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Investigation of perioperative and anesthetic variables affecting short‐term survival of horses with small intestinal strangulating lesions
Author(s) -
Espinosa Pablo,
Le Jeune Sarah S.,
Cenani Alessia,
Kass Philip H.,
Brosnan Robert J.
Publication year - 2017
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.12618
Subject(s) - medicine , anesthetic , perioperative , anesthesia , surgery
Objective To determine if preoperative and intraoperative physiologic variables, and surgical factors correlate with survival to anesthetic recovery or hospital discharge, repeat celiotomy, and postoperative nasogastric intubation (NGT) in horses undergoing exploratory celiotomy for small intestinal (SI) strangulating lesions. Study Design Retrospective case series. Animals Horses that had surgical correction of SI strangulating lesions (n = 258). Methods Medical records (January 2000‐December 2014) of horses that had surgical correction of SI strangulating lesions were reviewed. Data collection included signalment, preoperative physical examination variables, hematologic values, presence of gastric reflux, peritoneal fluid analysis, intraoperative physiologic variables, intraoperative findings/treatments, and arterial blood gas values. Risk factors for survival to anesthetic recovery and hospital discharge were determined using exact logistic regression. Results Survival to anesthetic recovery was 76% and survival to discharge after anesthetic recovery was 79%. The difference between abdominal and peripheral lactate concentrations and intraoperative tachycardia were associated with not surviving to anesthetic recovery or hospital discharge. Intraoperative hypotension, hypocapnia, and low intraoperative packed cell volume (PCV) were negative predictors of survival to anesthetic recovery. Low intraoperative PCV was also associated with NGT postoperatively. Performing resection‐anastomosis and jejunocecostomy were associated with repeat celiotomy and with not surviving to hospital discharge. Conclusion Several hematological and cardiorespiratory variables show good correlation with short‐term survival in horses undergoing surgery for SI strangulating lesions. These variables are easily measured and could be useful for prognosticating survival in horses presenting with SI strangulating lesions.