The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2

Johnston, G. M.; Eastment, J. K.; Wood, J. L. N.; Taylor, PM

doi:10.1046/j.1467-2995.2002.00106.x

Cited by 432 publications

(613 citation statements)

References 27 publications

(52 reference statements)

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“…A large-scale, multicenter study -CEPEF (Confidential enquiry of perioperative equine fatalities) reported a death rate from non-colic-related anaesthetics of 0.9% (Johnston et al 1995), while the perianaesthetic mortality rate at a single, equine surgical practice seemed to be more favourable with 0.12%, because of preponderance of short procedures (Bidwell et al 2007). Thirty percent of all equine perioperative deaths are related to severe injury of the musculoskeletal system including fractures during the recovery phase, making recovery a critical part of equine anaesthesia (Johnston et al 1995, Johnston et al 2002, Johnston et al 2004, Bidwell et al 2007). …”

Section: Introductionmentioning

confidence: 99%

“…Injuries during the recovery phase range from superficial skin abrasions, bruises and lacerations to luxations and fractures (Portier andWalsh 2006, Wagner 2008). The quality of the recovery phase depends on factors like lengths and type of anaesthesia, concurrent medications, duration of surgery, positioning during surgery, adverse events like hypotension and hypoxaemia and weight and temperament of the individual horse (Johnston et al 2002, Wagner 2008, Larenza et al 2009). The development of the neuropathy/myopathy syndrome might predispose horses to injuries as a consequence of uncoordinated and/or unsuccessful attempts to rise (Grandy et al 1987, Lindsay et al 1989, Franci et al 2006).…”

Section: Introductionmentioning

confidence: 99%

“…Head and tail ropes are able to stabilize a horse during its attempts to rise, however, it is evident that they cannot prevent fractures during standing up (Johnston et al 2002, Bidwell et al 2007) as they do not have a weight neutralizing function. For this reason several systems with lifting or weight neutralizing function mainly for recovery after fracture repair have been developed.…”

Section: Introductionmentioning

confidence: 99%

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Management der Aufwachphase- mit oder ohne Hilfe?

Kästner¹

2010

PHK

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management der Aufwachphase- mit oder ohne Hilfe?

Kästner¹

2010

PHK

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“…Existem muitos estudos sobre as fatalidades em equinos no momento pós-anestésico, e eles apontam problemas ortopédicos como um dos maiores causadores de morte (JOHNSTON et al, 1995(JOHNSTON et al, , 2002BIDWELL;BRAMLAGE;ROOD, 2007) dentro desse período, apesar de não detalharem a causa dessas mortes nesse grupo de pacientes. Johnston (2002), no entanto, relata que 13,1% das mortes de pacientes submetidos a cirurgias diferentes de cólica eram de causa abdominal.…”

Section: Comparação Entre Os Grupos No Momento D-entrada (Grupo 1) E unclassified

“…Johnston (2002), no entanto, relata que 13,1% das mortes de pacientes submetidos a cirurgias diferentes de cólica eram de causa abdominal.…”

Section: Comparação Entre Os Grupos No Momento D-entrada (Grupo 1) E unclassified

<b>Controle ultrassonográfico do sistema gastrointestinal de cavalos hospitalizados por queixas primárias de claudicação submetidos ou não a cirurgia ortopédica</b>

