title: Near-fatal misuse of medical tape around an endotracheal tube connector during inhalation anesthesia in a horse.
abstract: A 7-year-old gelded Irish sports horse weighing 650 kg was anesthetized on 2 consecutive days for lavage of a septic right radio-carpal joint. On both occasions the endotracheal tube connector, which had been bound in medical tape to produce an airtight seal, functioned as a unidirectional valve during mechanical ventilation, retarding expiration, imposing positive end expiratory pressure (PEEP), and probably continuous positive airway pressure (CPAP). The equipment dysfunction was not identified on either occasion despite close inspection prompted by progressive increases in airway pressure and thoracic distension. Whilst the PEEP and CPAP exerted unexpectedly modest cardiovascular effects and the horse recovered uneventfully on both occasions, the improvisation may have proven fatal in a higher-risk subject.
  
  
  
  A 7-year-old gelded Irish sports horse weighing 650 kg was anesthetized on 2 consecutive days for lavage of a septic right radio-carpal joint. On both occasions the endotracheal tube connector, which had been bound in medical tape to produce an airtight seal, functioned as a unidirectional valve during mechanical ventilation, retarding expiration, imposing positive end expiratory pressure (PEEP), and probably continuous positive airway pressure (CPAP). The equipment dysfunction was not identified on either occasion despite close inspection prompted by progressive increases in airway pressure and thoracic distension. Whilst the PEEP and CPAP exerted unexpectedly modest cardiovascular effects and the horse recovered uneventfully on both occasions, the improvisation may have proven fatal in a higher-risk subject.
authors: Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Sciences, The University of Edinburgh, Equine Hospital, Easter Bush Veterinary Centre, Midlothian, United Kingdom. rachael_gregson@hotmail.com
authors: Rachael
authors: R
authors: Gregson
authors: R Eddie
authors: RE
authors: Clutton
mesh_terms: D000769:Anesthesia, Inhalation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D000818:Animals; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D006734:Horse Diseases / Q000601:surgery; D006736:Horses; D008297:Male; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*