Effects of inspired oxygen concentration on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses

Mariana N. Crumley Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Rose M. McMurphy Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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David S. Hodgson Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Scott E. Kreider Department of Statistics, College of Arts and Science, Kansas State University, Manhattan, KS 66506.

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Abstract

Objective—To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses.

Animals—8 healthy adult horses.

Procedures—In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% oxygen for 90 minutes. Measurements obtained during anesthesia included inspiratory and expiratory peak flow and duration, tidal volume, respiratory frequency, end-tidal CO2 concentration, mixed expired partial pressures of CO2 and O2, Pao2, Paco2, blood pH, arterial O2 saturation, heart rate, and arterial blood pressure. Calculated values included the alveolar partial pressure of oxygen, alveolar-to-arterial oxygen tension gradient (Pao2 − Pco2), rate of change of Pao2 − Pao2, and physiologic dead space ratio. Ventilatory rhythm, based on respiratory rate and duration of apnea, was continuously observed and recorded.

Results—Use of the lower inspired oxygen fraction of 50% resulted in a lower arterial oxygen saturation and Pao2 than did use of the higher fraction. No significant difference in Paco2, rate of change of Pao2 − Pao2, ventilatory rhythm, or other measured variables was observed between the 2 sessions.

Conclusion and Clinical Relevance—Use of 50% inspired oxygen did not improve the ventilatory rhythm or gas exchange and increased the risk of hypoxemia in spontaneously breathing horses during isoflurane anesthesia. Use of both inspired oxygen fractions requires adequate monitoring and the capacity for mechanical ventilation.

Abstract

Objective—To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses.

Animals—8 healthy adult horses.

Procedures—In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% oxygen for 90 minutes. Measurements obtained during anesthesia included inspiratory and expiratory peak flow and duration, tidal volume, respiratory frequency, end-tidal CO2 concentration, mixed expired partial pressures of CO2 and O2, Pao2, Paco2, blood pH, arterial O2 saturation, heart rate, and arterial blood pressure. Calculated values included the alveolar partial pressure of oxygen, alveolar-to-arterial oxygen tension gradient (Pao2 − Pco2), rate of change of Pao2 − Pao2, and physiologic dead space ratio. Ventilatory rhythm, based on respiratory rate and duration of apnea, was continuously observed and recorded.

Results—Use of the lower inspired oxygen fraction of 50% resulted in a lower arterial oxygen saturation and Pao2 than did use of the higher fraction. No significant difference in Paco2, rate of change of Pao2 − Pao2, ventilatory rhythm, or other measured variables was observed between the 2 sessions.

Conclusion and Clinical Relevance—Use of 50% inspired oxygen did not improve the ventilatory rhythm or gas exchange and increased the risk of hypoxemia in spontaneously breathing horses during isoflurane anesthesia. Use of both inspired oxygen fractions requires adequate monitoring and the capacity for mechanical ventilation.

Contributor Notes

Dr. Crumley's present address is Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348.

Mr. Kreider's present address is Research Department, Craig Hospital, 3425 S Clarkson St, Englewood, CO 80113.

Supported by a Kansas State University College of Veterinary Medicine Mentored Clinical, Applied, or Transitional Research Grant.

Presented in abstract form at the 17th Annual International Veterinary Emergency and Critical Care Symposium, Nashville, Tenn, September 2011.

Address correspondence to Dr. Crumley (mariana.crumley@yahoo.com).
  • 1. Steffey EP, Howland D Jr. Comparison of circulatory and respiratory effects of isoflurane and halothane anesthesia in horses. Am J Vet Res 1980; 41: 821825.

    • Search Google Scholar
    • Export Citation
  • 2. Cuvelliez SG, Eicker SW, McLauchlan C, et al. Cardiovascular and respiratory effects of inspired oxygen fraction in halothane-anesthetized horses. Am J Vet Res 1990; 51: 12261231.

