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

Ko, Veres-Nyéki; Graubner, Claudia; Aloisio, F; Spadavecchia, Claudia

doi:10.1024/0036-7281/a000232

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…As a consequence, extravasa-tion of fluid can occur, leading to pulmonary oedema. 3 Veres-Nyèki et al 12 described pulmonary oedema in a horse during recovery due to acute upper airway obstruction, most likely caused by the nasogastric tube left in place during recovery and the left laryngeal hemiplegia that the horse suffered from. Additionally, pulmonary oedema has been described in a cat with elongation of the soft palate, which provoked an upper-way obstruction.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary and laryngeal oedema before induction of anaesthesia in a sheep

Ruíz‐López

Martens

Chantillon

et al. 2022

Vet Record Case Reports

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This case report describes the anaesthesia of a ram undergoing an exploratory laparotomy, which suffered from respiratory distress during the perioperative period. On the morning of surgery, the animal presented with oedematous ears, most likely caused by a tight-fitting muzzle that had been used for preoperative fasting. After sedation, a mild stridor was heard. During endotracheal intubation, a swollen larynx was observed, and a frothy discharge emerged through the endotracheal tube after placement. Most likely, the tight muzzle caused a partial obstruction of the nostrils, increasing the respiratory effort and causing an increase in the pressure gradient, which provoked laryngeal and pulmonary oedema. Treatment consisted of repeated suctioning of fluid from the endotracheal tube, furosemide, dexamethasone, mechanical ventilation with 100% oxygen during anaesthesia and oxygen supplementation during recovery. Despite moderately low arterial oxygen tension during anaesthesia, the animal recovered uneventfully and did not show further signs of respiratory distress.

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Section: Discussionmentioning

confidence: 99%

Pulmonary and laryngeal oedema before induction of anaesthesia in a sheep

Ruíz‐López

Martens

Chantillon

et al. 2022

Vet Record Case Reports

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“…Reported causes of this are traumatic intubation, 16 hypoxia of the CNS under general anaesthesia, 17 pre-existing unrecognised laryngeal hemiplegia, performance of a laryngeal surgery, hyperextension of the neck of prolonged duration in dorsal recumbency, 18 or obstruction caused by a nasogastric tube. 15 In these cases, the obstruction may not be witnessed during the recovery period, and the oedema can progress over minutes or hours and worsen when the horse's respiratory effort increases while walking back to the stables or whinnying. 1 Based on this statement and given the progression of the clinical signs, a laryngeal dysfunction is a plausible aetiology in the present case.…”

Section: Discussionmentioning

confidence: 99%

“…Although postoperative pulmonary oedema is a recognised complication associated with equine general anaesthesia,1 8 9 its incidence seems low based on the number of published case reports available in the literature10–13 13 4 14 15. Previous retrospective studies of equine anaesthesia‐related mortality report an incidence of postanaesthetic respiratory obstruction between 0.3 per cent1 8 and 3.7 per cent2 but do not mention the incidence of subsequent clinical pulmonary oedema.…”

Section: Discussionmentioning

confidence: 99%

Putative postanaesthetic pulmonary oedema in a horse

Merlin

Hewetson

Veres-Nyéki

2019

Vet Record Case Reports

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A two-year-ten-month colt was referred for investigation and surgical treatment of cryptorchidism. Preanaesthetic clinical examination revealed no abnormalities and no relevant history was reported. The patient was anaesthetised with a total intravenous anaesthesia technique, both testicles were identified after induction, and a bilateral open castration was performed in the recovery box. Surgery, anaesthesia and recovery were uneventful. However, in the first hour postrecovery, clinical signs compatible with pulmonary oedema developed. Following arterial blood sampling and airway endoscopy, a low-grade pulmonary oedema was suspected and alleged to have occurred following transient laryngeal spasm. The patient was treated symptomatically and received supportive care. Two days after the surgery, the clinical signs were resolved, and the patient was discharged.

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“…Reports of pulmonary oedema are accumulating (Jones et al 1988;Abrahamsen et al 1990;Dixon et al 1993;Kollias-Baker et al 1993;Shaw et al 1995;Ball and Trim 1996;Tute et al 1996;Tidwell et al 2002;Borer 2005;Senior 2005;Holbrook et al 2007;Pellegrini-Masini et al 2009;Kaartinen et al 2010;Veres-Ny eki et al 2011;Melis et al 2014;Merlin et al 2019). Respiratory complications are described in CEPEF as fatal in 12 out of 35,978 horses; some 4% of the fatalities, and presumably included pulmonary oedema, but not exclusively.…”

Section: Pulmonary Oedema and Upper Airway Obstructionmentioning

confidence: 99%

Mortality and morbidity in equine anaesthesia

Deutsch

Taylor

2021

Equine Veterinary Education

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Equine peri-anaesthetic mortality and morbidity are of interest to anaesthetists, practitioners, horse owners and insurance companies. The largest prospective study, 'The Confidential Enquiry into Perioperative Equine Fatalities' (CEPEF) was conducted more than 20 years ago. It included over 40,000 horses from multiple centres and reported mortality to be 1.9% that decreased to 0.9% when only elective cases were considered. This is in stark contrast to mortality rates in small animal (dogs: 0.17%, cats: 0.24%) and human anaesthesia (0.04-7/10,000). In spite of developments in understanding the pathophysiology of equine anaesthesia mortality has not decreased in the intervening years. The main contributors to peri-anaesthetic equine mortality are cardiac arrest, fractures and myopathy or neuropathy. Spinal cord myelopathy and cerebral necrosis are less common. Malignant hyperthermia and hyperkalaemic periodic paralysis are diseases associated with genetic mutations that can be triggered during general anaesthesia and may be fatal if not recognised and treated immediately. Morbidities are reported less frequently, presumably because often they do not cause permanent harm and may resolve within a short period of time. Complications in equine anaesthesia are numerous and include injuries at induction and recovery, damage to the airway associated with orotracheal or nasotracheal intubation, post-anaesthetic myopathy or neuropathy, regurgitation and aspiration of stomach contents, ocular injuries and complications associated with intravascular cannulation. Hypotension, hypoventilation, hypoxaemia, hypothermia and dysrhythmias may occur both during the maintenance phase of anaesthesia but also in recovery. Airway obstruction during recovery has repeatedly been reported over the years as causing pulmonary oedema, which is often fatal if the airway is not restored extremely quickly. This review summarises the literature on the risk of mortality and morbidity. Information has been gathered from single case reports as well as larger research studies.

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

Cited by 10 publications

References 12 publications

Pulmonary and laryngeal oedema before induction of anaesthesia in a sheep

Pulmonary and laryngeal oedema before induction of anaesthesia in a sheep

Putative postanaesthetic pulmonary oedema in a horse

Mortality and morbidity in equine anaesthesia

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