Post-anesthetic pulmonary edema in two horses

Kaartinen, Johanna; Pang, Daniel S. J.; Cuvelliez, Sophie

doi:10.1111/j.1467-2995.2009.00505.x

Cited by 20 publications

(29 citation statements)

References 21 publications

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Section: Introductionmentioning

confidence: 99%

“…However, the type and manner in which IV fluids are administered affects fluid shifts between the vasculature and tissues, and may possibly contribute to the development of pulmonary and tissue edema. Though infrequent, post-anesthetic pulmonary edema in horses has been reported in several cases and is associated with increased morbidity (Kaartinen et al 2010). The Starling-Landis equation describes the net filtration of fluids out of capillaries as determined by the balance of capillary and interstitial hydrostatic pressure, and capillary and interstitial oncotic pressure (Starling 1896;Landis & Pappenheimer 1963).…”

Section: Introductionmentioning

confidence: 99%

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The effects of lactated Ringer’s solution (LRS) or LRS and 6% hetastarch on the colloid osmotic pressure, total protein and osmolality in healthy horses under general anesthesia

Wendt‐Hornickle

Snyder

Tang

et al. 2011

Veterinary Anaesthesia and Analgesia

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Objective To investigate changes in colloid osmotic pressure (COP), total protein (TP) and osmolality (OSM) during anesthesia in horses given intravenous lactated Ringer’s solution (LRS) or LRS and hetastarch (HES). Study design Prospective, clinical trial. Animals Fourteen horses presented for surgery. Mean age 8.3 ± 1.9 years; mean weight 452 ± 25 kg. Methods Horses were premedicated with xylazine intravenously (IV); anesthesia was induced with ketamine and diazepam IV, and maintained with sevoflurane. Butorphanol was administered IV with pre-medications or immediately after induction. Xylazine was administered IV for recovery if necessary. LRS was administered IV to all horses with a target rate of 5–10 mL kg−1 hour−1. Half of the horses also received 6% HES, 2.5 mL kg−1 over 1 hour in addition to LRS. Horses that received LRS only were considered the LRS group. Horses that received both LRS and HES were considered the LRS/HES group. Blood was drawn pre- and post-anesthesia, immediately following induction, and every 30 minutes throughout anesthesia. COP, TP and OSM were measured. Results COP and TP significantly decreased at similar rates for both treatment groups from pre-anesthetic values. Pre-anesthetic COP was significantly greater in the LRS group when compared to the LRS/HES group pre-, post- and throughout anesthesia. In the LRS group post-anesthetic OSM was significantly different than the pre-anesthesia value and that for the LRS/HES group. Conclusions and clinical relevance Administration of IV HES (2.5 mL kg−1, over 1 hour) in combination with LRS does not attenuate the decrease in COP typically seen during anesthesia with crystalloid administration alone. Based on these results, administration of HES at this rate and total volume would not be expected to prevent fluid shifts into the interstitium through its effects on COP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of lactated Ringer’s solution (LRS) or LRS and 6% hetastarch on the colloid osmotic pressure, total protein and osmolality in healthy horses under general anesthesia

Wendt‐Hornickle

Snyder

Tang

et al. 2011

Veterinary Anaesthesia and Analgesia

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“…Pulmonary edema is a relatively rare but severe postanesthetic complication in horses which mainly results from upper airway obstruction during recovery. Most often obstruction of the orotracheal tube or the nostrils (Kaartinen et al, 2010) is responsible for the symptoms. The latter is typically caused by nasal congestion (Ball und Trim, 1996;Borer, 2005) due to dependent position of the head in dorsal recumbency.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary edema at recovery after colic operation with in-situ nasogastric tube in a horse

Ko¹,

Graubner²,

Aloisio³

et al. 2011

Schweizer Archiv für Tierheilkunde

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After an uneventful general anesthesia, in a horse negative pressure pulmonary edema developed due to acute upper airway obstruction during the anesthetic recovery phase after colic surgery. No pathologic alteration of respiration was observed until the horse stood up and began suffocating. The horse had recovered with the nasogastric tube in situ. This, together with the postmortem diagnosis of laryngeal hemiplegia resulted in impairment of airflow through the larynx and development of pulmonary edema. Our objective is to alert clinicians about the possible hazard of recovery with an in-situ nasogastric tube.

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“…While RPE is proposed as one of the mechanisms contributing to equine post anaesthetic pulmonary oedema (Ball and Trim ; Kaartinen et al . ), it has not been reported following equine pleural drainage. Given that human RPE may be underdiagnosed when mild or asymptomatic, and when post procedure imaging is not performed (Feller‐Kopman et al .…”

Section: Introductionmentioning

confidence: 90%

Adverse effects of intrapleural instillation of tissue plasminogen activator in a horse: Suspected re‐expansion pulmonary oedema

McGorum

Stratford

Keen

et al. 2016

Equine Veterinary Education

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This case report describes a 5-year-old pregnant Warmblood mare that was being treated for fibrinous bacterial pleuropneumonia. Since initial attempts to drain and lavage both pleural cavities were ineffective due to the presence of extensive intrapleural fibrin loculations, recombinant human tissue plasminogen activator (tPA) was instilled into both pleural cavities, to promote fibrinolysis and improve drainage. Within 1-2 h of instilling tPA, the horse became distressed, with increasing dyspnoea, tachycardia, pleurodynia and hypoxaemia. At 4 h post tPA instillation, diffuse bilateral pulmonary oedema was evidenced by the onset of widespread audible inspiratory crackles and ultrasonographic ring-down artefacts. Ultrasonography demonstrated that tPA had induced pleural fibrinolysis, thereby removing the restrictive effects of pleural adhesions on lung motion and facilitating lung re-expansion. Re-expansion pulmonary oedema was suspected, although an adverse drug reaction could not be excluded. The complication resolved with nasal oxygen supplementation, and administration of frusemide, meloxicam, morphine and hydroxyethyl starch. Subsequent repetition of intrapleural tPA instillation and thoracic drainage had no apparent adverse effect. The mare was discharged from the hospital and subsequently foaled successfully. The pathogenesis, diagnosis and management of re-expansion pulmonary oedema are reviewed.

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Post-anesthetic pulmonary edema in two horses

Cited by 20 publications

References 21 publications

The effects of lactated Ringer’s solution (LRS) or LRS and 6% hetastarch on the colloid osmotic pressure, total protein and osmolality in healthy horses under general anesthesia

The effects of lactated Ringer’s solution (LRS) or LRS and 6% hetastarch on the colloid osmotic pressure, total protein and osmolality in healthy horses under general anesthesia

Pulmonary edema at recovery after colic operation with in-situ nasogastric tube in a horse

Adverse effects of intrapleural instillation of tissue plasminogen activator in a horse: Suspected re‐expansion pulmonary oedema

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