Endotracheal intubation in horses – are complications truly rare?

Endotracheal intubation is an essential component of general anaesthesia in horses to facilitate delivery of inhalation anaesthetic agent and oxygen, artificial ventilation, and prevent pulmonary aspiration of blood or gastric reflux. Experimental studies have identified a high incidence of tracheal mucosal injury after intubation resulting from direct trauma or local ischaemia from the pressure of the inflated cuff. Recommendations to minimise injury include gentle intubation, disconnection from the anaesthesia machine when moving the horse, and monitoring the endotracheal tube cuff pressure. New studies are needed to evaluate trachea and cuff pressure interactions under current practice conditions, including specialised ventilation modalities such as positive end‐expiratory pressure and continuous airway pressure.