Prevalence and degree of orotracheal intubation-related tracheal lesions in horses
Creators: name: Parente, Aiden
name: Geburek, Florian
name: Kaestner, Sabine
name: Hopster, Klaus
Publisher: name: Zenodo
Year: 2025
Subjects: equine anesthesia
Intubation
Trachea

description: Background: Orotracheal intubation is commonly performed for inhalation anesthesia in horses to ensure safe and reliable administration of volatile anesthetics and to secure the airways. In human and equine medicine, the occurrence of intubation-associated complications has been described, which can range from mild mucosal irritation to severe necrosis. However, there are only sparse descriptions of mucosal alterations and the course of healing after elective surgery in horses.

Objective: To investigate the prevalemce and severity of tracheal lesions following endotracheal intubation associated with general anesthesia in equine patients.

Study design: Prospective, clinical study

Methods: Forty adult warmblood horses, weighing 400-600 kg, presented for elective surgery under general anesthesia were included. For orotracheal intubation a silicone tube was used and inflated until a cuff pressure of 40 cmH2O was confirmed. In all horses, endoscopic examination of the trachea with video documentation was performed prior to intubation and immediately after extubation as well as 1, 3, 5 and 7 days after general anesthesia. The type (redness, secretion, bleeding, erosions) and degree (0 = non-existent to 4 = severe) of corresponding lesions were assessed and scored. The occurrences of clinical signs were recorded. Statistical evaluation was performed using Friedman`s test and Pearson correlation.

Results: The median score immediately after recovery from anesthesia was 6 (2-12) and increased significantly to 11 (4-15) after one day (p =0.021). At day 7 the median score was 0 (0-2) with only four horses showing signs of mild tracheitis, and clinical signs were not observed throughout this time period.  Duration of intubation correlated with degree of tracheal damage (r2 =0.67, p < 0.001).

Main Limitations: Clinical, non-randomized study without control group.

Conclusion: Although orotracheal intubation was accompanied by focal inflammation of the trachea, in the present study no horse showed clinical signs and lesions healed within a week.
description: Funding provided by: University of Veterinary Medicine Hannover, FoundationROR ID: https://ror.org/015qjqf64Award Number:
description: Forty adult warmblood horses, weighing 400-600 kg, presented for elective surgery under general anesthesia were included. For orotracheal intubation a silicone tube was used and inflated until a cuff pressure of 40 cmH2O was confirmed. In all horses, endoscopic examination of the trachea with video documentation was performed prior to intubation and immediately after extubation as well as 1, 3, 5 and 7 days after general anesthesia. The type (redness, secretion, bleeding, erosions) and degree (0 = non-existent to 4 = severe) of corresponding lesions were assessed and scored. The occurrences of clinical signs were recorded. Statistical evaluation was performed using Friedman`s test and Pearson correlation.