Effect of head and neck position on respiratory mechanics in horses sedated with xylazine.

We studied the temporal changes in respiratory mechanics associated with xylazine administration (1.1 mg/kg of body weight, IV) in standing horses (experiment 1), and determined the effects of head and neck position (experiment 2) and atropine administration (experiment 3) on the observed changes. Thoroughbred geldings, 3 to 5 years old (5 in experiment 1, 4 in experiments 2 and 3) were used. Flow rates were obtained from a pneumotachograph and a differential transducer attached to a tight-fitting mask. Electronic integration of the flow signal gave tidal volume. Total pulmonary pressure (PL) was defined as the difference between esophageal pressure, measured with a balloon sealed to the end of a polyethylene catheter, and mask pressure. In experiment 3, a blunt cannula positioned in the dorsal third of the eighth or tenth intercostal space was used to estimate transpulmonary pressure. Lateral tracheal pressure was measured, using a polypropylene catheter inserted percutaneously in the midextrathoracic tracheal lumen. Upper and lower airway pressures were defined as the difference between mask pressure or transpulmonary pressure and lateral tracheal pressure, respectively. Five observations were made: (1) There was a significant (P less than 0.05) increase in PL from 10 to 40 minutes after administration of xylazine. (2) Although an overall agreement between head and neck position and PL was detected, the maximal PL value was not always obtained with lowest head and neck position. (3) Lower and upper airway resistance increased with low head carriage, with a greater increase in upper airway resistance resulting in a decrease in lower to total airway resistance ratio.(ABSTRACT TRUNCATED AT 250 WORDS)     

Nasal 'pressure' receptors

This study was performed to identify, recording from single fibers of the ethmoidal nerve, nasal receptors which respond to changes in the upper airway pressure during nasal occlusion. In 15 anaesthetized rats breathing through the nose, three consecutive nasal occlusions were performed while recording the afferent activity of ethmoidal nerve fibers, the EMG activity of an external intercostal muscle, temperature in the nose and upper airway pressure. Twenty-two afferent fibers were activated during the three inspiratory efforts with occlusions applied at end-expiration, when the upper airway was subjected to negative pressure (-1.93, -2.16 and -2.22 kPa at the 1st, 2nd and 3rd effort, respectively). The number of impulses was 24, 22 and 20 (n = 22) at the 1st, 2nd and 3rd effort, respectively. The pressure threshold were measured as -0.73, -0.87 and -0.96 kPa (n = 22) in each effort. Three fibers were also stimulated by positive pressure during occlusions performed at end-inspiration. In 5 rats breathing through a tracheostomy, maintained negative (-0.1-3.7 kPa) and positive (0.8-3.0 kPa) pressures were applied to the isolated upper airway. All the 12 fibers tested were activated by the maintained negative pressure, whereas three of them were also activated by the maintained positive pressure. However, none of fibers tested were stimulated by tracheal occlusions. These results indicate that the ethmoidal branch of the trigeminal nerve contains fibers connected to nasal 'pressure' receptors, mostly 'negative pressure' receptors, that may play a role in the maintenance of upper airway patency.     

Relationship between clinical signs and lung function in horses with recurrent airway obstruction (heaves) during a bronchodilator trial

During a trial to determine the dose response to the beta2-adrenergic agonist pirbuterol, we judged the severity of airway obstruction by use of a clinical scoring system and compared this to objective data obtained by quantitative measures of lung function. Six horses affected by recurrent airway obstruction were used in this trial. Four hundred and sixty-eight measurements of lung function and clinical scores were obtained from 13 measurement periods when horses received each of 6 doses of pirbuterol. Scores of 1-4 were assigned to degree of nasal flaring and abdominal effort and summed for a total score. The veterinarian scoring the signs did not know the dose of pirbuterol received by the horse and was unaware of the lung function data. Nasal, abdominal and total scores were significantly related to changes in lung function and changes in breathing pattern. There were significant differences between total scores greater than 5 in indices that reflected changes in breathing strategy (peak inspiratory and expiratory flow), peripheral airway obstruction (dynamic elastance), and effort of breathing (maximal change in pleural pressure). Below a total score of 5, there were fewer significant differences in lung function even though measurements of pulmonary resistance and dynamic elastance indicated considerable airway obstruction. Failure of clinical score to reflect this low-grade airway obstruction suggests that airway disease is underdiagnosed and its detection would be helped by the availability of a convenient lung function test.     

