Effects of two different dosages of dobutamine on pulmonary artery wedge pressure, systemic arterial blood pressure and heart rate in anaesthetized horses

The purpose of the present study was to investigate the effects of two different dobutamine concentrations on pulmonary artery wedge pressure (PAWP) and on mean systemic arterial blood pressure (MAP) in horses anaesthetized with isoflurane, after induction of general anaesthesia with xylazine, ketamine and diazepam. Eight healthy warm-blood horses were included in the study. Each horse was subjected to general anaesthesia twice with two different dosages of dobutamine, 3 and 5 microg/kg bw/min, being infused over 15 min, starting 50 min after induction of general anaesthesia (T(0)). The heart rate, the PAWP and the MAP were recorded after 10 min (T(1)) and then every 5 min until 15 min after cessation of intravenous dobutamine administration (T(3)-T(5)). The PAWP was measured by a right heart catheter, which was positioned in the pulmonary capillaries. Mean systemic arterial blood pressure was monitored at the facial artery for the duration of general anaesthesia. All parameters increased at both dosage rates of dobutamine and decreased significantly when dobutamine administration ceased. The increase in heart rate was significantly higher after administration of 3 microg/kg bw/min dobutamine compared with the dosage of 5 microg/kg bw/min dobutamine. The increase in MAP was also higher at this dosage, but not significantly different to the dosage of 5 microg/kg bw/min dobutamine. During both dosages the MAP was above a value considered to be compatible with good peripheral circulation. The greater increase in PAWP was observed during administration of 5 g/kg bw/min dobutamine, but PAWP was not significantly different with the dosage of 3 microg/kg bw/min dobutamine. In conclusion, the administration of dobutamine led to an increase in MAP and PAWP above a value considered to be compatible with a good peripheral circulation. The results of the present study indicate that dobutamine improves circulation, in addition to its well-known effect on the periphery.     

Effects of dobutamine on cardiovascular function and respiratory gas exchange after enoximone in isoflurane-anaesthetized ponies

ObjectiveTo evaluate the combined effects of enoximone and dobutamine on the cardiovascular system and respiratory gas exchange in isoflurane-anaesthetized ponies.Study designProspective, randomized, experimental study.AnimalsSix ponies (286 ± 52 kg), aged 5.0 ± 1.6 years.MethodsAfter sedation (romifidine 80 μg kg⁻¹), anaesthesia was induced with midazolam (0.06 mg kg⁻¹) and ketamine (2.2 mg kg⁻¹) and maintained with isoflurane in oxygen. The ponies were ventilated to maintain eucapnia. After 90 minutes (=T0), enoximone alone (0.5 mg kg⁻¹) (E) or enoximone, followed by a constant rate infusion of dobutamine (0.5 μg kg⁻¹ minute⁻¹) (ED) for 120 minutes, was administered. Each pony received both treatments in a crossover trial, with at least 2 weeks between treatments. Heart rate (HR), cardiac output (CO), stroke volume (SV), right atrial (RAP), systolic (SAP), diastolic (DAP) and mean arterial pressure (MAP), blood gases, systemic vascular resistance (SVR), oxygen delivery (D⌽O₂) and several respiratory gas exchange variables were measured before treatment and until T120. Statistical analysis was based on a mixed model with treatment, time and their interaction as fixed categorical effects, pony as random effect, comparing treatments globally (α = 0.05) and at specific timepoints (Bonferroni-adjusted α = 0.00625).ResultsCompared to enoximone alone, ED treatment produced an increase in HR, CO, SV, RAP, SAP, DAP, MAP, packed cell volume (PCV) and D⌽O₂. The difference was significant from T60 to T120 (except at T80) for HR, throughout the observational period for CO, SAP, MAP, PCV and D⌽O₂, from T40 to T120 for DAP, at T10,T60,T80 and T120 for SV and at T10 and T20 for RAP. Overall decreases occurred in SVR and dead space ventilation (V_D/V_T). V_D/V_T was lower at T20 and from T80 to T120. Venous oxygen saturation was increased from T60 onwards.Conclusions and clinical relevanceThe results suggest that enoximone and dobutamine have additive cardiovascular effects and reduce V_D/V_T in isoflurane-anaesthetized ponies.     

