Continuous measurement of arterial oxygenation in mechanically ventilated horses

Background The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2) 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 PaO2 (PaO2Sensor) 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 PaO2Sensor. After an alveolar recruitment manoeuvre, a decremental positive end-expiratory pressure (PEEP) titration using 20-minute steps of 5 cm H2O from 20 to 0 cm H2O was performed. An arterial blood sample was collected at 15 minutes of ventilation at each PEEP level for PaO2 measurement using an automated blood gas machine (PaO2Ref). The agreement between PaO2Sensor and PaO2Ref 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 PaO2Sensor and PaO2Ref was 4% with limits of agreement between -17% and 29%. The correlation coefficient between PaO2Sensor and PaO2Ref was 0.98 (P < .001). The PaO2Sensor and PaO2Ref concordance rate for changes was 95%. Measurements of PaO2Sensor during the slow inflation/deflation manoeuvre at PEEP 15 and 10 cm H2O were not possible because of significant noise on the PaO2 signal generated by a small blood clot. Main limitations Small sample size. Conclusion The tested fibreoptic probe was able to accurately and continuously measure PaO2Sensor 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 PaO2 measurements.