Premium
Severe intraoperative hypoxaemia in a horse due to failure of an oxygen concentrator and auxiliary oxygen supply
Author(s) -
Kropf Josephine,
Hughes J. M. Lynne
Publication year - 2018
Publication title -
veterinary record case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.165
H-Index - 4
ISSN - 2052-6121
DOI - 10.1136/vetreccr-2018-000740
Subject(s) - medicine , anesthesia , exploratory laparotomy , oxygen , insufflation , horse , surgery , paleontology , chemistry , organic chemistry , biology
A horse with acute colic underwent exploratory laparotomy. Following anaesthetic induction, the inspired fraction of oxygen (FiO 2 ) was found to be 0.23 and severe hypoxaemia (PaO 2 : 4.12 kPa [30.9 mmHg]) was detected. The terminal oxygen outlet was delivering mostly pressurised room air due to a mechanical fault within the oxygen concentrator, with subsequent failure of the auxiliary oxygen manifold. The oxygen supply in the operating room was switched to a cylinder (FiO 2 : 0.95) but PaO 2 increased to only 12.3 kPa [92.3 mmHg], indicating probable ventilation/perfusion mismatch. Anaesthetic recovery was uneventful, but signs of abdominal pain returned four days later. A second laparotomy revealed perforation of the jejunum and generalised peritonitis, and the horse was euthanased. Failure of both an oxygen concentrator and the backup supply is rare but potentially disastrous. A thorough preanaesthetic equipment check, including the FiO 2 , and detailed knowledge of all equipment components are essential for the anaesthetist.