Agreement of high definition oscillometry with direct arterial blood pressure measurement at different blood pressure ranges in horses under general anaesthesia

ObjectiveTo determine the agreement of high definition oscillometry (HDO) with direct arterial blood pressure measurements in normotensive, hypotensive and hypertensive horses during general anaesthesia.Study designExperimental study.AnimalsSeven healthy warmblood horses, aged 3–11 years, weighing 470–565 kg.MethodsMeasurements from a HDO device with the cuff placed around the base of the tail were compared with pressures measured invasively from the facial artery. High blood pressures were induced by intravenous (IV) administration of dobutamine (5 μg kg⁻¹ minute⁻¹) over ten minutes followed by norepinephrine (0.1 mg kg⁻¹ IV) and low pressures by increasing the inspired fraction of isoflurane and administration of nitroglycerine (0.05 mg kg⁻¹ IV). For analysis three pressure levels were determined: high (MAP>110 mmHg), normal (60 mmHgResultsA total of 245 paired measurements of systolic (SAP), mean (MAP) and diastolic (DAP) pressures were obtained. The HDO device underestimated blood pressure at hypertensive and normotensive levels and overestimated blood pressure at hypotensive levels. Best agreement was obtained for SAP and MAP within normotensive limits. At normotension, bias ± standard deviation for SAP, MAP and DAP were 0.1 ± 19.4 mmHg, 0.5 ± 14.0, 4.7 ± 15.6, respectively. At high pressure levels bias and SD were 26.1 ± 37.3 (SAP), 4.2 ± 19.4 (MAP), 1.5 ± 16.8 (DAP) and at low pressures -20.0 ± 20.9 (SAP), -11.4 ± 19.6 (MAP), -4.7 ± 20.1 (DAP), with HDO measurements at a MAP <50 mmHg often failing.Conclusion and clinical relevanceGood agreement with invasive arterial blood pressures was obtained with HDO at normotensive levels in horses. At high and low pressure ranges HDO was unreliable. Therefore, if haemodynamic instability is expected, invasive measurement remains preferable.     

Effects of intravenous terbutaline on heart rate,arterial pressure and blood gases in anesthetized horses breathing air

Objective

To investigate the effects of intravenous (IV) administration of terbutaline on PaO₂, PaCO₂, pH, heart rate (HR) and arterial pressures in healthy, laterally recumbent horses breathing ambient air under total intravenous anesthesia (TIVA).

Long-term facial artery catheter implantation for serial arterial blood sampling and invasive arterial blood pressure measurement in horses

The purpose of this investigation was to evaluate surgical catheter implantation in the facial artery of horses and the long-term maintenance of such arteries using heparin and ascorbic acid as filling solution. Nine horses were implanted with a polyurethane catheter. The catheters were flushed with a heparin/ascorbic acid solution every 8h and remained patent for 25 days. Arterial blood samples were collected twice a day, and one exercise test that included serial blood samples and arterial pressure recordings was performed on a treadmill. Polyurethane catheters surgically implanted in the facial artery can be kept patent by filling with a heparin/ascorbic acid solution and provide convenient invasive arterial access in horses which is suitable for use for serial blood sampling and blood pressure recordings, even during exercise on treadmill.     

Agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses under clinical conditions

Objective

To determine agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses undergoing elective surgery.

