Influence of subclinical inflammatory airway disease on equine respiratory function evaluated by impulse oscillometry

Reasons for performing study: Inflammatory airway disease (IAD) is a nonseptic condition of the lower respiratory tract. Its negative impact on respiratory function has previously been described using either forced expiration or forced oscillations techniques. However, sedation or drug‐induced bronchoconstriction were usually required. The impulse oscillometry system (IOS) is a noninvasive and sensitive respiratory function test validated in horses, which could be useful to evaluate IAD‐affected horses without further procedures. Objectives: To determine the sensitivity of IOS in detecting alterations of the respiratory function in subclinically IAD‐affected horses without inducing bronchoprovocation and to characterise their respiratory impedance according to frequency for each respiratory phase. Methods: Pulmonary function was evaluated at rest by IOS in 34 Standardbred trotters. According to the cytology of bronchoalveolar lavage fluid (BALF), 19 horses were defined as IAD‐affected and 15 horses were used as control (CTL). Total respiratory resistance (Rrs) and reactance (Xrs) from 1–20 Hz as well as their inspiratory and expiratory components were compared between groups. Results: A significant increase of Rrs at the lower frequencies (R_{1–10 Hz}) as well as a significant decrease of Xrs beyond 5 Hz (X_{5–20 Hz}) was observed in IAD compared to CTL horses. IOS‐data was also significantly different between inspiration and expiration in IAD‐affected horses. In the whole population, both BALF eosinophil and mast cell counts were significantly correlated with IOS measurements. Conclusions: Functional respiratory impairment may be measured, even in the absence of clinical signs of disease. In IAD‐affected horses, the different parameters of respiratory function (Rrs or Xrs) may vary depending on the inflammatory cell profiles represented in BALF. Potential relevance: Impulse oscillometry could be used in a routine clinical setting as a noninvasive method for early detection of subclinical respiratory disease and of the results of treatment in horses.     

Use of the impulse oscillometry system for testing pulmonary function during methacholine bronchoprovocation in horses

OBJECTIVE: To compare sensitivity of the impulse oscillometry system (IOS) with that of the conventional reference technique (CRT; ie, esophageal balloon method) for pulmonary function testing in horses. ANIMALS: 10 horses (4 healthy; 6 with recurrent airway obstruction [heaves] in remission). PROCEDURE: Healthy horses (group-A horses) and heaves-affected horses (group-B horses) were housed in a controlled environment. At each step of a methacholine bronchoprovocation test, threshold concentration (TC(2SD); results in a 2-fold increase in SD of a value) and sensitivity index (SI) were determined for respiratory tract system resistance (R(rs)) and respiratory tract system reactance (X(rs)) at 5 to 20 Hz by use of IOS and for total pulmonary resistance (RL) and dynamic lung compliance (C(dyn)), by use of CRT. RESULTS: Bronchoconstriction resulted in an increase in R(rs) at 5 Hz (R(5Hz)) and a decrease in X(rs) at all frequencies. Most sensitive parameters were X(rs) at 5 Hz (X(5Hz)), R(5Hz), and R(5Hz):R(10Hz) ratio; RL and the provocation concentration of methacholine resulting in a 35% decrease in dynamic compliance (PC(35)C(dyn)) were significantly less sensitive than these IOS parameters. The TC(2SD) for X(rs) at 5 and 10 Hz was significantly lower in group-B horses, compared with group-A horses. The lowest TC(2SD) was obtained for X(5Hz) in group-B horses and R(5Hz) in group-A horses. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to CRT parameters, IOS parameters were significantly more sensitive for testing pulmonary function.The IOS provides a practical and noninvasive pulmonary function test that may be useful in assessing subclinical changes in horses.     

Qualitative and quantitative evaluation of equine respiratory mechanics by impulse oscillometry

