Pulsed inhaled nitric oxide improves arterial oxygenation in colic horses undergoing abdominal surgery

Wiklund, Maja; Granswed, Izabella; Nyman, Görel

doi:10.1016/j.vaa.2016.11.015

Cited by 9 publications

(9 citation statements)

References 25 publications

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“…However, PiNO does not affect ventilation and hypercarbia developed in all or most horses in previous studies [12][13][14][15]. These findings were also confirmed in a clinical study where spontaneously breathing horses undergoing colic surgery treated with PiNO remained hypercarbic despite improved arterial oxygenation [16].…”

Section: Introductionsupporting

confidence: 70%

“…Based on PiNO‐induced increases in PaO 2 , SaO 2 and decreases in F‐shunt, the results of this study show that delivery of PiNO is an effective method to improve oxygenation in horses undergoing arthroscopy and colic surgery that are mechanically ventilated during anaesthesia. The improvement in arterial oxygenation and decrease in shunt was expected based on the results from previous studies . However, horses in those studies were hypercarbic due to hypoventilation.…”

Section: Discussionmentioning

confidence: 70%

“…Practical aspects and time limit influenced the final sample size which became 50 healthy horses undergoing elective arthroscopy (25 receiving PiNO and 25 controls) and 30 horses undergoing emergency colic surgery (15 horses receiving PiNO and 15 controls). Sample size calculations based on improvement in PaO 2 with PiNO in previous studies indicated that with a power of 80 and 5% Type I error rate a sufficient number of horses in each group was 11 to detect an effect size of 50%. With the present sample size smaller effect sizes can be detected with the same power.…”

Section: Methodsmentioning

confidence: 99%

“…The NO was delivered by a devicem that was triggered by the positive pressure at the beginning of each breath from the ventilator. The pulse was delivered during the first part of inspiration, as determined in previous studies . The delivery device was connected with a plastic line to an adapter located at the proximal end of the endotracheal tube, and once started the horse would receive a pulse of NO with every mechanical breath.…”

Section: Methodsmentioning

confidence: 99%

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Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery

Wiklund

Kellgren

Wulcan

et al. 2019

Equine Veterinary Journal

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Summary Background Administration of pulsed inhaled nitric oxide (PiNO) improves arterial oxygenation in spontaneously breathing anaesthetised healthy horses and in horses undergoing colic surgery. However, because hypoventilation commonly occurs, horses are often mechanically ventilated to prevent hypercarbia. Objectives To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. Study design Prospective nonblinded clinical trial. Methods Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing colic surgery (Group C) in dorsal recumbency were included in the study. Every second horse in each group received PiNO (A‐INO, C‐INO), the others served as controls (A‐CN, C‐CN). All horses were mechanically ventilated and anaesthesia was maintained with isoflurane. PiNO was mechanically delivered at the proximal end of the endotracheal tube as a pulse during the first part of each inspiration. Data were collected at the start (baseline, before PiNO) and at the end of inhalation anaesthesia. The Tukey method was used to compare baseline and end values for each parameter. Results Arterial oxygen tension (PaO2) increased from (median [IQR]) 13.6 (9.3, 30.1) at baseline to 24.2 (18.6, 37.0) kPa at the end of anaesthesia in A‐INO (P = 0.005) and from 7.7 (6.4, 8.5) to 15.5 (9.9, 26.9) kPa in C‐INO (P = 0.007). Mean (95% CI) difference in F‐shunt between baseline and end were −6 (−10; −1) and −11 (−22; −1) % in A‐INO (P = 0.005) and C‐INO (P = 0.04) respectively. There was no change in PaO2 or F‐shunt from baseline to end of anaesthesia in A‐CN or C‐CN. Main limitations Cardiac output was not measured, thus O2 delivery could not be calculated. Conclusions The combination of mechanical ventilation and PiNO improved pulmonary gas exchange during anaesthesia by a simultaneous decrease in F‐shunt and improved alveolar ventilation.

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Section: Introductionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery

Wiklund

Kellgren

Wulcan

et al. 2019

Equine Veterinary Journal

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“…In alignment with concurrent research on anesthetic recovery, the procedure was done under general anesthesia in the six horses. They were anesthetized according to a standard protocol [ 27 ] and placed in lateral recumbency on a medical foam mattress. The ponies were sedated as routine, [ 28 ] and local infiltration anesthesia with mepivacaine (Carbocaine) from Aspen Nordic was administrated in an inverted L‐block, at least 10 cm from the skin incision.…”

Section: Methodsmentioning

confidence: 99%

In Vivo Versus In Vitro Degradation of a 3D Printed Resorbable Device for Ligation of Vascular Tissue in Horses

Adolfsson

Sjöberg

Höglund

et al. 2021

Macromolecular Bioscience

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A resorbable 3D printed polydioxanone (PDO) device is manufactured to facilitate ligation of vascular tissue during surgery. The device must provide sufficient mechanical performance throughout the healing period. Therefore, degradation and mechanical performance of the device are investigated as a function of in vivo and in vitro aging. During aging the PDO device released cyclic and linear water‐soluble products. In vivo aging resulted in higher relative number of linear oligomers in comparison to in vitro aging. A major loss of mechanical performance is observed after only 10 days in vivo and the Young’s modulus (E) and tensile strength at break (σb) decreased by 28% and 54%, respectively. This is in contrast to in vitro aging, where no loss of mechanical properties is observed during the same period. The in vivo aged devices exhibit clear holes in the matrices after 28 days, while apparent cracks are observed first after 140 days in vitro. These results highlight the sensitivity of the degradation process of resorbable devices with regards to the interactions of the device with the surrounding environment (tissues) and demonstrate the importance of in vivo testing as compliment to in vitro testing before clinical use of devices.

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Peripheral Vasodilators

Kennedy

2024

Pharmacology in Veterinary Anesthesia and Analgesia

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Pulsed inhaled nitric oxide improves arterial oxygenation in colic horses undergoing abdominal surgery

Cited by 9 publications

References 25 publications

Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery

Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery

In Vivo Versus In Vitro Degradation of a 3D Printed Resorbable Device for Ligation of Vascular Tissue in Horses

Peripheral Vasodilators

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