Effects of blood donation on arterial blood pressure in retired racing Greyhounds

The purpose of this study was to evaluate changes in systolic arterial blood pressure (SABP) immediately after collection of blood for transfusion in retired racing Greyhounds. We prospectively evaluated 19 blood donor Greyhounds before and after the collection of a unit (450 mL) of blood. The SABP was measured with Doppler in the right forearm after the dogs had been in the blood collection room for a few minutes (PRE-FLOOR) and again 5-10 minutes after the dogs were placed on the table where they would be bled (PRE-TABLE). A total of 3-5 minutes after completing the blood collection, the SABP was measured again while the dogs were still in lateral recumbency on the table (POST-TABLE) and once more 60-90 minutes later, when the dogs were on the floor after completing the donation (POST-FLOOR). All dogs were monitored for clinical signs of hypotension, including depression, weakness, collapse, and pallor, for a minimum of 2 hours after donation. There was a significant difference in SABP for the group between PRE-FLOOR and POST-TABLE (P = .02) and between PRE-TABLE and POST-TABLE determinations (P = .01). There were no significant differences for any of the other time points; there were no adverse events. Therefore, we conclude that the collection of 450 mL of blood from normal Greyhounds results in a short-lived yet significant decrease in SABP, but the likelihood of adverse events is negligible.     

Electroencephalographic and cardiovascular variables as nociceptive indicators in isoflurane-anaesthetized horses

OBJECTIVE: To evaluate Fourier-transformed electroencephalographic (EEG) variables, mean arterial blood pressure (MAP) and pulse rate as nociceptive indicators in isoflurane-anaesthetized horses. ANIMALS: Five standardbred and three Norwegian cold-blooded trotter stallions undergoing castration, aged 2-4 years, mass 378-538 kg. MATERIALS AND METHODS: All horses received intravenous (IV) detomidine (10 microg kg(-1) IV) and butorphanol (0.01 mg kg(-1) IV). Additional detomidine (4 microg kg(-1) IV) was administered in the induction area. Anaesthesia was induced with ketamine (2.5 mg kg(-1) IV) and diazepam (40 microg kg(-1) IV), and maintained for 30 minutes with isoflurane (end-tidal concentration of 1.4%) vaporized in oxygen. The electroencephalogram, MAP and pulse rate were recorded for 15 minutes, beginning 5 minutes before skin incision. Differences between the mean values of recordings taken before, and during surgery were calculated and tested for significant differences using a two-sided Student's t-test. RESULTS: A significant rise in MAP and a fall in pulse rate were found. No significant change was found in any EEG variable. CONCLUSION/CLINICAL relevance Of the variables evaluated, MAP seems to be the most sensitive and reliable indicator of nociception in isoflurane-anaesthetized horses.     

Effects of dobutamine on cardiovascular function and oxygen delivery in standing horses

Dobutamine is routinely used to improve cardiovascular function in anaesthetized horses. However, dobutamine in conscious horses is insufficiently investigated. Ten research horses that were already instrumented for a preceding trial were included into the study. Cardiovascular variables were recorded and blood samples taken after instrumentation (Baseline), before starting dobutamine and after 10 min of dobutamine infusion (2 µg kg⁻¹ min⁻¹). A significant increase in systemic blood pressure, mean pulmonary artery pressure and right atrial pressure, and a decrease in heart rate were observed with dobutamine compared with baseline measurements. Arterial and mixed venous haemoglobin and oxygen content, as well as mixed venous partial pressure of oxygen increased. No significant changes in cardiac output, stroke volume, systemic vascular resistance, arterial partial pressure of oxygen, or oxygen consumption, delivery and extraction ratio were detected. Concluding, dobutamine increased systemic blood pressure without detectable changes in stroke volume, cardiac output or systemic vascular resistance in conscious horses.     

