Hemodynamic and respiratory responses in halothane-anesthetized horses exposed to positive end-expiratory pressure alone and with dobutamine

Abstract

The influence of positive end-expiratory pressure (PEEP) on the alveolar-arterial O2 tension difference [P(A-a)O2], physiologic right-to-left shunt fraction, physiologic dead space-to-tidal volume ratio, and hemodynamic variables was studied in halothane-anesthetized horses maintained in dorsal recumbency during controlled ventilation. Dobutamine was used to minimize the adverse cardiovascular consequences of PEEP. Six adult horses were anesthetized, using xylazine (2.2 mg/kg of body weight, IM), guaifenesin (50 mg/kg, IV), thiamylal Na (4.4 mg/kg, IV), and halothane (1.5 to 2% inspired) in 100% O2. Mechanical ventilation was controlled to maintain arterial eucapnia for at least 45 minutes during base-line measurements. Hemodynamic and respiratory variables were determined every 15 minutes during equilibration. Each horse was subjected to 4 randomized treatments: 5 cm of H2O PEEP, 10 cm of H2O PEEP, 5 cm of H2O PEEP plus dobutamine (1 microgram/kg/min), and 10 cm of H2O PEEP plus dobutamine (1 microgram/kg/min). Each treatment lasted 15 minutes and immediately followed its predecessor. Although the magnitude of PEEP was randomized with and without dobutamine, PEEP without dobutamine always preceded PEEP with dobutamine. Differences in hemodynamic or respiratory variables among base-line measurements, 5 cm of H2O PEEP, or 10 cm of H2O PEEP were not significant (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)