Implications of different degrees of arytenoid cartilage abduction on equine upper airway characteristics

Reason for performing study: The necessary degree of arytenoid cartilage abduction (ACA) to restore airway patency at maximal exercise has not been determined. Objectives: Use computational fluid dynamics modelling to measure the effects of different degrees of ACA on upper airway characteristics of horses during exercise. Hypothesis: Maximal ACA by laryngoplasty is necessary to restore normal peak airflow and pressure in Thoroughbred racehorses with laryngeal hemiplegia. Methods: The upper airway was modeled with the left arytenoid in 3 different positions: maximal abduction; 88% cross‐sectional area of the rima glottis; and 75% cross‐sectional area of the rima glottis. The right arytenoid cartilage was maximally abducted. Two models were assumed: Model 1: no compensation of airway pressures; and Model 2: airway pressure compensation occurs to maintain peak airflow. The cross‐sectional pressure and velocity distributions for turbulent flow were studied at peak flow and at different positions along the airway. Results: Model 1: In the absence of a change in driving pressure, 12 and 25% reductions in cross‐sectional area of the larynx resulted in 4.11 and 5.65% reductions in peak airflow and 3.68 and 5.64% in tidal volume, respectively, with mild changes in wall pressure. Model 2: To maintain peak flow, a 6.27% increase in driving tracheal pressure was required to compensate for a cross‐sectional reduction of 12% and a 13.63% increase in driving tracheal pressure was needed for a cross‐sectional area reduction of 25%. This increase in negative driving pressure resulted in regions with low intraluminal and wall pressures, depending on the degree of airway diameter reduction. Conclusion: Assuming no increase in driving pressure, the decrease in left ACA reduced airflow and tidal volume. With increasing driving pressure, a decrease in left ACA changed the wall pressure profile, subjecting the submaximally abducted arytenoid cartilage and adjacent areas to airway collapse. Clinical relevance: The surgical target of ACA resulting in 88% of maximal cross‐sectional area seems to be appropriate.     

Incidence of swallowing during exercise in horses with dorsal displacement of the soft palate

Reasons for performing study: The relationship between dorsal displacement of the soft palate (DDSP) and swallowing is unclear. Objective: To quantify the relationship between DDSP and swallowing in horses at exercise. Hypotheses: The frequency of swallowing increases immediately prior to DDSP in horses at exercise. Methods: Videoendoscopic and upper airway pressure data were collated from horses with a definitive diagnosis of DDSP at exercise. Horses with no upper airway abnormalities were matched by age, breed and sex and used as controls. Sixty‐nine horses were identified with a definitive diagnosis of DDSP during the study interval. Airway pressure data were available for 42 horses. Results: The majority of horses displaced at high exercising speeds while accelerating; a smaller number displaced during deceleration after peak speed had been reached. Horses swallowed significantly more frequently in the 1 min immediately preceding DDSP than in the control horses at equivalent speeds. DDSP at exercise results in a significant increase in tracheal expiratory pressure, a significant decrease in pharyngeal expiratory pressure and a significantly less negative pharyngeal inspiratory pressure compared to matched controls and compared to the pressures during the 1 min interval prior to DDSP. There was no significant difference between any measure of airway pressure before or after a swallow when examined at each time interval in the DDSP population. Conclusions: The frequency of swallowing decreases with increasing speed in normal horses. In contrast, the frequency of swallowing increases immediately prior to onset of DDSP. This is not a result of pharyngeal and tracheal pressure changes. Potential relevance: The increased frequency of swallowing observed prior to DDSP may be related to the aetiology of the disease.     

