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健康马全身麻醉择期手术的围术期肺超声检查。

Perioperative lung ultrasonography in healthy horses undergoing general anesthesia for elective surgery.

机构信息

Dierenkliniek de Morette, Asse, Belgium.

Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiege), Fundamental and Applied Research for Animal Health (FARAH) Center, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.

出版信息

J Vet Intern Med. 2022 May;36(3):1160-1172. doi: 10.1111/jvim.16408. Epub 2022 Mar 24.

Abstract

BACKGROUND

Lung ultrasound (LUS) is poorly evaluated in horses, especially perioperatively.

OBJECTIVES

(1) Describe LUS findings in healthy horses before and after general anesthesia (GA), (2) evaluate if GA induces ultrasonographic changes in healthy horses, (3) suggest a LUS scoring system, (4) identify horse variables that are associated to LUS changes after anesthesia.

ANIMALS

Twenty-five healthy adult horses undergoing elective surgery.

METHODS

Prospective hypothesis-driven observational study. LUS findings were recorded before anesthesia, 5 minutes in recovery, 15 minutes, 2H, 3H, 4H, 6H, and 24H after anesthesia in 8 lung regions. Clinical data were collected perioperatively.

RESULTS

There was a significant increase in amount of I-lines (10.8 ± 8.7 vs 15.28 ± 8.19), B-lines (3.2 ± 3.5 vs 8.72 ± 4.86), and coalescent B-lines (0.04 ± 0.2 vs 1.12 ± 1.45) after anesthesia compared to before anesthesia, and a significantly higher LUS score 2H after anesthesia (4.92 ± 8.40) compared to before anesthesia (0.9 ± 1.8; P = .02). The maximal LUS score after anesthesia was correlated to total procedure time (Pearson r = 0.4, P = .05; Spearman r = 0.44, P = .03) and was significantly higher in horses with abnormal cardiorespiratory values during anesthesia (P = .005).

CONCLUSIONS

LUS changes can be induced by GA in healthy horses. This study did not investigate if and which LUS findings indicate lesions, however, this information can aid clinicians to identify pulmonary complications after anesthesia.

摘要

背景

肺部超声(LUS)在马中评估不佳,特别是在围手术期。

目的

(1)描述健康马在全身麻醉(GA)前后的 LUS 表现,(2)评估 GA 是否会引起健康马的超声变化,(3)提出 LUS 评分系统,(4)确定麻醉后与 LUS 变化相关的马变量。

动物

25 匹接受择期手术的健康成年马。

方法

前瞻性假设驱动的观察性研究。在麻醉前、麻醉后 5 分钟、15 分钟、2 小时、3 小时、4 小时、6 小时和 24 小时,在 8 个肺区记录 LUS 表现。围手术期采集临床数据。

结果

与麻醉前相比,麻醉后 I 线(10.8±8.7 对 15.28±8.19)、B 线(3.2±3.5 对 8.72±4.86)和融合 B 线(0.04±0.2 对 1.12±1.45)的数量显著增加,麻醉后 2 小时的 LUS 评分(4.92±8.40)明显高于麻醉前(0.9±1.8;P=0.02)。麻醉后最大 LUS 评分与总手术时间相关(Pearson r=0.4,P=0.05;Spearman r=0.44,P=0.03),并且在麻醉期间心肺值异常的马中显著更高(P=0.005)。

结论

GA 可引起健康马的 LUS 变化。本研究并未探讨 LUS 表现是否以及哪些表现表明存在病变,但这些信息可以帮助临床医生识别麻醉后肺部并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d7/9151480/e3339336eda1/JVIM-36-1160-g001.jpg

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