Pulsed delivery of inhaled nitric oxide counteracts hypoxaemia during 2.5 hours of inhalation anaesthesia in dorsally recumbent horses.
Abstract: The study aimed to investigate the effect of varying pulse lengths of inhaled nitric oxide (iNO), and 2.5 hours of continuous pulse-delivered iNO on pulmonary gas exchange in anaesthetized horses. Methods: Experimental study. Methods: Six Standardbred horses. Methods: Horses received acepromazine, detomidine, guaifenesin, thiopentone and isoflurane in oxygen, were positioned in dorsal recumbency and were breathing spontaneously. iNO was on average pulsed during the first 20, 30, 43 or 73% of the inspiration in 15 minute steps. The pulse length that corresponded to the highest (peak) partial pressure of arterial oxygen (PaO(2) ) in the individual horses was determined and delivered for a further 1.5 hours. Data measured or calculated included arterial and mixed venous partial pressures of O(2) and CO(2) , heart rate, respiratory rate, expired minute ventilation, pulmonary and systemic arterial mean pressures, cardiac output and venous admixture. Data (mean ± SD) was analysed using anova with p < 0.05 considered significant. Results: Although the pulse length of iNO that corresponded to peak PaO(2) varied between horses, administration of all pulse lengths of iNO increased PaO(2) compared to baseline. The shortest pulse lengths that resulted in the peak PaO(2) were 30 and 43% of the inspiration. Administration of iNO increased PaO(2) (12.6 ± 4.1 kPa [95 ± 31 mmHg] at baseline to a range of 23.0 ± 8.4 to 25.3 ± 9.0 kPa [173 to 190 mmHg]) and PaCO(2) (8.5 ± 1.2 kPa [64 ± 9 mmHg] to 9.8 ± 1.5 kPa [73 ± 11 mmHg]) and decreased venous admixture from 32 ± 6% to 25 ± 6%. The increase in PaO(2) and decrease in venous admixture was sustained for the entire 2.5 hours of iNO delivery. Conclusions: The improvement in arterial oxygenation during pulsed delivery of iNO was significant and sustained throughout 2.5 hours of anaesthesia. Conclusions: Pulsed iNO potentially could be used clinically to counteract hypoxemia in anaesthetized horses.
© 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.
Publication Date: 2012-05-30 PubMed ID: 22642513DOI: 10.1111/j.1467-2995.2012.00740.xGoogle Scholar: Lookup
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- Clinical Trial
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research examines the impacts of various pulse lengths of inhaled nitric oxide (iNO) on the pulmonary gas exchange in anaesthetized horses over a time period of 2.5 hours and its potential clinical use against hypoxemia.
Methodology
- The experimental design involved six Standardbred horses. These horses were given various sedative and anesthetic drugs, including acepromazine, detomidine, guaifenesin, thiopentone, and were maintained on isoflurane in oxygen.
- Once sedated and anaesthetized, horses were laid on their backs and were left to breathe on their own.
- iNO was pulsed during different durations of ingestion, namely the first 20, 30, 43, or 73% of the inspiration spanning 15-minute steps. The pulse length that produced the highest arterial oxygen pressure (PaO(2)) was recorded.
- This optimal pulse length was then maintained for an additional 1.5 hours.
- Throughout the procedure, various measures were recorded or calculated, such as arteries and mixed venous partial pressures of oxygen (O2) and carbon dioxide (CO2), heart rate, respiratory rate, expired minute ventilation, pulmonary and systemic arterial mean pressures, cardiac output, and venous admixture.
Results
- Although the optimal pulse length of iNO varied among horses, all pulse lengths boosted PaO(2) from their baseline levels.
- The administration of iNO escalated PaO(2) and PaCO(2) levels, and decreased venous admixture.
- The shortest pulse lengths that reached the highest PaO(2) were 30 and 43% of the inspiration.
- The enhancements in PaO(2) and reductions in venous admixture lasted the whole duration of the iNO delivery, a total of 2.5 hours.
Conclusions
- The significant and persistent improvement in arterial oxygenation during pulsed delivery of iNO was noted throughout the 2.5 hours of anaesthesia.
- Given these findings, pulsed iNO could be potentially incorporated in clinical practices to counteract hypoxemia in anaesthetized horses.
Cite This Article
APA
Nyman G, Grubb TL, Heinonen E, Frendin J, Edner A, Malavasi LM, Frostell C, Högman M.
(2012).
Pulsed delivery of inhaled nitric oxide counteracts hypoxaemia during 2.5 hours of inhalation anaesthesia in dorsally recumbent horses.
Vet Anaesth Analg, 39(5), 480-487.
https://doi.org/10.1111/j.1467-2995.2012.00740.x Publication
Researcher Affiliations
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden. gorel.nyman@slu.se
MeSH Terms
- Anesthetics / administration & dosage
- Anesthetics / pharmacology
- Animals
- Drug Administration Schedule
- Female
- Horses
- Hypoxia / drug therapy
- Hypoxia / veterinary
- Male
- Nitric Oxide / administration & dosage
- Nitric Oxide / pharmacology
- Pulmonary Gas Exchange / drug effects
- Respiratory Therapy / veterinary
Citations
This article has been cited 3 times.- 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).
- Stefanik E, Drewnowska O, Lisowska B, Turek B. Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia. Animals (Basel) 2021 Jul 9;11(7).
- Pickerodt PA, Hofferberth MBT, Busch T, Russ M, Taher M, Boemke W, Weber-Carstens S, Köbrich R, Swenson E, Deja M, Francis RCE. In vitro validation and characterization of pulsed inhaled nitric oxide administration during early inspiration. J Clin Monit Comput 2022 Jun;36(3):637-648.
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