REASONS FOR PERFORMING STUDY: The long-established conventional reference technique (CRT) for measuring respiratory mechanics in horses lacks sensitivity and there is a need for further refinement in new technology, such as the impulse oscillometry system (IOS). OBJECTIVES: To evaluate the potential use of the IOS as a clinical respiratory function test and compare it to the current CRT in horses suffering from common upper and lower airway dysfunctions. METHODS: Six healthy horses were tested before and after induction of a unilateral nasal obstruction (UNO) or transient left laryngeal hemiplegia (LLH). Six heaves-affected horses were tested in clinical remission and during a heaves crisis, before and after nebulisation of cumulative doses of a bronchodilator therapy (ipratropium bromide; IPB). RESULTS: As opposed to the CRT, the IOS was able to detect partial upper airway obstruction (UAO) caused by UNO or LLH in resting horses, without differentiating both conditions. Upper airway obstruction caused an upward shift of resistance (R(rs)) from 5 to 35 Hz without altering reactance (X(rs)). As for the CRT, IOS respiratory parameters measured in heaves-affected horses in crisis differed significantly from values measured during remission. The difference in frequency-dependent behaviour of R(rs) and X(rs) allowed discrimination between upper and lower airway obstructions. Bronchodilator treatment induced significant dose-dependent changes in X(rs) at 5 and 10 Hz, from the first dose. Total pulmonary resistance (RL) and R(rs) at 5 Hz were affected from the second dose and displayed similar sensitivity. Although post treatment RL values were comparable to remission, R(rs) and X(rs) remained significantly different, characterising persistent peripheral obstruction. CONCLUSIONS: The IOS was more sensitive than the CRT in detecting partial UAO in resting horses and persistent post treatment peripheral dysfunction in heaves-affected horses. The IOS is a sensitive test that provides graded quantitative and qualitative information on disease-induced respiratory dysfunctions as well as on treatment efficiency in horses. POTENTIAL RELEVANCE: The IOS could represent a practical and sensitive alternative respiratory function test for routine clinical investigations of common airway obstructive diseases and therapy in horses.     

Analysis of respiratory mechanics by impulse oscillometry in non-sedated and diazepam-sedated swine

Analysis of respiratory mechanics using impulse oscillometry is applicable to sedated, or non-sedated (trained) pigs when they are fixed in a sling. In this study, the influence of the following sources of variability on measurement results was examined: (i) sedation with diazepam; (ii) body weight of animals (ranging in age: 40 to 102 days); and (iii) time of the measurement (circadian influences). The following parameters were examined: respiratory rate (RR), tidal volume (v(t)), spectral resistance, reactance and coherence, each at 5, 10, 15 and 20 Hz (R5,...R20, X5,...X20, CO5...CO20, respectively), distal respiratory resistance (Rdist), and proximal airway resistance (Rprox). After sedation (using 1.5 mg diazepam per kg body weight), RR and v(t) decreased significantly. There was a significant improvement of CO5, CO10 and CO15. Increase in body weight was strongly correlated to v(t), furthermore to spectral resistance parameters. Impulse oscillometry system (IOS) parameters showed only slight non-significant alterations in dependency on the time of day. In consequence, different sources of variability must be taken into account when performing IOS measurements in swine.     

Influence of breathing pattern and lung inflation on impulse oscillometry measurements in horses

The objective of this paper was to determine if changes in ventilation patterns could influence the outcome of respiratory function measurements performed with our impulse oscillometry system (IOS) in horses. In a first study, IOS tests were performed in vitro on six isolated equine lungs. Lung inflation levels were controlled by modifying depressurisation inside an artificial thorax and different ventilation patterns were imposed. In a second in vivo study, transient variations in breathing pattern were evaluated both with the IOS and a current reference technique (CRT) in five healthy mature horses after an intravenous (i.v.) injection of lobeline hydrochloride. In both studies, respiratory rate (RR, range: 7-42 breaths/min.) and tidal volume (V(T), range: 0.4-25 L) had minor or no influence on IOS parameters. The influence of lung inflation, most marked for resistance at 5 Hz (R(5 Hz)), was limited for the considered physiological range. In vivo, statistical models indicated that maximal changes in pleural pressure (Max Delta Ppl) and peak flows were the main determinants of the variability of the resistance (R(rs)) and the reactance (X(rs)) of the respiratory system. The fourfold increase in baseline Max Delta Ppl and peak flows obtained during hyperpnoea caused a significant increase in R(rs) at 5 and 10 Hz and a decrease in X(rs) at all frequencies. We conclude that IOS parameters are not influenced by tachypnoea, but will reflect alterations in respiratory mechanics caused by hyperpnoeic breathing.     