    • Search Google Scholar
    • Export Citation
  • 3. Hall LW, Gillespie JR, Tyler WS. Alveolar-arterial oxygen tension differences in anaesthetized horses. Br J Anaesth 1968; 40: 560568.

  • 4. Gillespie JR, Tyler WS, Hall LW. Cardiopulmonary dysfunction in anesthetized, laterally recumbent horses. Am J Vet Res 1969; 30: 6172.

    • Search Google Scholar
    • Export Citation
  • 5. Nyman G, Hedenstierna G. Ventilation-perfusion relationships in the anaesthetised horse. Equine Vet J 1989; 21: 274281.

  • 6. Steffey EP, Hodgson DS, Dunlop CI, et al. Cardiopulmonary function during 5 hours of constant-dose isoflurane in laterally recumbent, spontaneously breathing horses. J Vet Pharmacol Ther 1987; 10: 290297.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Steffey EP, Dunlop CI, Farver TB, et al. Cardiovascular and respiratory measurements in awake and isoflurane-anesthetized horses. Am J Vet Res 1987; 48: 712.

    • Search Google Scholar
    • Export Citation
  • 8. Hodgson DS, Steffey EP, Grandy JL, et al. Effects of spontaneous, assisted, and controlled ventilatory modes in halothane-anesthetized geldings. Am J Vet Res 1986; 47: 992996.

    • Search Google Scholar
    • Export Citation
  • 9. Marntell S, Nyman G, Hedenstierna G. High inspired oxygen concentrations increase intrapulmonary shunt in anaesthetized horses. Vet Anaesth Analg 2005; 32: 338347.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. De Moor A, Desmet P, Verschooten F. Influence of change of body position on arterial oxygenation and acid-base status in the horse in lateral recumbency, anesthetized with halothane and efficiency of postanesthetic oxygen administration. Zentralbl Veterinarmed A 1974; 21: 525531.

    • Search Google Scholar
    • Export Citation
  • 11. Weaver BM, Walley RV. Ventilation and cardiovascular studies during mechanical control of ventilation in horses. Equine Vet J 1975; 7: 915.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Hedenstierna G. Airway closure, atelectasis, and gas exchange during anesthesia. Minerva Anesthesiol. 2002; 68: 332336.

  • 13. Lindberg P, Gunnarsson L, Tokics L, et al. Atelectasis and lung function in the postoperative period. Acta Anaesthesiol Scand 1992; 36: 546553.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Benoît Z, Wicky S, Fischer JF, et al. The effect of increased Fio(2) before tracheal extubation on postoperative atelectasis. Anesth Analg 2002; 95: 17771781.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. van Kaam AH, Lachmann RA, Herting E, et al. Reducing atelectasis attenuates bacterial growth and translocation in experimental pneumonia. Am J Respir Crit Care Med 2004; 169: 10461053.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Rothen HU, Sporre B, Engberg G, et al. Influence of gas composition on recurrence of atelectasis after a reexpansion maneuver during general anesthesia. Anesthesiology 1995; 82: 832842.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17. Staffieri F, De Monte V, De Marzo C, et al. Effects of two fractions of inspired oxygen on lung aeration and gas exchange in cats under inhalant anaesthesia. Vet Anaesth Analg 2010; 37: 483490.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Staffieri F, Franchini D, Carella GL, et al. A computed tomographic analysis of the effects of two inspired oxygen concentrations on pulmonary aeration in anesthetized and mechanically ventilated dogs. Am J Vet Res 2007; 68: 925931.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Staffieri F, Bauquier SH, Moate PJ, et al. Pulmonary gas exchange in anaesthetised horses mechanically ventilated with oxygen or a helium/oxygen mixture. Equine Vet J 2009; 41: 747752.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Hedenstierna G, Lundquist H, Lundh B, et al. Pulmonary densities during anaesthesia. An experimental study on lung morphology and gas exchange. Eur Respir J 1989; 2: 528535.