Effects of duration of isoflurane anesthesia and mode of ventilation on intracranial and cerebral perfusion pressures in horses

OBJECTIVE: To test the hypothesis that isoflurane-anesthetized horses during controlled ventilation and spontaneous ventilation exhibit temporal changes in cerebral hemodynamics, as measured by intracranial pressure and cerebral perfusion pressure, that reflect temporal changes in systemic arterial pressure. ANIMALS: 6 healthy adult horses. PROCEDURE: Horses were anesthetized in left lateral recumbency with 1.57% isoflurane in O2 for 5 hours in 2 experiments by use of either controlled ventilation (with normocapnia) or spontaneous ventilation (with hypercapnia) in a randomized crossover design. Intracranial pressure was measured with a subarachnoid strain-gauge transducer. Carotid artery pressure, central venous pressure, airway pressures, blood gases, and minute ventilation also were measured. RESULTS: Intracranial pressure during controlled ventilation significantly increased during constant dose isoflurane anesthesia and thus contributed to decreasing cerebral perfusion pressure. Intracranial pressure was initially higher during spontaneous ventilation than during controlled ventilation, but this difference disappeared over time; no significant differences in cerebral perfusion pressures were observed between horses that had spontaneous or controlled ventilation. CONCLUSIONS AND CLINICAL RELEVANCE: Cerebral hemodynamics and their association with ventilation mode are altered over time in isoflurane-anesthetized horses and could contribute to decreased cerebral perfusion during prolonged anesthesia.     

Effects of Left Recurrent Laryngeal Neurectomy, Prosthetic Laryngoplasty, and Subtotal Arytenoidectomy on Upper Airway Pressure during Maximal Exertion

Upper airway pressure was measured with a nasotracheal catheter system and a portable pressure transducer in 10 normal horses during maximal exercise before and after left recurrent laryngeal neurectomy. Measurements were repeated 16 weeks after prosthetic laryngoplasty (5 horses) or subtotal arytenoidectomy (5 horses). During maximal exertion, prosthetic laryngoplasty was more effective than subtotal arytenoidectomy in reversing the increases in upper airway pressure that followed left recurrent laryngeal neurectomy.     

The effects of alpha2 adrenoceptor agonists on airway pressure in anaesthetized sheep

Xylazine and clonidine, given intravenously, cause an increase in airway pressure in the anaesthetized, ventilated sheep. This increase was dose dependent and was not mediated by histamine, nor was it blocked by the alpha 1-adrenoceptor antagonist prazosin. However, the increase was abolished by the alpha 2-adrenoceptor antagonist, idazoxan. When the alpha 2-adrenoceptor agonists were administered into the cerebrospinal fluid by injection into the cisterna magna there was no increase in airway pressure, although a similar dose given peripherally still produced an effect. These findings would indicate that the increase in airway pressure seen in these sheep, following administration of xylazine and clonidine, was mediated by peripherally located alpha 2-adrenoceptors.     

Reflex activities of the upper airway muscles during experimental nasal occlusion in anesthetized dogs

Reflex responses of the upper airway muscles during experimental nasal and tracheal occlusions were studied in 21 anesthetized dogs breathing through the nose or a tracheostomy (tracheal cannula). Out of them, five animals were examined for maintained negative and positive pressures applied to the isolated upper airway. When the nose was occluded at end-expiration during three consecutive breathings, the electromyographic (EMG) activity of alae nasi (AN) and posterior cricoarytenoid (PCA) muscle markedly increased. The upper airway was subjected to negative pressure, -2.41 approximately -3.04 kPa (n = 34) by these nasal occlusions. The activity of upper airway muscles was also increased by tracheal occlusions. However, such augmentation of PCA activity was much less in tracheal occlusions than nasal occlusions, whereas there was the smaller difference in AN activity between both occlusions. During nasal occlusions, a prolongation of the inspiratory time (TI) was observed. Furthermore, maintained negative pressure applied to the isolated upper airway provoked an augmentation of PCA activity. Such an augmented EMG activity of PCA and the prolongation of TI were largely diminished by sectioning the superior laryngeal nerves. These results proves that the upper airway muscles play an important role to protect the upper airway from collapsing by nasal occlusions. In addition, it is suggested that a lack of lung volume feedback is substantially concerned with the activation of AN, while negative pressure in the upper airway is essential to stimulate PCA.     

