Journal
JOURNAL OF EQUINE VETERINARY SCIENCE
Volume 96, Issue -, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jevs.2020.103315
Keywords
Thoracotomy; Anesthesia; Surgery; Gas exchange; Ventilation
Categories
Funding
- European Union's Horizon 2020 MSCA ITN [675351]
- Kustos Foundation of 1881
- Kirsten and Freddy Johansens Foundation
- Oda and Hans Svenningsens Foundation
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The study aimed to develop an experimental surgical procedure providing access to the entire circumference of the heart in horses and investigate the effect of thoracotomy on pulmonary gas exchange. Results showed a significant decrease in arterial oxygen partial pressure during the procedure, but arterial carbon dioxide levels remained within normal limits.
Thoracotomy is an uncommon procedure in horses but remains essential in a variety of cases of pleuropneumonia, pericarditis, thoracic trauma or diaphragmatic herniation, and for experimental thoracic and cardiac procedures. This study aimed at developing an experimental surgical procedure allowing access to the entire circumference of the heart and describing the effect of thoracotomy on pulmonary gas exchange in these horses. The study consisted of two arms, arm one (undergoing thoracotomy), was a terminal experimental study that included 11 Standardbred horses with experimentally induced (by tachypacing) atrial fibrillation. Arm two consisted of 6 Standardbred horses undergoing anesthesia for reasons unrelated to the present study. These horses functioned as controls. Anesthesia was induced using zolazepam and tiletamine. Anesthesia was maintained with isoflurane in 100% oxygen and ventilation with intermittent positive pressure (IPPV); no positive end-expiratory pressure (PEEP) was performed. Rib resection and pericardiotomy were performed for complete exposure of the entire circumference of the heart. Arterial blood samples were collected prior to, 5 and 30 minutes after puncture of pleura parietalis. In 10 horses, resection of the fifth rib was adequate for exposure of the heart. In one horse, removal of the sixth rib was also necessary. The duration of the surgical procedure (thoracotomy, pericardiotomy) was < 45 minutes. During a thoracotomy, PaO2 decreased significantly (P < .05) from 291.8 +/- 82.8 mmHg to 165.2 +/- 73.5 mmHg but was not different from normal anesthetized controls. The PaCO2 remained within normal limits. This surgical approach provided access to the entire circumference of the heart. (C) 2020 Elsevier Inc. All rights reserved.
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