Mechanics of the respiratory system in healthy newborn calves using impulse oscillometry

Arterial blood gases, acid-base balance and respiratory function tests using impulse oscillometry (IOS) were performed on 40 clinically healthy newborn calves during the first 24 hours of life to evaluate their respiratory adaptation to extrauterine life. Gas exchange efficiency of the lung was significantly improved with time and was accompanied by the correction of the mixed acidosis observed at birth and by significant changes in respiratory mechanics. Major changes were detected within the first 6 hours. The significant decrease in resistance (R) and the increase in reactance (X) with time, demonstrate the improvement in respiratory mechanics of both upper and lower airways, and reflect the increase in lung volume, the improved lung tissue elasticity and/or distribution of the ventilation. Respiratory mechanical, arterial blood gases and acid-base balance data provided in this study describe a successful respiratory adaptation to extrauterine life in healthy newborn calves.     

The use of impulse oscillometry for separate analysis of inspiratory and expiratory impedance parameters in horses: effects of sedation with xylazine

AIM: To improve the outcome of parameters measured by the impulse oscillometry system (IOS) in horses by separate assessment of inspiratory and expiratory impedance spectra in the frequency range between 1 and 10 Hz. As basis for further studies, the influence of sedation with xylazine on respiratory impedance was also investigated. METHODS: (i) The respiratory impedance of 11 horses was measured using IOS before and 6 min after sedation (xylazine; 0.6 mg/kg b.w.). (ii) The time course of impedance parameters in a period of 24 min after administration of xylazine was evaluated in 12 horses at regular intervals of 3 min. Resistance (R(rs)), reactance (X(rs)), and coherence (Co) were calculated as mean spectra (R(rs),X(rs),Co) of the entire measurement as well as separated into inspiration (Ri(rs),Xi(rs),Coi) and expiration (Re(rs),Xe(rs),Coe) at frequencies of 1, 5, and 10 Hz. RESULTS: (i) R(rs), X(rs) as well as Re(rs) and Xe(rs) revealed no significant influence of sedation. However, separate analysis of inspiration and expiration revealed a significant influence of sedation on all inspiratory impedance parameters. (ii) During the 24 min period after sedation, almost all inspiratory parameters were found significantly dependent on the time course of sedation whereas expiratory parameters Re10, Xe1, and Xe5 were not influenced. These results indicate that confounding factors due to sedation act mainly during inspiration. Muscle relaxation in upper airways due to xylazine is suspected to be the main cause of these phenomena.     

Respiratory mechanics in conscious swine: effects of face mask,head position and bronchoconstriction evaluated by impulse oscillometry

Airway obstruction in pigs (sedated or non-sedated) fixed in a sling was studied using impulse oscillometry (IOS). (i) Vertical flexion of the pig's head was used to simulate an artificial obstruction of the upper airways. (ii) Bronchial obstruction was induced by inhaling differing quantities of an aerosol produced from 0.33% carbachol solution. The ventilatory pattern was examined by measuring respiratory rate (RR) and tidal volume (V(t)). To evaluate respiratory mechanics, impedance parameters resistance (R) and reactance (X) as well as coherence (Co) were examined, each at frequencies of 5, 10, 15, 20, 25 and 35 Hz. Using a simple 7-element-model introduced by J. Mead [Physiological Review 41 (1961) 281], distal respiratory resistance (R(dist)), proximal airway resistance (R(prox)), and additional shunt compliance (C(a)) of the animal's snout and the air inside the facemask were evaluated. By fitting this model to the primary measured impedance spectra, the influence of the face mask could be eliminated in the model calculation to allow assessment of the real respiratory impedance. This recalculation made clear that the facemask had an influence on the spectral course of R and X, depending on the clinical situation, and the upper frequency range was altered the most. Under conditions of (i) upper airway obstruction, especially the X values were distorted by facemask almost over the whole frequency range. Once the data were corrected for the mask, resistance was increased across all frequencies by a fixed amount while reactance was not affected. Under (ii) bronchial airway obstruction (bronchospasm) caused the resistance spectrum to be increased mainly in the lower frequency range. This became visible in both, originally measured impedance spectra and spectra after correction of the mask influence. The reactance course (originally measured and recalculated) decreased at all frequencies during bronchospasm. Coherence over the whole frequency range was lowered at both bronchial and upper airway obstruction.     

The effect of anesthetic drug choice on accuracy of high-definition oscillometry in laterally recumbent horses

Objective

To determine the accuracy of high-definition oscillometry (HDO) for arterial pressure measurement during injectable or inhalation anesthesia in horses.