Martins¹

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AgradecimentosAo meu pai, que apesar de não ter tido oportunidade de me acompanhar nessa trajetória, sempre me apoiou em todas as minhas decisões e com quem sempre compartilhei meus sonhos. À minha mãe, responsável por muito do que sou e do que serei. A vocês, obrigada por todo amor e dedicação na minha formação. À minha irmã Isabelle, pelo suporte e apoio nos momentos de maior tensão.Ao Fefê, por todo amor, cumplicidade, ensinamento e parceria neste período.Obrigada por me passar um pouco de sua espiritualidade, por me ensinar a superar as dificuldades e mostrar que o no amor não existem diferenças. Agradeço também às nossas cachorrinhas Clara, Madona e Tina.À Elisinha, por todo amor e festa desde o momento que acordo até a minha volta para casa. Obrigada por me ensinar a amar mais os animais e ter ainda mais compaixão por eles. Group 2 comprised horses admitted to the hospital for medically managed orthopedic cases. Group 1 consisted of horses admitted to the hospital for surgical management under general anesthesia. Group 2 comprised horses admitted to the hospital for medically managed orthopedic cases. Group 1 consisted of horses admitted to the hospital for orthopedic surgery. Group 2 comprised horses admitted to the hospital for medically managed orthopedic cases. Abdominal ultrasonography was performed daily from admission to fifth day of hospitalization. Group 1 animals also had pre-and post-operative ultrasonographic evaluation to assess the effect of surgery on the gastrointestinal system. Ultrasonography was not successful at early detection of colic in any animal. The results also showed a higher incidence of colic in animals undergoing surgery (with no statistical difference), particularly on the second or third day postoperative, as well as a reduction in both large and small colon motility in animals undergoing surgery. No significant changes in wall thickness of the evaluated loops were observed. In conclusion, ultrasonographic examination could not successfully predict colic but was useful for confirmation of gastrointestinal originof clinical symptoms during the examination of affected animals.

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Anesthetic Considerations for Horses with Neurologic Disease

Smith¹

2007

Equine Neurology

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149Neurologic disease can present a variety of challenges for the anesthetist. The unique anatomical features of the brain limit its ability to respond to inflammatory, traumatic, and neoplastic challenges. Horses presenting with spinal cord or peripheral neuropathies can be challenging to the anesthetist due to the increased danger of a large, ataxic patient. The goal of neurologic anesthesia is to maintain adequate nourishment and blood delivery to the brain, minimize the development of seizures, minimize the effects of ataxia on the patient's safety, and prevent further deterioration of neurologic status.An understanding of the anatomy and physiology of the nervous system and how it relates to anesthesia is important in understanding how best to maximize patient safety and minimize morbidity and mortality.The brain is housed entirely within a bony cavity. This rigid structure does not allow for an increase in volume when faced with a traumatic, inflammatory, or neoplastic insult. Minor changes in cerebral blood flow (CBF), cerebrospinal fluid (CSF), or tissue volume (i.e., mass) can quickly result in a moderateto-severe increase in intracranial pressure (ICP). Elevated ICP can cause regional and global cerebral ischemia and hypoxia due to a reduction in cerebral perfusion pressure (CPP) and CBF, and ultimately can lead to potentially fatal displacement of brain and neuronal tissue, including brainstem herniation. 1 CBF is directly proportional to CPP and indirectly proportional to cerebral vascular resistance (CVR). Of these components, only CBF can be easily influenced by the anesthetist and thus is of particular interest.In a normal horse, CBF is under metabolic (chemical), myogenic (autoregulation), and neurogenic factors. 2 This control ensures consistent, high flow of blood to the brain over a range of arterial blood pressures. The mean arterial pressure (MAP) range within which CBF remains under autoregulatory control has not been defined in horses; however, in humans, the CBF remains consistent over 70-140 mm Hg, and animals may have better regulation of flow at lower arterial pressures. 2 Horses, due to their large size, undergo large orthostatic shifts when positioned in lateral or dorsal recumbency for general anesthesia. 3 These fluid shifts can alter MAP and thus have an effect on CPP.Chemical or metabolic factors that influence CBF include cerebral metabolic rate (CMR), the partial pressure of arterial carbon dioxide (P a CO 2 ), the partial pressure of arterial oxygen (P a O 2 ), and temperature. An increase in CMR will lead to an increase in CBF. 2 Anesthetics, both injectable and inhaled, can alter CMR and therefore influence CBF. Likewise, an increase in the temperature of the brain causes an increase in CBF.There is a directly proportionate relationship between CBF and P a CO 2 . These changes are due to intra-and extracellular pH alterations. Hypocapnia and alkalemia lead to a decrease in CBF due to vasoconstriction, resulting in an increase in CVR. Conversely, hypercapnia and acidemia resul...

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The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2

Cited by 432 publications

References 27 publications

Management der Aufwachphase- mit oder ohne Hilfe?

Management der Aufwachphase- mit oder ohne Hilfe?

<b>Controle ultrassonográfico do sistema gastrointestinal de cavalos hospitalizados por queixas primárias de claudicação submetidos ou não a cirurgia ortopédica</b>

Anesthetic Considerations for Horses with Neurologic Disease

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