Continuous measurement of arterial oxygenation in mechanically ventilated horses

Summary Background The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO 2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. Objectives The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO 2 (PaO 2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. Study design In vivo experimental study. Methods Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteries through a catheter to continuously measure and record PaO 2Sensor . After an alveolar recruitment manoeuvre, a decremental positive end‐expiratory pressure (PEEP) titration using 20‐minute steps of 5 cm H 2 O from 20 to 0 cm H 2 O was performed. An arterial blood sample was collected at 15 minutes of ventilation at each PEEP level for PaO 2 measurement using an automated blood gas machine (PaO 2Ref ). The agreement between PaO 2Sensor and PaO 2Ref was assessed by Pearson's correlation, Bland‐Altman plot and four‐quadrant plot analysis. In the last minute of ventilation at each PEEP level, a slow tidal inflation/deflation manoeuvre was performed. Results The mean relative bias between PaO 2Sensor and PaO 2Ref was 4% with limits of agreement between −17% and 29%. The correlation coefficient between PaO 2Sensor and PaO 2Ref was 0.98 ( P < .001). The PaO 2Sensor and PaO 2Ref concordance rate for changes was 95%. Measurements of PaO 2Sensor during the slow inflation/deflation manoeuvre at PEEP 15 and 10 cm H 2 O were not possible because of significant noise on the PaO 2 signal generated by a small blood clot. Main limitations Small sample size. Conclusion The tested fibreoptic probe was able to accurately and continuously measure PaO 2Sensor in anaesthetised horses undergoing ventilatory manoeuvres. A heparinised system in the catheter used by the fibreoptic sensor should be used to avoid blood clots and artefacts in the PaO 2 measurements.