• 1.

    Palmer JE. Ventilatory support of the critically ill foal. Vet Clin North Am Equine Pract 2005; 21: 457486.

  • 2.

    Soubani AO. Noninvasive monitoring of oxygen and carbon dioxide. Am J Emerg Med 2001; 19: 141146.

  • 3.

    Geiser DR, Rohrbach BW. Use of end-tidal CO2 tension to predict arterial CO2 values in isoflurane-anesthetized equine neonates. Am J Vet Res 1992; 53: 16171621.

    • Search Google Scholar
    • Export Citation
  • 4.

    Hopkins SR, Bayly WM, Slocombe RF, et al. Effect of prolonged heavy exercise on pulmonary gas exchange in horses. J Appl Physiol 1998; 84: 17231730.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Kelmer E, Scanson LC, Reed A, et al. Agreement between values for arterial and end-tidal partial pressures of carbon dioxide in spontaneously breathing, critically ill dogs. J Am Vet Med Assoc 2009; 235: 13141318.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Moses JM, Alexander JL, Agus MS. The correlation and level of agreement between end-tidal and blood gas Pco2 in children with respiratory distress: a retrospective analysis. BMC Pediatr [serial online] 2009; 9:20. Available at: www.biomedcentral.com/1471-2431/9/20. Accessed Aug 10, 2010.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Schmitz BD, Shapiro BA. Capnography. Respir Care Clin North Am 1995; 1: 107117.

  • 8.

    Raffe M. Oximetry and capnography In: Wingfield W, Raffe M, eds. The veterinary ICU book. Jackson, WY: Teton NewMedia, 2002;8695.

  • 9.

    Amuchou Singh S, Singhal N. Does end-tidal carbon dioxide measurement correlate with arterial carbon dioxide in extremely low birth weight infants in the first week of life? Indian Pediatr 2006; 43: 2025.

    • Search Google Scholar
    • Export Citation
  • 10.

    Barton CW, Wang ES. Correlation of end-tidal CO2 measurements to arterial Paco2 in nonintubated patients. Ann Emerg Med 1994; 23: 560563.

  • 11.

    Cheng KI, Tang CS, Tsai EM, et al. Correlation of arterial and end-tidal carbon dioxide in spontaneously breathing patients during ambulatory gynecologic laparoscopy. J Formos Med Assoc 1999; 98: 814819.

    • Search Google Scholar
    • Export Citation
  • 12.

    Sinex JE. Pulse oximetry: principles and limitations. Am J Emerg Med 1999; 17: 5967.

  • 13.

    Chaffin MK, Matthews NS, Cohen ND, et al. Evaluation of pulse oximetry in anaesthetised foals using multiple combinations of transducer type and transducer attachment site. Equine Vet J 1996; 28: 437445.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Smale K, Anderson LS, Butler PJ. An algorithm to describe the oxygen equilibrium curve for the Thoroughbred racehorse. Equine Vet J 1994; 26: 500502.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307310.

  • 16.

    Ambalavanan N, Carlo WA. Hypocapnia and hypercapnia in respiratory management of newborn infants. Clin Perinatol 2001; 28: 517531.

  • 17.

    Jankov RP, Tanswell AK. Hypercapnia and the neonate. Acta Paediatr 2008; 97: 15021509.

  • 18.

    Giguere S, Slade JK, Sanchez LC. Retrospective comparison of caffeine and doxapram for the treatment of hypercapnia in foals with hypoxic-ischemic encephalopathy. J Vet Intern Med 2008; 22: 401405.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Vaala WE. Peripartum asphyxia. Vet Clin North Am Equine Pract 1994; 10: 187218.

  • 20.

    Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135160.

  • 21.

    Meyer RE, Short CE. Arterial to end-tidal CO2 tension and alveolar dead space in halothane- or isoflurane-anesthetized ponies. Am J Vet Res 1985; 46: 597599.

    • Search Google Scholar
    • Export Citation
  • 22.

