By V. Bernard, William
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Extra info for Equine Pediatric Medicine
The main problem with direct monitoring of BP is maintenance of the catheter, especially in struggling or 17 17 Infiltration of local anesthetic subcutaneously over the dorsal metatarsal artery prior to catheterization. 19 19 Arterial catheter in place. The catheter has been fixed to the skin of the foal using instant bonding glue. seizuring foals. The author’s preferred technique is to place a rolled, half 4 × 4 gauze (swab) either side of the catheter and then wrap it with self-adhesive bandage.
Attempts to reduce the risk of infection with antibacterial impregnated catheters have not been successful in human medicine. Therapies aimed at improving cardiovascular status that result in decreased urine output are highly unlikely to be beneficial and should be urgently reviewed. Conversely, improved urine output is one of the earliest signs of successful therapy. Falling urine output is an early indicator of hypovolemia. Hemodynamics are not the only factors that can affect urine output. Acute renal failure may result in oliguria, anuria or, uncommonly in foals, polyuria.
In normal adult horses, phenylephrine infusion resulted in increased SVR and mean arterial pressure, but decreased cardiac output. The decrease in cardiac output was a result of decreased heart rate, and cardiac stroke volume was unchanged. Similar findings were found in anesthetized normal neonatal foals; however, these were normal horses, and findings in septic or endotoxic animals may differ. These findings may suggest that norepinephrine, which is also an agonist for beta-1 receptors and, therefore, a positive inotrope, may have advantages over phenylephrine as a vasopressor.