Influencing respiratory gas analytical lung function parameters by intravenous injection of clenbuterol in horses with chronic lung diseases

In a placebo-controlled drug study data were collected about flow, volume and expiratory CO2-concentration in 13 horses with chronic obstructive pulmonary disease before and until 2.5 h after intravenous injection of clenbuterol. An ultrasonic flow measuring unit and an infrared-CO2-analyser (Spiroson Scientific) were used. functional deadspace and expiratory mixed volume were calculated. In addition the effect on the partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2) in arterial blood was tested and the alveolo-arterial oxygen difference (AaDO2) determined. The volume of the functional deadspace directly after injection of clenbuterol was 24% bigger than the one after placebo injection. 45 min after injection there was no significant difference anymore. The PaO2 showed a decrease with a maximum difference of 11.6 mmHg to the starting value at 45 min after the injection of clenbuterol. As the PaCO2 didn't show significant changes this resulted in an increase of the AaDO2 of up to 15 mmHg (45 min p. inj.). All these alterations had a short-term character and started approaching their basic values 45 min p. inj.. Only the PaO2 did not reach the starting level 150 min after injection of clenbuterol. The expiratory mixed volume didn't show a straight tendency. On the one hand the results indicate that the functional deadspace is an interesting pathophysiological parameter. On the other hand the combined presentation of the changes in blood gas-tension and deadspace volume after the injection of clenbuterol gives indications, that the increase of anatomic deadspace caused by bronchospasmolysis combined with a delayed opening of alveoli, that were not ventilated beforehand, are the reason for the initial decrease in PaO2. Other reasons are discussed.     

Measurement of free thyroxine concentration in horses by equilibrium dialysis

The purpose of the study reported here was to validate measurement of free thyroxine (fT4) concentration in equine serum by equilibrium dialysis (fT4D), and to compare values with fT4 concentration measured directly and with total T4 (TT4) concentration. The fT4D, fT4, and TT4 concentrations were measured over a range of values in euthyroid horses and horses made hypothyroid by administration of propylthiouracil (PTU). Concentrations of fT4D (<1.8-83 pmol/L) were consistently higher than those of fT4 (<1-40 pmol/L). There was a significant (P < .001) regression of fT4D on fT4 in 503 samples from normal horses (y = 2.086x - 0.430). In baseline samples from 71 healthy euthyroid horses, fT4 concentration ranged from 6-21 pmol/L (median, 11 pmol/L; 95% confidence interval [CI]10.5-11.8 pmol/L), and fT4D concentration ranged from 7-47 pmol/L (median, 22 pmol/L; 95% CI 20.9-25.1 pmol/L). Free T4D, fT4, and TT4 concentrations were also measured in 34 ill horses. Horses consuming PTU and ill horses had significantly (P < .05) lower serum concentration of TT4, fT4, and fT4D than did clinically normal, healthy horses. If serum samples from ill horses were further subdivided into samples from horses that lived and samples from horses that died, fT4D concentration was not significantly different in ill horses that lived, compared with that in healthy horses, whereas fT4 concentration was still significantly decreased in ill horses that died (P < 0.001). We conclude that measurement of fT4 concentration by equilibrium dialysis is a valid technique in the horse, and its use may provide improved ability to distinguish nonthyroidal illness syndrome from hypothyroidism in that species.     

Measurement of serum myoglobin concentrations in horses by immunodiffusion.

Quantitative immunodiffusion in one dimension was performed in 6-mm Duran tubes containing a 1% Nobel agar solution and various dilutions of antisera. A series of dilutions of pure myoglobin in equine sera as well as plasma from horses with rhabdomyolysis were tested. Standard curves were prepared of the migration distance of the formed precipitate from the meniscus of the gel after 3, 6, 12, and 24 hours. The clearest line of precipitate was formed with a 1:20 dilution of antisera in agar. Standard curves were nonlinear and plasma myoglobin could be detected at 2 micrograms of myoglobin/ml or greater. The test was optimal, with an error of 5.6%, when read at 24 hours at approximately 25 C. Tubes with agar could be stored for 6 months at 4 C without affecting the accuracy of the test. The specificity of myoglobin for skeletal or cardiac muscle, and its rapid clearance from serum after muscle necrosis, make it ideally suited for evaluating acute muscle damage and for testing the susceptibility of horses for rhabdomyolysis following an exercise test.     