A clinical evaluation of an oscillometric blood pressure monitor on anesthetized horses

The accuracy of an oscillometric blood pressure monitor (Vet/BP 6000, Sensor Devices, Inc., Waukesha, WI) was assessed in 13 anesthetized horses undergoing a variety of clinical procedures. The oscillometric blood pressure measurements using a cuff placed around the base of the tail were compared to simultaneously recorded direct pressure readings. One hundred nine sets of blood pressure measurements were recorded. In addition the pulse rates, as determined by digital palpation and oscillometric measurement, the time required for an oscillometric measurement, and the number of attempts required by the oscillometric unit were recorded. The average difference between the direct and oscillometric blood pressures were 18, 9, and 11 mmHg for the systolic, diastolic and mean arterial blood pressures, respectively. The oscillometric and direct pressure measurements showed significant correlation with a correlation coefficient of 0.93 for the mean arterial pressure. The oscillometrically determined pulse rate (average-33 pulses/min) was significantly different than the pulse rate determined by palpation (average-33.4 pulses/minute) but the difference was less than one. The average time required for a determination was 69 seconds and the average number of attempts required was 1.02 per determination.     

Effects of syringe type and storage temperature on results of blood gas analysis in arterial blood of horses

BACKGROUND: Results of arterial blood gas analysis can be biased by pre-analytical factors, such as time to analysis, syringe type, and temperature during storage. However, the acceptable delay between time of collection and analysis for equine arterial blood gas remains unknown. HYPOTHESIS: Dedicated plastic syringes provide better stability of arterial blood gases than multipurpose plastic syringes. ANIMALS: Eight mares, 1 stallion, and 1 gelding, ages 3 to 10 years old. METHODS: Arterial blood samples were collected in a glass syringe, a plastic syringe designated for blood gas collection, and a multipurpose tuberculin plastic syringe. Blood samples were stored at ambient temperature or in iced water. For each sample, partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2), and pH were measured within a few minutes of collection and at 5, 20, 30, 60, 90, and 120 minutes after collection. RESULTS: Collection into glass syringes stored in iced water provided adequate PaO2 results for up to 117 +/- 35 minutes, whereas blood collected in either of the plastic syringes resulted in a variation >10 mm Hg after 10 +/- 3 to 17 +/- 2 minutes, depending on the storage conditions. Plastic syringes kept at ambient temperature offered more stability for PaCO2 analysis because they could be stored up to 83 +/- 16 minutes without significant variations. Values of pH did not show variations more than 0.02 for the first hour, irrespectively of storage condition. CONCLUSIONS AND CLINICAL IMPORTANCE: Glass syringes placed on ice are preferable for analysis of PaO2. Blood collected in plastic syringes should be analyzed within 10 minutes, irrespective of the storage temperature, to ensure the accuracy of PaO2 values.     

The cardiorespiratory effects of morphine and butorphanol in horses anaesthetised under clinical conditions

Twenty-five horses admitted for minor orthopaedic or soft tissue surgery were anaesthetised with detomidine, ketamine and halothane. Heart rate, arterial blood pressure, respiratory rate, tidal volume, minute volume, blood gases and occlusion pressures were measured before and for 30 mins after intravenous (iv) injection of saline, butorphanol 0.05 mg/kg bodyweight (bwt) or morphine 0.02 or 0.05 mg/kg bwt. Drug or saline treatment induced no significant changes from pre-treatment values within a group for arterial blood pressure, heart rate, respiratory rate, arterial carbon dioxide tension, arterial oxygen tension and occlusion pressure. In conclusion, both morphine and butorphanol at the stated doses cause no adverse effects on the cardiovascular and respiratory systems of anaesthetised horses.     

Effects of epidural opioid analgesics on heart rate, arterial blood pressure, respiratory rate, body temperature, and behavior in horses

Heart rate, arterial blood pressures, respiratory rate, body temperature, and central nervous system excitement were compared before and after epidural administration of morphine (0.1 mg/kg), butorphanol (0.08 mg/kg), alfentanil (0.02 mg/kg), tramadol (1.0 mg/kg), the k-opioid agonist U50488H (0.08 mg/kg), or sterile water using an incomplete Latin square crossover design in five conscious adult horses. Treatments were administered into the first intercoccygeal epidural space. Significant (P <.05) reductions in respiratory rate were detected after epidural administration of morphine, alfentanil, U50488H, and sterile water. Additionally, significant (P <.05) head ptosis was observed within the first hour after administration of morphine, U50488H, and tramadol, but neither of these changes appeared to be of clinical significance. No treatment-related changes in motor activity or behavior were observed.     

