The effects of pulse-delivered inhaled nitric oxide on arterial oxygenation, ventilation-perfusion distribution and plasma endothelin-1 concentration in laterally recumbent isoflurane-anaesthetized horses.
Abstract: Anaesthetized horses commonly become hypoxaemic due to ventilation/perfusion (V·A/Q·) mismatch and increased pulmonary shunt fraction (Qs·/Qt·). Pulse-delivered inhaled nitric oxide may improve oxygenation but may increase plasma concentration of the potent vasoconstrictor, endothelin-1 (ET-1). Objectives: Study 1) compare arterial oxygen concentration (PaO2) and saturation (SaO2), calculated Qs·/Qt· and ET-1 concentration; and Study 2) assess V·A/Q· matching and measured Qs·/Qt· in isoflurane-anaesthetized horses in left lateral recumbency receiving pulse-delivered inhaled nitric oxide (PiNO group) or inhalant gas only (C group). Methods: Prospective research trial. Methods: Ten Healthy adult Standardbred horses. Two horses were anaesthestized in both groups in a random cross-over design with >4 weeks between studies. Methods: Study 1) Cardiopulmonary data including PaO2, SaO2, Qs·/Qt· and ET-1 concentration were measured or calculated prior to and at various points during PiNO administration in 6PiNO and 6C horses. Two-way repeated measures anova with Bonferroni significant difference test was used for data analysis with p < 0.05 considered significant. Study 2) V·A/Q· matching and Qs·/Qt· were determined using the multiple inert gas elimination technique in 3 horses. Data were collected after 60 minutes of anaesthesia without PiNO (baseline) and 15 minutes after PiNO was pulsed during the first 30%, and then the first 60%, of inspiration. Data were descriptive only. Results: Study 1) PaO2 and SaO2 were higher and calculated Qs·/Qt· was lower in the PiNO group than the C group at most time points. ET-1 was not different over time or between groups. Study 2) V·A/Q· matching and measured Qs·/Qt· were improved from baseline in all horses but PiNO60% provided no improvement when compared to PiNO30%. Conclusions: PiNO delivered in the initial portion of the inspiration effectively relieves hypoxaemia in anaesthetized horses by improving V·A/Q· matching and decreasing Qs·/Qt· without affecting ET-1.
© 2013 The Authors. Veterinary Anaesthesia and Analgesia © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.
Publication Date: 2013-04-20 PubMed ID: 23601237DOI: 10.1111/vaa.12037Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research examined the effects of pulse-delivered inhaled nitric oxide (PiNO) on oxygen concentration in the blood, distribution of ventilation and blood flow in the lungs, and endothelin-1 concentrations in anaesthetized horses. It found that PiNO effectively improved oxygenation and ventilation-perfusion matching, and lowered pulmonary shunt, without affecting levels of a potent vasoconstrictor known as endothelin-1.
Overview and Objectives of the Study
- This study examined the effects of pulse-delivered inhaled nitric oxide (PiNO) in anaesthetized horses. The use of PiNO is known to improve oxygenation, but it was unclear whether it would alter the concentrations of endothelin-1, a potent vasoconstrictor.
- The aim of the research was twofold. The first objective was to compare levels of oxygen in the blood, pulmonary shunt fraction, and endothelin-1 concentration. The second goal was to assess ventilation-perfusion (V·A/Q·) matching and pulmonary shunt in horses that were given PiNO or inhalant gas.
Methods and Sample Group
- The study was conducted on ten healthy adult Standardbred horses. A random cross-over design was used, with two horses being anaesthetized in both the PiNO and control groups, with more than 4 weeks gap between studies.
- Data was collected on cardiopulmonary performance, including oxygen levels in the blood, pulmonary shunt fraction, saturation of oxygen, and endothelin-1 concentration. Measures were taken both before and during the administration of PiNO.
- A method called the multiple inert gas elimination technique was employed to determine V·A/Q· matching and pulmonary shunt. Data were collected after 60 minutes of anaesthesia without PiNO, and then after 15 minutes of PiNO being administered during the first 30%, and then the first 60%, of inspiration.
Results and Conclusions of the Study
- The results showed that oxygen concentration and saturation in blood were higher and calculated pulmonary shunt was lower in the PiNO group compared to the control group. There was no significant difference in endothelin-1 concentration.
- When it came to V·A/Q· matching and measured pulmonary shunt, improvement from the baseline was seen in all horses. However, increasing the proportion of PiNO to 60% of inspiration did not show further improvement compared to 30%.
- In conclusion, the administration of PiNO effectively improved oxygenation and V·A/Q· matching, while reducing pulmonary shunt in anaesthetized horses without affecting endothelin-1 levels.
Cite This Article
APA
Grubb T, Frendin JH, Edner A, Funkquist P, Hedenstierna G, Nyman G.
(2013).
The effects of pulse-delivered inhaled nitric oxide on arterial oxygenation, ventilation-perfusion distribution and plasma endothelin-1 concentration in laterally recumbent isoflurane-anaesthetized horses.
Vet Anaesth Analg, 40(6), e19-e30.
https://doi.org/10.1111/vaa.12037 Publication
Researcher Affiliations
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, Skara, Sweden; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA.
MeSH Terms
- Anesthesia, Inhalation / methods
- Anesthesia, Inhalation / veterinary
- Anesthetics, Inhalation
- Animals
- Endothelin-1 / blood
- Female
- Horses / blood
- Horses / surgery
- Isoflurane
- Male
- Nitric Oxide / administration & dosage
- Oxygen / blood
- Ventilation-Perfusion Ratio / drug effects
Citations
This article has been cited 1 times.- Xia R, Xu J, Yin H, Wu H, Xia Z, Zhou D, Xia ZY, Zhang L, Li H, Xiao X. Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients.. Mediators Inflamm 2015;2015:238041.
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