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Fatal post-anaesthetic pulmonary haemorrhage in a horse suffering from chronic-active exercise-induced pulmonary haemorrhage
Equine Veterinary Education ( IF 0.9 ) Pub Date : 2020-06-09 , DOI: 10.1111/eve.13292
K. J. Boustead 1, 2 , J. Steyl 3 , K. Joubert 1, 4
Affiliation  

A 17-year-old Thoroughbred gelding was admitted for arthroscopic examination and lavage of the right tarso-crural joint under general anaesthesia. Based on preanaesthetic examination, the patient was considered clinically healthy. No complications were experienced during induction and maintenance of anaesthesia. During the recovery period, the patient experienced acute pulmonary haemorrhage resulting in death. Post-mortem examination revealed macroscopic and histopathological lesions indicative of exercise-induced pulmonary haemorrhage (EIPH) with associated acute rupture of the pulmonary vessels (primarily venous). The cause of acute pulmonary blood vessel rupture in this case was speculated to be a result of increased transmural pressures in weakened blood vessels. Partial airway obstruction, catecholamine release, hypoxic pulmonary vasoconstriction, the use of the alpha-2 adrenoreceptor agonists, fluid overload and blunt trauma may have led to the increase in pulmonary blood vessel transmural pressures. To the best of the authors’ knowledge, this is the first description of acute pulmonary haemorrhage in the peri-anaesthetic period in a horse with underlying EIPH. In addition to describing the case, this case report also looks at anaesthetic management options in horses with known EIPH.

中文翻译:

一匹患有慢性活动性运动诱发的肺出血的马的致命麻醉后肺出血

一头 17 岁的纯种阉马在全身麻醉下接受关节镜检查和右侧跗脚关节灌洗。根据麻醉前检查,患者被认为临床健康。在麻醉诱导和维持期间没有出现并发症。在恢复期间,患者经历了急性肺出血导致死亡。尸检显示肉眼可见的和组织病理学病变表明运动诱发的肺出血 (EIPH) 伴有相关的肺血管(主要是静脉)急性破裂。在这种情况下,急性肺血管破裂的原因被推测是由于削弱的血管中的跨壁压增加。部分气道阻塞,儿茶酚胺释放,缺氧性肺血管收缩、使用 α-2 肾上腺素能受体激动剂、液体超负荷和钝性创伤可能导致肺血管跨壁压升高。据作者所知,这是对一匹患有潜在 EIPH 的马在麻醉期间出现急性肺出血的首次描述。除了描述病例外,本病例报告还研究了已知 EIPH 马匹的麻醉管理选择。
更新日期:2020-06-09
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