Partitioning of pulmonary resistance in Friesian calves

Eight right cranial lobes of healthy Friesian calves were suspended in an airtight box. They were inflated at a constant transpulmonary pressure (Ptp) and ventilated from the outside by modifying pressures in the box with a quasi-sinusoidal pump at a frequency of 30 counts per minute. Peak-to-peak changes were 0.5 kPa. Lobar resistance (Rl) was partitioned into three components: central airway resistance (Rc), small airway resistance (Rp) and tissue resistance (Rt). Partitioning of R1 was realised at six different lung volumes. Minimal R1 was observed for a value of Ptp between 0.5 and 0.7 kPa. At a Ptp of 0.5 kPa, Rc, Rp, Rt represent 30, 15 and 55 per cent of R1, respectively. Lobar resistance increases at high and low lung volumes. Small airway resistance is small and independent of the level of lung inflation, except at low lung volumes where a marked increase is observed. Tissue resistance is relatively high and responsible for the increase of R1 at high lung volumes. Central airway resistance does not change significantly with lung volumes.     

Upper Airway Function during Maximal Exercise in Horses with Obstructive Upper Airway Lesions Effect of Surgical Treatment

Upper airway pressure was measured during maximal exercise in 10 Thoroughbred racehorses with naturally occurring upper airway obstruction. Left laryngeal hemiplegia and arytenoid chondropathy resulted in substantial increases (30-40 cm H2O) in inspiratory upper airway pressure (Pl), whereas complicated aryepiglottic entrapment and subepiglottic cysts produced only modest increases (15 cm H2O) in Pl. Uncomplicated aryepiglottic entrapment and grade IV pharyngeal lymphoid hyperplasia produced only slight increases (3-5 cm H2O). In general, surgical procedures restored airway pressures to within normal limits. Subtotal arytenoidectomy improved but did not normalize airway pressures in horses with arytenoid chondropathy. Pharyngeal lymphoid hyperplasia appeared to have little effect on upper airway function.     

Effect of a tongue-tie on upper airway mechanics during exercise following sternothyrohyoid myectomy in clinically normal horses

OBJECTIVE: To determine the effect of a tongue-tie on upper airway mechanics in clinically normal horses exercising on a treadmill following sternothyrohyoid myectomy. ANIMALS: 6 Standardbreds. PROCEDURE: Upper airway mechanics were measured with horses exercising on a treadmill at 5, 8, and 10 m/s 4 weeks after a sternothyrohyoid myectomy was performed. Pharyngeal and tracheal inspiratory and expiratory pressures were measured by use of transnasal pharyngeal and tracheal catheters connected to differential pressure transducers. Horses were fitted with a facemask and airflow was measured by use of a pneumotachograph. Horses underwent a standardized exercise protocol on a treadmill at 5, 8, and 10 m/s with and without a tongue-tie in a randomized cross-over design. Inspiratory and expiratory airflow, tracheal pressure, and pharyngeal pressure were measured, and inspiratory and expiratory resistances were calculated. RESULTS: We were unable to detect an effect of a tongue-tie on any of the respiratory variables measured. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate that a tongue-tie does not alter upper airway mechanics following sternothyrohyoid myectomy in clinically normal horses during exercise.     

Effect of halothane on bronchial calibre of anaesthetised cattle

A computer-aided forced oscillation technique was used to examine the effects of halothane on bronchial calibre in three adult cows after anaesthesia had been induced with xylazine and thiopentone. The administration of halothane failed to produce bronchodilatation, possibly owing to low resting bronchomotor tone in the animals. However, an increase in expiratory reserve volume, associated with a small fall in airway resistance, was observed, suggesting that changes in elastic recoil may make a significant contribution to changes in airway resistance during anaesthesia. The results also emphasise the importance of relating airway resistance to lung volume.     

Effects of posture and intraruminal pressure on the bronchial calibre of cattle during xylazine/halothane anaesthesia

The effects of changes in body position and intraruminal pressure on the bronchial calibre of anaesthetised, paralysed adult cattle were investigated using a computer-aided forced airflow oscillation technique which enabled the measurement of specific lower airways conductance (sGlaw), expiratory reserve volume (ERV) and residual resistance (RA). sGlaw and RA were highest in dorsal and lowest in sternal recumbency, but ERV was very much greater in sternal recumbency than in other positions. Turning the animals from right to left lateral recumbency resulted in a marked reduction in sGlaw and increase in ERV, providing further evidence of functional impairment of the dependent areas of the lungs of large animals. Changes in intraruminal pressure had little effect on bronchial calibre, suggesting that the respiratory dysfunction resulting from ruminal tympany is primarily caused by a reduction in compliance rather than an increase in airway resistance.     

