Literature DB >> 30257797

Impact of Trendelenburg (head down) and reverse Trendelenburg (head up) position on respiratory and cardiovascular function in anaesthetized horses.

Anna Binetti1, Martina Mosing2, Muriel Sacks2, Luc Duchateau3, Frank Gasthuys3, Stijn Schauvliege3.   

Abstract

OBJECTIVE: To describe the cardiorespiratory effects of a change in table position in anaesthetized horses. STUDY
DESIGN: Prospective, crossover, randomized, experimental study. ANIMALS: Six adult horses (mean body weight 621 ± 59 kg, aged 13 ± 4 years).
METHODS: The horses were anaesthetized twice in dorsal recumbency. They were either placed in the Trendelenburg position (head down; HD) followed by reverse Trendelenburg position (head up; HU) or in reverse order. Every position was maintained for 90 minutes. The order of positions was randomly assigned at initial anaesthesia. Extensive cardiorespiratory monitoring was performed. Statistical analysis consisted of a mixed model with horses as random effect and time, position, section of anaesthesia and interaction between those as fixed effects (p < 0.05).
RESULTS: When HU was applied during the first section of anaesthesia, PaO2, (p = 0.012), oxygen saturation (SaO2, p < 0.01) and oxygen content (CaO2, p < 0.01) were significantly higher, while venous admixture (Q˙s/Q˙t, p < 0.01), mean arterial (p = 0.039), right atrial (p < 0.01) and mean pulmonary arterial pressure (p < 0.01) were lower than in HD. After changing from HU to HD, PaO2 and SaO2 remained higher and Q˙s/Q˙t lower compared to the inverse order. Independent of the order, in the HD position Q˙s/Q˙t (p = 0.019) increased while PaO2 (p < 0.01), SaO2 (p = 0.011), CaO2 (p < 0.01), venous PO2 (Pv¯O2; p = 0.019), venous saturation (p = 0.004) and venous oxygen content (p = 0.010) decreased over time. No significant differences were found for cardiac output, oxygen delivery, oxygen consumption and dobutamine requirement between the two positions. CONCLUSIONS AND CLINICAL RELEVANCE: Gas exchange is better preserved in HU compared to HD, especially if applied from the start of the anaesthesia.
Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

Entities:  

Keywords:  Trendelenburg; anaesthesia; equine; hypoxaemia; reverse Trendelenburg; table position

Mesh:

Year:  2018        PMID: 30257797     DOI: 10.1016/j.vaa.2018.01.012

Source DB:  PubMed          Journal:  Vet Anaesth Analg        ISSN: 1467-2987            Impact factor:   1.648


  3 in total

1.  Effect of position on transdiaphragmatic pressure and hemodynamic variables in anesthetized horses.

Authors:  Cori D Youngblood; David S Hodgson; Warren L Beard; Yuqi Song; Punit Prakash; Lindsay V Heflin
Journal:  Can J Vet Res       Date:  2020-07       Impact factor: 1.310

2.  Highlights of recent clinically relevant papers.

Authors:  S Wright
Journal:  Equine Vet Educ       Date:  2019-02-05       Impact factor: 1.063

3.  Effect of 15° Reverse Trendelenburg Position on Arterial Oxygen Tension during Isoflurane Anesthesia in Horses.

Authors:  Laura Tucker; Daniel Almeida; Erin Wendt-Hornickle; Caroline F Baldo; Sandra Allweiler; Alonso G P Guedes
Journal:  Animals (Basel)       Date:  2022-02-01       Impact factor: 2.752

  3 in total

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