The tracheal mucus score was higher after anesthesia (P=0.001); severe local inflammation was present in several horses at the site of endotracheal tube cuff. Neutrophil count was significantly higher on tracheal wash fluid cytology after anesthesia (P=0.016), without any significant changes on bacterial load. Increased tracheal mucus score and neutrophil count in tracheal wash samples were observed after general anesthesia in healthy horses without clinical evidence of pneumonia (fever, cough). Tracheal inflammation secondary to endotracheal intubation and cuff inflation was, therefore, suspected. Elective surgery without complications can induce inflammation of the trachea and changes in ultrasound images of the lungs in healthy horses and should be considered when evaluating respiratory system after a general anesthesia.
Publication Date: 2023-12-21 PubMed ID: 38135197DOI: 10.1016/j.jevs.2023.104986Google Scholar: Lookup
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  • Journal Article

Summary

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This research study investigates how general anesthesia with controlled ventilation affects the respiratory systems of horses undergoing minor elective surgeries. The researchers found that the process can induce inflammation in the trachea and changes in the lungs, discovered using ultrasound imaging and tracheal examinations.

Study Design and Methodology

  • The investigation was designed as a prospective observational study and utilized eleven client-owned horses which were being prepared for elective surgeries.
  • Prior to anesthesia and 24 hours after, a series of evaluations were carried out on each horse. These examinations included a physical exam, auscultation with a rebreathing bag, complete blood cell count, lung ultrasound imaging, tracheal endoscopy imaging and a transendoscopic tracheal wash.
  • Lung ultrasound imaging was also repeated immediately after each horse had fully recovered from the anesthesia.

Main Findings and Implications

  • The results clearly indicated a significant increase in blood neutrophil count between pre- and post-anesthesia.
  • Ultrasonographic score of the lungs was found to have increased at recovery for both the left and right sides of the lungs.
  • Moreover, the score of the dependent lung was higher than the independent lung at recovery time. However, no difference between the two was observed 24 hours after anesthesia.
  • The researchers noted that the tracheal mucus score was higher after anesthesia. They also observed severe local inflammation in several horses at the site of the endotracheal tube cuff.
  • Neutrophil count was significantly higher on tracheal wash fluid cytology after anesthesia, without any significant changes noticed on bacterial load.
  • The increase in tracheal mucus score and neutrophil count in tracheal wash samples were observed after general anesthesia in healthy horses that showed no clinical evidence of pneumonia, such as fever or cough. Therefore, the investigators attributed these increased scores and counts to the inflammation triggered by endotracheal intubation and cuff inflation.
  • This suggests that even a minor elective surgery with no complications could result in inflammation of the trachea and changes in the ultrasound images of the lungs in otherwise healthy horses. This is an important note, particularly for veterinarians and medical personnel when evaluating the respiratory system of horses post general anesthesia.

Cite This Article

APA
Laclaire AL, Manguin E, Tanquerel L. (2023). Lower airway ultrasonographic, endoscopic, and cytological changes in horses undergoing inhalation anesthesia with controlled ventilation for minor elective surgeries. J Equine Vet Sci, 132, 104986. https://doi.org/10.1016/j.jevs.2023.104986

Publication

ISSN: 0737-0806
NlmUniqueID: 8216840
Country: United States
Language: English
Volume: 132
Pages: 104986
PII: S0737-0806(23)00802-X

Researcher Affiliations

Laclaire, Anne-Louise
  • National Veterinary School of Alfort, 7 Avenue du Gu00e9nu00e9ral de Gaulle, 94700 Maisons-Alfort, France. Electronic address: anne-louise.laclaire@vet-alfort.fr.
Manguin, Estelle
  • National Veterinary School of Alfort, 7 Avenue du Gu00e9nu00e9ral de Gaulle, 94700 Maisons-Alfort, France.
Tanquerel, Ludovic
  • National Veterinary School of Alfort, 7 Avenue du Gu00e9nu00e9ral de Gaulle, 94700 Maisons-Alfort, France.

Conflict of Interest Statement

Declaration of Competing Interest None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper.

Citations

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