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Equine veterinary journal2025; doi: 10.1111/evj.14487

Prevalence and degree of orotracheal intubation-related tracheal lesions in horses.

Abstract: Orotracheal intubation is commonly performed for inhalation anaesthesia in horses to ensure safe and reliable administration of volatile anaesthetics and to secure the airways. In human and equine medicine, the occurrence of intubation-associated complications has been described, which can range from mild mucosal irritation to severe necrosis. However, there are only sparse descriptions of mucosal alterations and the course of healing after elective surgery in horses. Objective: To investigate the prevalence and severity of tracheal lesions following endotracheal intubation associated with general anaesthesia in equine patients. Methods: Prospective, clinical study. Methods: Forty adult Warmblood horses, weighing 400-600 kg, presented for elective surgery under general anaesthesia were included. For orotracheal intubation, a silicone tube was used and inflated until a cuff pressure of 40 cmHO was confirmed. In all horses, endoscopic examination of the trachea with video documentation was performed prior to intubation and immediately after extubation, as well as 1, 3, 5 and 7 days after general anaesthesia. The type (redness, secretion, bleeding, erosions) and degree (0 = non-existent to 4 = severe) of corresponding lesions were assessed and scored. The occurrences of clinical signs were recorded. Statistical evaluation was performed using Friedman's test and Pearson correlation. Results: The median score immediately after recovery from anaesthesia was 6 (2-12) and increased significantly to 11 (4-15) after 1 day (p = 0.021). At day 7, the median score was 0 (0-2) with only four horses showing signs of mild tracheitis, and clinical signs were not observed throughout this time period. The duration of intubation correlated with the degree of tracheal damage (r = 0.67, p < 0.001). Conclusions: Clinical, non-randomised study without a control group. Conclusions: Although orotracheal intubation was accompanied by focal inflammation of the trachea, in the present study no horses showed clinical signs and lesions healed within a week.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-02-18 PubMed ID: 39967273DOI: 10.1111/evj.14487Google 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.

This research study explored the prevalence and severity of tracheal (the windpipe) damage in horses attributed to orotracheal intubation, a procedure performed during anesthesia administration. Findings showed that, while the procedure does cause localized inflammation, these effects largely resolve within a week without causing noticeable clinical symptoms.

Research Objective

The aim of the research was to investigate the frequency and severity of tracheal damage in horses related to the use of orotracheal intubation in anesthesia administration during surgery. Despite the commonality of the procedure, prior to this study, there was minimal data documenting how the horse’s mucous membranes, the moist lining of certain body cavities, recovered following intubation.

Methodology

  • The researchers conducted a prospective clinical study involving forty adult Warmblood horses, each weighing between 400 to 600 kg.
  • A silicone tube used for the intubation was inflated until a cuff pressure of 40 cmHO was confirmed.
  • Each horse underwent endoscopic examinations of their trachea with video documentation before intubation and immediately after extubation. Follow-ups took place 1, 3, 5, and 7 days after anesthesia.
  • The team examined the type and severity of lesions (damage to the tissue) incurred, scoring them from a range of 0 (non-existent) to 4 (severe).
  • Any clinical symptoms during the period of study were also documented.
  • Friedman’s test and Pearson correlation were used for statistical evaluation.

Results

  • Immediately after recovery from anesthesia, the median damage score was 6, which significantly escalated to 11 after 1 day.
  • By the 7th day, the median score dropped to zero with only four horses showing minor signs of tracheitis (inflammation of the trachea). However, no clinical symptoms were observed during this period.
  • There was a statistically significant correlation between the duration of intubation and the degree of tracheal damage.

Conclusion

Although orotracheal intubation does lead to localized inflammation of the trachea, no horses showed clinical signs and lesions healed completely within a week. The research is non-randomized and doesn’t have a control group. Even though the procedure leads to temporary discomfort, these findings suggest it’s a comparatively safe practice.

Cite This Article

APA
Parente A, Geburek F, Kästner S, Iversen C, Hopster K. (2025). Prevalence and degree of orotracheal intubation-related tracheal lesions in horses. Equine Vet J. https://doi.org/10.1111/evj.14487

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Parente, Aiden
  • New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Geburek, Florian
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
Kästner, Sabine
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
Iversen, Charlotte
  • Department of Veterinary Clinical Studies, University of Copenhagen, Copenhagen, Denmark.
Hopster, Klaus
  • New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.

Grant Funding

  • University of Veterinary Medicine Hannover, Foundation, Clinic for Horses

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