Whole body barometric plethysmography: a screening method to investigate airway reactivity and acute lung injuries in freely moving pigs

The aim of this work was to investigate whether the Penh index, measured using whole body barometric plethysmography, can be used as a screening parameter to evaluate the airway reactivity and the intensity of the pulmonary response to endotoxins. Penh was firstly recorded in non-sedated freely moving piglets exposed (1) to a nebulized acetylcholine (Ach) pre-treated or not with clenbuterol, or (2) to endotoxin challenge. To measure Penh simultaneously with total pulmonary resistance (R(L)), dynamic compliance (C(dyn)) and intrapleural pressure changes (Max Delta Ppl), an oesophageal balloon catheter technique was used and the piglets were anaesthetised. The recordings were performed during (1) an intravenous metacholine (Mch) challenge and (2) in endotoxin-exposed animals. In freely moving animals, Ach induced a significant dose-dependent increase in Penh, which was significantly blocked by clenbuterol. Endotoxin instillation also resulted in a significant rise in Penh while the corresponding response measured under anaesthesia was significantly and positively correlated with R(L) and Max Delta Ppl. Similar results were obtained during Mch challenge but the Penh was negatively correlated with C(dyn). We conclude that Penh could be used in freely moving piglets as a screening index for airway reactivity and pulmonary functional changes in cholinergic and endotoxin challenges.     

The effects of three models of airway disease on tidal breathing flow-volume loops of thoroughbred horses

The effects of histamine and methacholine aerosols and of a fixed inspiratory resistance on tidal breathing flow-volume loops (TBFVL) were investigated using 18 unsedated, standing, healthy thoroughbred horses. The data were first analysed using traditional flow-volume loop indices and then reduced using standardized factor scoring coefficients obtained in a previous study in this laboratory using similar experimental techniques. On the basis of resting TBFVL analysis, the degree of pulmonary dysfunction caused by inhalation of histamine and methacholine aerosols with concentrations of 10 and 2 mg/ml, respectively, was similar. The fixed resistance also caused significant changes in the resting spirogram and TBFVL indices, suggesting that this model may prove valuable for further studies involving upper respiratory tract (URT) conditions.Administration of histamine and methacholine aerosols resulted in significant changes in all factor scores, although most of the observed changes were due to the effects of these aerosols on the respiratory rate. These findings re-emphasize the importance of the effects of respiratory rate on pulmonary mechanics. Application of the resistance resulted in significant changes in factor score 3, the inspiratory factor, which lends support to the validity of this model for URT conditions. The close agreement between the factor scores obtained under controlled conditions in this study and in a previous study in this laboratory confirms that the factor analysis used for both of these studies provides an adequate means of reducing TBFVL data obtained from thoroughbred horses.The large intra- and inter-individual variation observed both with the indices of TBFVL and with the factor scores limits the potential of these variables for detecting individual animals with obstructive airway disease. Re-evaluation of these indices under the stress of exercise may reduce the variability observed in these data and may increase the magnitude of differences between different animals, providing a means of detecting individual animals with subclinical obstructive airway conditions.Abbreviations CV coefficient of variation - P _pl,max maximal intrapleural pressure difference - FVL flow-volume loop - LRT lower respiratory tract - P _ao airway opening pressure - P _tp transpulmonary pressure - TBVFL tidal breathing flow-volume loop - URT upper respiratory tract - USPTM ultrasonic pneumotachometer     

Relationship of age,sex, body weight,and hematologic and respiratory variables with airway reactivity in adult cats

