To remedy the hypercapnia , IPPV can be performed up to 20 cmH 2
O , which would actively reduce the CO 2 by causing the body to expel the expiratory gas via increased respiratory minute volume . In this instance , the patient may briefly present with alkalaemia while the HCO 3
– responds and reduces . The buffering system is a short-term solution to maintain the pH , as metabolic compensation takes longer to have an effect .
An increase in lactate implies there is a lack of oxygen delivery to the tissues , in other words , a perfusion problem . In this case , hypotension could have been the cause of an increase in lactate . As the blood pressure increased , the lactate reduced . Another possibility is that the lateral positioning of the patient could have caused a compression of dependent tissues ; the pressure meant that blood flow decreased , causing the tissues to become poorly perfused .
Recovery
Once the surgical procedure had been completed , the isoflurane was turned off and O 2 flow was increased to aid the removal of the isoflurane from the circuit . The patient was extubated at signs of swallowing and limb movement . To avoid hypoxia during recovery , O 2 therapy was provided intranasally until the patient was standing . Once the nystagmus had diminished , the patient was allowed to stand ; one person supported his head by holding on to the halter , with another person ready at the base of the tail to support his back , if necessary .
Conclusions
This case study highlights the challenges of anaesthetising donkeys , whose unique anatomy and physiology require specific management . Despite the routine nature of the procedure , complications such as hypoventilation , hypotension , hypothermia and hypoxia emerged , underscoring the importance of vigilant monitoring and timely intervention .
Key learnings include recognising species-specific responses to anaesthetic agents and the critical role of arterial blood gas analysis in assessing a patient ' s respiratory and metabolic status . In this case , addressing complications with strategies such as adjusting anaesthetic depth , administering fluids or inotropes , employing ARM , and maintaining normothermia through active warming , proved effective .
VNs play an essential role in performing these interventions and ensuring optimal patient outcomes . By deepening our understanding of species-specific anaesthetic considerations and refining techniques , we can better mitigate risks and improve patient care in future procedures .
Acknowledgements
The author would like to thank Brighton Dzikiti , Carly Walters and Olivia Shelley for their valuable feedback and constructive comments during the peer-review process . Their insights greatly contributed to the improvement of this manuscript .
Assessment of learning
1 . Which of the following reduces MAC ? a ) Hypotension b ) Hypoventilation c ) Hypothermia d ) Hypercapnia
2 . A pH of 7.305 indicates which of the following ? a ) Acidaemia b ) Alkalaemia c ) Respiratory acidosis d ) Lactic acidosis
3 . A V / Q mismatch when ventilation is compromised can be caused by which of the following ?
a ) A shallow respiratory pattern b ) Atelectasis of the down lung c ) Anaemia d ) Pulmonary embolism 4 . If a patient has a PaO 2 of 250 mmHg on 100 %
O 2
, what is the expected PaO 2 on 21 % oxygen ? a ) 250 mmHg b ) 60 mmHg c ) 500 mmHg d ) 52 mmHg
1 . c ) Hypothermia 2 . a ) Acidaemia 3 . b ) Atelectasis of the down lung 4 . d ) 52 mmHg
Answers
22 Veterinary Nursing Journal