Comparative evaluation of impulse oscillometry and a monofrequency forced oscillation technique in clinically healthy calves undergoing bronchochallenges

Multifrequency impulse oscillometry ( ) was compared with a monofrequency forced oscillation technique ( ) in calves undergoing experimentally induced bronchoconstriction and subsequent bronchodilatation. The dynamic lung compliance (Cdyn) was also measured by conventional methods. For each test, the baseline mean and the responses to saline, a bronchoconstrictive agent (carbachol) and a bronchodilator (fenoterolhydrobromide) were calculated. Using the 1os, the information was markedly frequency-dependent. The resistance (R) and the magnitude of respiratory impedance (Z) were only sensitive at 5 Hz, leading to negative frequency dependence of these parameters as an indicator of peripheral airway obstruction. A high sensitivity for reactance (X) and phase angle (0) values was observed between 5 and 20 Hz. For MFO (10 Hz), the parameters Ros (which includes resistive and capacitive components of the respiratory system), phase shift (psi), and the oscillatory derived compliance of the respiratory system (Crs) were of the greatest clinical potential. Crs showed a significant coefficient of linear correlation (r=0.88, P<0·001) with Cdyn. At the 10 Hz test frequency similar results were observed with MFO and 105, suggesting that for healthy calves the measurement effect of an impulse is not significant. With respect to peripheral airway calibre, a test frequency less than 10 Hz appeared to be most sensitive and least variable.     

Daily variability of forced oscillometry parameters in horses suffering recurrent airway obstruction, a pilot study

The aim of the study was to analyse the day-to-day variability of the respiratory resistance (R_rs) and the reactance (X_rs) in 5 horses in a status of remission of recurrent airway obstruction by forced oscillometry system (FOS). Furthermore, the effects of stabling, outdoor and room temperature and humidity on these parameters were determined. Mean R_rs at oscillation frequencies 1, 1.5, 2 and 3 Hz were all significantly higher in the morning than in the afternoon, while X_rs was not significantly affected by time of the day. R_rs was significantly different on various sampling days at all frequencies, in the morning as well as in the afternoon. X_rs showed the same significant differences for frequencies greater than 1 Hz. Overall, R_rs showed a smaller variability than X_rs. Neither outdoor temperature, nor room temperature affected R_rs. This also applied to X_rs except for the measurements at 2 Hz that were significantly (p?=?0.044) affected by outdoor temperature. Turning out these horses at paddock for day and night caused a significant lower mean R_rs that when kept at stable for all night. While R_rs showed a very weak positive frequency dependency, X_rs clearly showed a positive frequency dependance for all horses. Resonance frequency (f_res) was between 2 and 4 Hz. These studies showed that FOS generated parameters are affected by environmental and management factors and thus only after well-designed standardized procedures FOS could be a useful diagnostic tool for the diagnosis and monitoring of equine respiratory disorders.     

Effect of a respiratory gas collection mask on some measurements of cardiovascular and respiratory function in horses exercising on a treadmill

The effects of a respiratory gas collection mask on arterial blood gases, acid base values, oxygen content, respiratory frequency and heart rate, were investigated in standardbred horses during treadmill exercise at speeds up to 10 m sec-1 and a treadmill slope of 10 per cent. The mask had no significant effect on heart rates during exercise, but respiratory frequency was lower when the mask was used. The increase in respiratory frequency as treadmill velocity increased was also significantly slower with the mask operative. Arterial carbon dioxide tensions were significantly higher during exercise with the mask than without, and arterial oxygen tension was significantly lower at the highest exercise intensity. Arterial oxygen content was significantly lower at all work speeds when the mask was used. There were minimal effects of the mask on arterial acid base values. It was concluded that a respiratory gas collection mask caused alveolar hypoventilation in exercising horses, but did not markedly influence heart rate or arterial acid base values during exercise.     

Pasture-associated seasonal respiratory disease in two horses

Two horses on separate farms developed severe obstructive pulmonary disease in successive years during the early summer months. In both cases clinical remission of the respiratory distress was achieved by moving the animals to different environments. The suggested aetiology for this outdoor chronic respiratory disease is a pulmonary allergy to pollen. Both animals were also shown to suffer from classical chronic obstructive pulmonary disease, i.e., obstructive pulmonary disease in the presence of hay and, or, straw.     

Viral respiratory infections of horses: structure and function of lungs in relation to viral infection.

Since the advent of cell culture techniques, numerous viruses have been shown to be related to respiratory diseases in horses. Although the viruses differ in many ways, they cause disease with some common characteristics. This report is a summary of some of the available material from written sources and from personal observations. It is intended to help explain some of the changes observed in viral-induced respiratory disease.