Effects of intramuscular administration of acepromazine on palmar digital blood flow, palmar digital arterial pressure, transverse facial arterial pressure, and packed cell volume in clinically healthy, conscious horses

Objective— To determine the magnitude and duration of effects of acepromazine administered intramuscularly (IM) on digital and systemic hemodynamic variables in clinically healthy horses.
Study Design— Experimental study.
Animals— Healthy adult horses (n=12).
Methods— An ultrasonic Doppler flow probe was surgically implanted around the medial palmar digital artery before the study. Catheters were inserted in the transverse facial artery, lateral palmar digital artery, and jugular vein. A treatment group (n=6) was administered 0.04 mg/kg body weight of acepromazine IM; control horses (n=6) were administered an equivalent volume of saline IM. Palmar digital blood flow, and digital and facial arterial pressures were measured at baseline and for 6 hours after administration. Venous blood was collected for measurement of packed cell volume (PCV).
Results— Horses administered acepromazine had significantly lower facial arterial pressure compared with control horses administered saline. Palmar digital arterial blood flow in acepromazine-treated horses was not significantly different from that in control horses but increased significantly post-administration, compared with the respective baseline values for acepromazine-treated horses. PCV significantly decreased in horses administered acepromazine compared with their respective baseline value.
Conclusion— IM acepromazine causes hypotension and increases palmar digital blood flow over time but the magnitude of the effect on digital blood flow was not sufficient to yield differences compared with saline-treated horses.
Clinical Relevance— IM acepromazine has a modest effect on palmar digital blood flow, facial arterial pressures and PCV in healthy horses with minimal sedation.     

Effect of different inspired fractions of oxygen on F-shunt and arterial partial pressure of oxygen in isoflurane-anaesthetized and mechanically ventilated Shetland ponies

ObjectiveTo determine the effect of fraction of inspired oxygen (FiO₂) on intrapulmonary shunt fraction as measured by F-shunt in ponies during isoflurane anaesthesia.Study designProspective, randomized clinical study.AnimalsA group of 23 adult Shetland ponies undergoing a total of 32 anaesthetic procedures.MethodsPonies were premedicated intravenously (IV) with detomidine (0.01 mg kg^–1) and either morphine (0.1 mg kg^–1) or butorphanol (0.02 mg kg^–1). Anaesthesia was induced with ketamine (2.2 mg kg^–1) and midazolam (0.07 mg kg^–1) administered IV. Ponies were randomly allocated to maintenance of anaesthesia with isoflurane in oxygen (group TH; FiO₂ = 0.95) or a mixture of oxygen and medical air (group TL; FiO₂ = 0.65); all ponies were given a constant rate of infusion of detomidine. Animals were mechanically ventilated to maintain PaCO₂ between 40 and 50 mmHg. Arterial blood gas analysis was performed every 30 minutes. The F-shunt equation was calculated for each time point T0, T30, T60 and T90. Data were analysed using linear mixed model analysis and presented as mean ± standard deviation (p < 0.05).ResultsPaO₂ was greater in group TH than in group TL (TH: 406 ± 90, 438 ± 83, 441 ± 69 and 464 ± 53 mmHg versus TL: 202 ± 90, 186 ± 84, 172 ± 85 and 191 ± 98 mmHg at T0, T30, T60 and T90, respectively; p < 0.0001). In TH, F-shunt was < TL. Significant differences were found at T60 (TH: 13.2% ± 4.3 versus TL: 19.4% ± 8.3; p = 0.016) and T90 (TH: 11.7% ± 3.5 versus TL: 18.6% ± 9.5; p = 0.036).Conclusions and clinical relevanceOur findings do not support a beneficial effect of using a reduced FiO₂ to improve oxygenation in anaesthetized and mechanically ventilated Shetland ponies.