    Cribb PH. Capnographic monitoring during anesthesia with controlled ventilation in the horse. Vet Surg 1988; 17: 4852.

  • 23.

    Koenig J, McDonell W, Valverde A. Accuracy of pulse oximetry and capnography in healthy and compromised horses during spontaneous and controlled ventilation. Can J Vet Res 2003; 67: 169174.

    • Search Google Scholar
    • Export Citation
  • 24.

    Choudhury M, Kiran U, Choudhary SK, et al. Arterial-to-endtidal carbon dioxide tension difference in children with congenital heart disease. J Cardiothorac Vasc Anesth 2006; 20: 196201.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Hagerty JJ, Kleinman ME, Zurakowski D, et al. Accuracy of a new low-flow sidestream capnography technology in newborns: a pilot study. J Perinatol 2002; 22: 219225.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Short JA, Paris ST, Booker PD, et al. Arterial to end-tidal carbon dioxide tension difference in children with congenital heart disease. Br J Anaesth 2001; 86: 349353.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Taniguchi S, Irita K, Sakaguchi Y, et al. Arterial to end-tidal CO2 gradient as an indicator of silent pulmonary embolism. Lancet 1996; 348:1451.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Thys F, Elamly A, Marion E, et al. Paco(2)/etco(2) gradient: early indicator of thrombolysis efficacy in a massive pulmonary embolism. Resuscitation 2001; 49: 105108.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    McNulty SE, Roy J, Torjman M, et al. Relationship between arterial carbon dioxide and end-tidal carbon dioxide when a nasal sampling port is used. J Clin Monit 1990; 6: 9398.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Takano Y, Sakamoto O, Kiyofuji C, et al. A comparison of the end-tidal CO2 measured by portable capnometer and the arterial Pco2 in spontaneously breathing patients. Respir Med 2003; 97: 476481.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Severinghaus JW. Water vapor calibration errors in some capnometers: respiratory conventions misunderstood by manufacturers? Anesthesiology 1989; 70: 996998.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Fletcher R, Jonson B, Cumming G, et al. The concept of dead-space with special reference to the single breath test for carbon dioxide. Br J Anaesth 1981; 53: 7788.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Marino PL. Oximetry and capnography In: Marino PL, ed. The ICU book. Philadelphia: Lippincott Williams & Wilkins, 1998;355370.

  • 34.

    Matthews NS, Hartke S & Allen JC Jr. An evaluation of pulse oximeters in dogs, cats and horses. Vet Anaesth Analg 2003; 30: 314.

  • 35.

    Watney GC, Norman WM, Schumacher JP, et al. Accuracy of a reflectance pulse oximeter in anesthetized horses. Am J Vet Res 1993; 54: 497501.

    • Search Google Scholar
    • Export Citation
  • 36.

    Whitehair KJ, Watney GC, Leith DE, et al. Pulse oximetry in horses. Vet Surg 1990; 19: 243248.

  • 37.

    Matthews NS, Hartsfield SM, Sanders EA, et al. Evaluation of pulse oximetry in horses surgically treated for colic. Equine Vet J 1994; 26: 114116.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Hackett TB. Pulse oximetry and end tidal carbon dioxide monitoring. Vet Clin North Am Small Anim Pract 2002; 32: 10211029.

  • 39.

    Casati A, Gallioli G, Passaretta R, et al. End tidal carbon dioxide monitoring in spontaneously breathing, nonintubated patients. A clinical comparison between conventional sidestream and microstream capnometers. Minerva Anestesiol 2001; 67: 161164.

    • Search Google Scholar
    • Export Citation
  • 40.

