Retrospective study of the changes in dynamic compliance and ventilation/perfusion mismatch following salbutamol inhalation in hypoxaemic mechanically ventilated anaesthetized horses.
Abstract: To study the changes in dynamic compliance (C), ventilation/perfusion (V˙/ Q˙) mismatch and haemodynamic variables in hypoxaemic anaesthetized horses whose PaO increased following salbutamol inhalation. Methods: Retrospective, clinical, cohort study. Methods: A group of 73 client-owned horses treated with salbutamol when PaO <100 mmHg (13.3 kPa) during anaesthesia. Methods: Horses were divided into two groups: responders (R), where PaO after salbutamol ≥1.2 PaO before treatment (i.e. ≥20% increase), and non-responders (NR), where PaO after salbutamol <1.2 PaO before treatment. Demographic data and intraoperative variables before treatment were compared between R and NR. C, arterial to end-tidal carbon dioxide difference [P(a-E´)CO], estimated ratio of dead space to tidal volume (est.V/V), estimated shunt fraction (F-shunt), heart rate, systolic, mean and diastolic arterial pressure and dobutamine requirements were compared before and after treatment within R and NR. For each variable, the difference (Δ) between values pre- and posttreatment was calculated and compared between groups R and NR. Numerical data were compared using univariate or bivariate analysis and categorical data were compared using chi-square test; p < 0.05. Results: Of the 73 horses 50 were classified as R while 23 horses were classified as NR. There was no statistical difference between R and NR for demographic data or initial intraoperative variables except for body weight [R: 531 (170-715) kg, NR: 540 (420-914) kg]. While salbutamol did not alter C in either group, it significantly decreased P(a-E´)CO, est.V/V and F-shunt in R only. ΔP(a-E´)CO, Δest.V/V and ΔF-shunt were significantly greater in R (-17.8%, -19.0% and -24.1%, respectively) than in NR (11.5%, 6.6% and -0.3%, respectively). Conclusions: In hypoxaemic anaesthetized horses responding to inhaled salbutamol by a ≥1.2 increase in PaO no change in C was detected, but indicators of V˙/ Q˙ mismatch improved.
Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
Publication Date: 2024-06-18 PubMed ID: 39142981DOI: 10.1016/j.vaa.2024.06.008Google Scholar: Lookup
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Summary
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The research article presents a retrospective study on the effects of salbutamol inhalation on the dynamic compliance and ventilation/perfusion mismatch in hypoxemic, anaesthetized horses. The research shows that horses that responded positively to salbutamol inhalation showed improved indicators in ventilation/perfusion mismatch but without changes in their dynamic compliance.
Understanding the Study
- The study was conducted to observe changes in dynamic compliance (a measure of lung elasticity), ventilation/perfusion mismatch (imbalance between alveolar ventilation and pulmonary capillary blood flow), and hemodynamic variables in horses suffering from low oxygen levels induced by anaesthesia and treated with salbutamol, a bronchodilator.
- A retrospective, clinical cohort study method was used wherein data was collected from past cases; in this case, the researchers used data from 73 client-owned horses that were treated with salbutamol.
Group Division and Comparison
- The horses were divided into two groups: responders (R) and non-responders (NR). Responders were the horses that showed a ≥20% increase in arterial oxygen tension (PaO) after salbutamol inhalation, and the non-responders were the horses that showed less than a 20% increase.
- The researchers compared demographic data (such as age, sex, and breed) and recorded intraoperative variables before treatment between both groups. They also compared several physiological variables such as dynamic compliance, arterial to end-tidal carbon dioxide difference, estimated ratio of dead space to tidal volume, estimated shunt fraction, heart rate, blood pressure, and requirement for dobutamine (a drug used to treat heart failure and low blood pressure) before and after the salbutamol treatment within each group.
Results
- Out of the total, 50 horses were classified as responders while 23 horses were classified as non-responders. No significant differences were found between responders and non-responders in terms of demographic data or initial intraoperative variables. The only exception being body weight, which was slightly higher in the non-responders group.
- Although salbutamol inhalation did not alter the dynamic compliance in either group, it significantly reduced the arterial to end-tidal carbon dioxide difference, estimated ratio of dead space to tidal volume, and estimated shunt fraction in only the responders group.
Conclusion
- The conclusion drawn from the study was that, in horses suffering from hypoxemia during anesthesia, an increase in arterial oxygen tension by at least 20% after administering inhaled salbutamol was not associated with any changes in dynamic compliance. However, indicators of ventilation/perfusion mismatch showed improvement.
Cite This Article
APA
Dupont J, Roman Dura B, Salciccia A, Serteyn D, Sandersen C.
(2024).
Retrospective study of the changes in dynamic compliance and ventilation/perfusion mismatch following salbutamol inhalation in hypoxaemic mechanically ventilated anaesthetized horses.
Vet Anaesth Analg, S1467-2987(24)00119-3.
https://doi.org/10.1016/j.vaa.2024.06.008 Publication
Researcher Affiliations
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium. Electronic address: julien.dupont@ulg.ac.be.
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.
- Department of Clinical Sciences, Anesthesiology and Equine Surgery, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.
Citations
This article has been cited 1 times.- Román Durá B, Dunham O, Grulke S, Salciccia A, Dupont J, Sandersen C. A Retrospective Study on Pre- and Intraoperative Predictors on the Recovery Quality of Horses After General Anesthesia. Vet Sci 2025 Mar 11;12(3).
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