Severe intraoperative hypoxaemia in a horse due to failure of an oxygen concentrator and auxiliary oxygen supply

Kropf, Josephine; Hughes, J. M. L.

doi:10.1136/vetreccr-2018-000740

Cited by 1 publication

(1 citation statement)

References 30 publications

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“…Failure to check or identify malfunctioning anaesthetic equipment prior to use may lead to complications: malfunction of the oxygen concentrator and the auxiliary oxygen supply causing hypoxaemia (Kropf and Hughes 2018); malfunction of the inspiratory valve resulting in hypercapnia (Baxter et al 1991) or inability to mechanically ventilate the © 2021 EVJ Ltd 160…”

Section: Human Error and Equipment Failurementioning

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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Section: Human Error and Equipment Failurementioning

confidence: 99%