    Keogh BF, Kopotic RJ. Recent findings in the use of reflectance oximetry: a critical review. Curr Opin Anaesthesiol 2005; 18: 649654.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

Agreement between arterial partial pressure of carbon dioxide and saturation of hemoglobin with oxygen values obtained by direct arterial blood measurements versus noninvasive methods in conscious healthy and ill foals

David M. Wong DVM, MS, DACVIM, DACVECC1, Cody J. Alcott DVM, DACVIM2, Chong Wang PhD3, Jennifer L. Bornkamp DVM4, Jessica L. Young DVM5, and Brett A. Sponseller DVM, PhD, DACVIM6
View More View Less
  • 1 Lloyd Veterinary Medical Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 2 Lloyd Veterinary Medical Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 3 Department of Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 4 Lloyd Veterinary Medical Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 5 Lloyd Veterinary Medical Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 6 Lloyd Veterinary Medical Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

Abstract

Objective—To investigate tissue diffusion of anesthetic agent following administration of low palmar nerve blocks (LPBs) in horses.

Design—Randomized clinical trial.

Animals—12 adult horses.

Procedures—In 9 horses, mepivacaine hydrochloride–iohexol (50:50 dilution) injections were administered bilaterally (2 or 4 mL/site) to affect the medial and lateral palmar and palmar metacarpal nerves (4 sites). Lateral radiographic views of both metacarpal regions were obtained before and at 5, 15, 30, 60, 90, and 120 minutes after block administration; proximal and distal extents of contrast medium (and presumably anesthetic agent) diffusion from palmar and palmar metacarpal injection sites were measured and summed to determine total diffusion. Methylene blue solution was injected in forelimbs of 3 other horses that were subsequently euthanized to determine the potential route of anesthetic agent diffusion to the proximal suspensory ligament region.

Results—Mean extents of proximal and total contrast medium diffusion were 4.0 and 6.6 cm, respectively, for the palmar metacarpal nerves and 4.3 and 7.1 cm, respectively, for the palmar nerves. Subtle proximal diffusion secondary to lymphatic drainage was evident in 17 of the 18 limbs. Contrast medium was detected in the metacarpophalangeal joint or within the digital flexor tendon sheath in 8 and 7 limbs, respectively. In the cadaver limbs, methylene blue solution did not extend to the proximal suspensory ligament region.

Conclusions and Clinical Relevance—In horses, LPBs resulted in minimal proximal diffusion of anesthetic agent from the injection sites. Limbs should be aseptically prepared prior to LPB administration because inadvertent intrasynovial injection may occur.

Abstract

Objective—To investigate tissue diffusion of anesthetic agent following administration of low palmar nerve blocks (LPBs) in horses.

Design—Randomized clinical trial.

Animals—12 adult horses.

Procedures—In 9 horses, mepivacaine hydrochloride–iohexol (50:50 dilution) injections were administered bilaterally (2 or 4 mL/site) to affect the medial and lateral palmar and palmar metacarpal nerves (4 sites). Lateral radiographic views of both metacarpal regions were obtained before and at 5, 15, 30, 60, 90, and 120 minutes after block administration; proximal and distal extents of contrast medium (and presumably anesthetic agent) diffusion from palmar and palmar metacarpal injection sites were measured and summed to determine total diffusion. Methylene blue solution was injected in forelimbs of 3 other horses that were subsequently euthanized to determine the potential route of anesthetic agent diffusion to the proximal suspensory ligament region.

Results—Mean extents of proximal and total contrast medium diffusion were 4.0 and 6.6 cm, respectively, for the palmar metacarpal nerves and 4.3 and 7.1 cm, respectively, for the palmar nerves. Subtle proximal diffusion secondary to lymphatic drainage was evident in 17 of the 18 limbs. Contrast medium was detected in the metacarpophalangeal joint or within the digital flexor tendon sheath in 8 and 7 limbs, respectively. In the cadaver limbs, methylene blue solution did not extend to the proximal suspensory ligament region.

Conclusions and Clinical Relevance—In horses, LPBs resulted in minimal proximal diffusion of anesthetic agent from the injection sites. Limbs should be aseptically prepared prior to LPB administration because inadvertent intrasynovial injection may occur.

Contributor Notes

Address correspondence to Dr. Wong (dwong@iastate.edu).