An unusual obstruction in the breathing system of a large animal anaesthesia machine

Pleyers, Tekla; Spadavecchia, Claudia; Raillard, Mathieuv

doi:10.1016/j.vaa.2020.05.010

Cited by 1 publication

(1 citation statement)

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“…Complications in equine anaesthesia patient (Pleyers et al 2020); ventilator bellows leaking into the breathing system causing increased airway pressure and decreasing depth of anaesthesia (Klein and Wilson 1989); rebreathing due to an incompetent expiratory valve leading to severe hypercapnia (Thompson 2014); positive-endexpiratory pressure and increased airway pressure caused by slipping of leucoplast tape that was applied to prevent a leak between endotracheal tube and connector (Gregson and Clutton 2012)…”

Section: Human Error and Equipment Failurementioning

confidence: 99%

Mortality and morbidity in equine anaesthesia

Deutsch

Taylor

2021

Equine Veterinary Education

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Equine peri-anaesthetic mortality and morbidity are of interest to anaesthetists, practitioners, horse owners and insurance companies. The largest prospective study, 'The Confidential Enquiry into Perioperative Equine Fatalities' (CEPEF) was conducted more than 20 years ago. It included over 40,000 horses from multiple centres and reported mortality to be 1.9% that decreased to 0.9% when only elective cases were considered. This is in stark contrast to mortality rates in small animal (dogs: 0.17%, cats: 0.24%) and human anaesthesia (0.04-7/10,000). In spite of developments in understanding the pathophysiology of equine anaesthesia mortality has not decreased in the intervening years. The main contributors to peri-anaesthetic equine mortality are cardiac arrest, fractures and myopathy or neuropathy. Spinal cord myelopathy and cerebral necrosis are less common. Malignant hyperthermia and hyperkalaemic periodic paralysis are diseases associated with genetic mutations that can be triggered during general anaesthesia and may be fatal if not recognised and treated immediately. Morbidities are reported less frequently, presumably because often they do not cause permanent harm and may resolve within a short period of time. Complications in equine anaesthesia are numerous and include injuries at induction and recovery, damage to the airway associated with orotracheal or nasotracheal intubation, post-anaesthetic myopathy or neuropathy, regurgitation and aspiration of stomach contents, ocular injuries and complications associated with intravascular cannulation. Hypotension, hypoventilation, hypoxaemia, hypothermia and dysrhythmias may occur both during the maintenance phase of anaesthesia but also in recovery. Airway obstruction during recovery has repeatedly been reported over the years as causing pulmonary oedema, which is often fatal if the airway is not restored extremely quickly. This review summarises the literature on the risk of mortality and morbidity. Information has been gathered from single case reports as well as larger research studies.

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Section: Human Error and Equipment Failurementioning

confidence: 99%