A simple method to provide positive end expiratory pressure to treat hypoxaemia in an anaesthetised Asian Elephant (Elephas maximus)

Journal of the South African Veterinary Association

Field Value
Title A simple method to provide positive end expiratory pressure to treat hypoxaemia in an anaesthetised Asian Elephant (Elephas maximus)
Creator Leung, Jessica Beths, Thierry Lynch, Michael Frith, Sarah Bauquier, Sebastien H.
Subject Anaesthesia; immobilization; anaesthesia; Asian elephant; Elephas maximus; hypoxaemia; Positive end-expiratory pressure; ventilation
Description Hypoxaemia is a common complication in anaesthetised or immobilised elephants. It is presumably because of hypoventilation and ventilation-perfusion mismatch. To prevent hypoxaemia, orotracheal intubation and positive pressure ventilation are recommended. This case report describes a hypoxaemic period despite positive pressure ventilation in a 46-year-old female Asian elephant (Elephas maximus) anaesthetised with azaperone-etorphine, medetomidine and an etorphine constant rate infusion in lateral recumbency for a dental procedure. The hypoxaemia was corrected utilising positive end-expiratory pressure (PEEP) of 5 cm – 10 cm H2O, a technique that has not previously been reported in the management of anaesthetised elephants. PEEP decreases atelectasis, shunt fraction, and increases lung compliance. Positive end-expiratory pressure was achieved by partial occlusion of the tailpiece of a manually triggered demand valve ventilator during expiration. This is a simple effective method of generating PEEP and correcting hypoxaemia without the need for any additional specialised equipment. However, PEEP decreased arterial blood pressure and should be implemented with caution if arterial blood pressure is not monitored.
Publisher AOSIS
Date 2021-05-19
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/jsava.v92i0.2118
Source Journal of the South African Veterinary Association; Vol 92 (2021); 4 pages 2224-9435 1019-9128
Language eng
Relation https://journals.jsava.aosis.co.za/index.php/jsava/article/view/2118/2718 https://journals.jsava.aosis.co.za/index.php/jsava/article/view/2118/2717 https://journals.jsava.aosis.co.za/index.php/jsava/article/view/2118/2719 https://journals.jsava.aosis.co.za/index.php/jsava/article/view/2118/2716
Coverage — — —
Rights Copyright (c) 2021 Sebastien H Bauquier, Jessica Leung, Thierry Beths, Sarah Frith, Michael Lynch https://creativecommons.org/licenses/by/4.0