OBJECTIVE: To evaluate the association between airway reactivity and age, sex, body weight, and radiographic findings in cats. ANIMALS: 32 mature cats that constituted 2 age groups (17 young cats that were 1 to 2 years old and 15 old cats that were 12 to 13 years old). PROCEDURE: Cats were placed in the chamber of a barometric whole-body plethysmograph (volume, 38 L), and box pressure was measured at baseline and after aerosol administration of increasing concentrations of carbachol. Airway reactivity was assessed by monitoring increases in enhanced pause (PENH), a unitless variable that measures bronchoconstriction as derived from dose-response curves. The endpoint chosen was the provocative concentration of carbachol that increased PENH to 300% of the baseline value (PCPENH300). RESULTS: We did not find a correlation between PCPENH300 and sex, body weight, number of eosinophils, PENH before bronchoconstriction, respiratory frequency, tidal volume, or minute ventilation. Airway reactivity was significantly less in the old cats (mean +/- SD PCPENH300, 0.578 +/- 0.051%), compared with the value for the young cats (0.053 +/- 0.006%). Radiographic patterns differed significantly between groups of cats; a greater proportion of old cats (12/15) had bronchointerstitial patterns, compared with the proportion of young cats (4/17). CONCLUSIONS AND CLINICAL RELEVANCE: These data support the notion that age exerts a strong influence on airway reactivity in adult cats, and radiographic differences suggest that structural changes in older cats may contribute to this effect. These findings have important implications for interpretation of results of airway reactivity tests in cats.     

Duration of antigen-induced hyperresponsiveness in horses with allergic respiratory disease and possible links with early airway obstruction

Fairbairn, S.M., Lees, P., Page, C.P., Cunningham, F.M. Duration of antigen-induced hyperresponsiveness in horses with allergic respiratory disease and possible links with early airway obstruction. J. vet. Pharmacol. Therap. 16, 469–476.
Antigen-induced airway hyperresponsiveness in allergic horses has previously been demonstrated when clinical signs of acute airway obstruction were apparent, as a consequence of exposure of animals to hay and straw for variable periods of time, and repeat measurements of hyperresponsiveness have been made no earlier than 1 week after challenge. In the present study airway responsiveness to methacholine has been measured in normal horses and allergic horses in clinical remission before and 24, 48 and 72 h after a hay and straw challenge of fixed, short, duration (7 h). Correlations between early increases in interpleural pressure and hyperresponsiveness have also been investigated. As in other studies, the mean airway responsiveness of groups of normal and allergic horses in clinical remission was not significantly different. The responsiveness to methacholine of allergic, but not normal, horses was increased after antigen challenge and was significantly greater than that of normal horses at 48 and 72 h after challenge (log PD _{8 cm}: -0.77 ± 0.28 vs. 0.27 ± 0.14 at 48 h and -0.6 ± 0.25 vs. 044 ± 01 at 72 h; P < 0.05). There was also a significant correlation between interpleural presssure at the end of the 7-h challenge in allergic horses and the increase in responsiveness to methacholine at 24, 48 and 72 h. These results demonstrate that antigen induces an increase in airway responsiveness in allergic horses that persists for up to 3 days and which may be linked to the initial increase in interpleural pressure.     

Continuous positive airway pressure therapy for aspiration pneumonia in a dog

A 14-year-old mixed-breed dog aspirated a large amount of liquid barium sulfate. Calculation of the alveolar arterial oxygen tension difference (34 mm of Hg; normal, less than 7.5 mm of Hg) from the alveolar gas equation and the arterial blood gas analysis indicated impaired pulmonary gas exchange. The dog was treated for 5 days with continuous positive airway pressure and supplemental oxygen administered by a simple apparatus connected to a tracheostomy tube. Continuous positive airway pressure was believed to improve gas exchange and to increase pulmonary compliance by decreasing alveolar collapse in this dog.     

Increased adenosine concentration in bronchoalveolar lavage fluid of horses with lower airway inflammation

Several reports have suggested a role for adenosine in the pathogenesis of chronic airway conditions and this has led to new therapeutic strategies to limit airway inflammation. In this study, detectable levels of adenosine in bronchoalveolar lavage (BAL) samples from 11 horses with non-infectious lower-airway inflammation and 14 healthy controls are reported, with significantly higher values in horses with airway inflammation. Although these increased levels did not correlate with changes in neutrophil percentage in BAL, a positive association between adenosine levels and signs of lower airway inflammation (clinical score) was observed. These novel findings support the hypothesis that adenosine may contribute to bronchoconstriction and also act as a pro-inflammatory mediator in the bronchoalveolar milieu of horses with airway inflammation. Further investigation of this axis could lead to new approaches for the treatment of highly prevalent lower airway inflammatory conditions in the horse.