    • Search Google Scholar
    • Export Citation
  • 21. Lumb AB. Distribution of pulmonary ventilation and perfusion. In: Fam P, Andjelkovic N, eds. Nunn's applied respiratory physiology. 6th ed. Philadelphia: Butterwoth-Heinemann Elsevier, 2007;110124.

    • Search Google Scholar
    • Export Citation
  • 22. Putt M, Chinchilli VM. A mixed effects model for the analysis of repeated measures cross-over studies. Stat Med 1999; 18: 30373058.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Nyman G, Funkquist B, Kvart C, et al. Atelectasis causes gas exchange impairment in the anaesthetised horse. Equine Vet J 1990; 22: 317324.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24. Hedenstierna G. Alveolar collapse and closure of airways: regular effects of anaesthesia. Clin Physiol Funct Imaging 2003; 23: 123129.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Torda TA. Alveolar-arterial oxygen tension difference: a critical look. Anaesth Intensive Care 1981; 9: 326330.

  • 26. McDonell WN, Hall LW, Jeffcott LB. Radiographic evidence of impaired pulmonary function in laterally recumbent anaesthetised horses. Equine Vet J 1979; 11: 2432.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Hubbell JA, Aarnes TK, Bednarski RM, et al. Effect of 50% and maximal inspired oxygen concentrations on respiratory variables in isoflurane-anesthetized horses. BMC Vet Res 20113; 7:23.

    • Search Google Scholar
    • Export Citation
  • 28. Steffey EP, Kelly AB, Woliner MJ. Time-related responses of spontaneously breathing, laterally recumbent horses to prolonged anesthesia with halothane. Am J Vet Res 1987; 48: 952957.

    • Search Google Scholar
    • Export Citation
  • 29. Day TK, Gaynor JS, Muir WW III, et al. Blood gas values during intermittent positive pressure ventilation and spontaneous ventilation in 160 anesthetized horses positioned in lateral or dorsal recumbency. Vet Surg 1995; 24: 266276.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Hopster K, Kästner SB, Rohn K, et al. Intermittent positive pressure ventilation with constant positive end-expiratory pressure and alveolar recruitment manoeuvre during inhalation anaesthesia in horses undergoing surgery for colic, and its influence on the early recovery period. Vet Anaesth Analg 2011; 38: 169177.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. Wilson DV, Soma LR. Cardiopulmonary effects of positive end-expiratory pressure in anesthetized, mechanically ventilated ponies. Am J Vet Res 1990; 51: 734739.

    • Search Google Scholar
    • Export Citation
  • 32. Magnusson L, Tenling A, Lemoine R, et al. The safety of one, or repeated, vital capacity maneuvers during general anesthesia. Anesth Analg 2000; 91: 702707.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33. Mason DE, Muir WW, Wade A. Arterial blood gas tensions in the horse during recovery from anesthesia. J Am Vet Med Assoc 1987; 190: 989994.

    • Search Google Scholar
    • Export Citation
  • 34. McMurphy RM, Cribb PH. Alleviation of postanesthetic hypoxemia in the horse. Can Vet J 1989; 30: 3741.

  • 35. Grandy JL, Hodgson DS, Dunlop CL, et al. Cardiopulmonary effects of ephedrine in halothane-anesthetized horses. J Vet Pharmacol Ther 1989; 12: 389396.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36. Swanson CR, Muir WW III, Bednarski RM, et al. Hemodynamic response in halothane-anesthetized horses given infusions of dopamine or dobutamine. Am J Vet Res 1985; 46: 365370.

    • Search Google Scholar
    • Export Citation
  • 37. Moens Y, Lagerweij E, Gootjes P, et al. Influence of tidal volume and positive end-expiratory pressure on inspiratory gas distribution and gas exchange during mechanical ventilation in horses positioned in lateral recumbency. Am J Vet Res 1998; 59: 307312.

    • Search Google Scholar
    • Export Citation

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