Effect of different inspired fractions of oxygen on F-shunt and arterial partial pressure of oxygen in isoflurane-anaesthetized and mechanically ventilated Shetland ponies

Objective: To determine the effect of fraction of inspired oxygen (FIO2) on intrapulmonary shunt fraction as measured by F-shunt in ponies during isoflurane anaesthesia. Study design: Prospective, randomized clinical study. Animals: A group of 23 adult Shetland ponies undergoing a total of 32 anaesthetic procedures. Methods: Ponies were premedicated intravenously (IV) with detomidine (0.01 mg kg–1) and either morphine (0.1 mg kg–1) or butorphanol (0.02 mg kg–1). Anaesthesia was induced with ketamine (2.2 mg kg–1) and midazolam (0.07 mg kg–1) administered IV. Ponies were randomly allocated to maintenance of anaesthesia with isoflurane in oxygen (group TH; FIO2 = 0.95) or a mixture of oxygen and medical air (group TL; FIO2 = 0.65); all ponies were given a constant rate of infusion of detomidine. Animals were mechanically ventilated to maintain PaCO2 between 40 and 50 mmHg. Arterial blood gas analysis was performed every 30 minutes. The F-shunt equation was calculated for each time point T0, T30, T60 and T90. Data were analysed using linear mixed model analysis and presented as mean ± standard deviation (p < 0.05). Results: PaO2 was greater in group TH than in group TL (TH: 406 ± 90, 438 ± 83, 441 ± 69 and 464 ± 53 mmHg versus TL: 202 ± 90, 186 ± 84, 172 ± 85 and 191 ± 98 mmHg at T0, T30, T60 and T90, respectively; p < 0.0001). In TH, F-shunt was < TL. Significant differences were found at T60 (TH: 13.2% ± 4.3 versus TL: 19.4% ± 8.3; p = 0.016) and T90 (TH: 11.7% ± 3.5 versus TL: 18.6% ± 9.5; p = 0.036). Conclusions and clinical relevance: Our findings do not support a beneficial effect of using a reduced FIO2 to improve oxygenation in anaesthetized and mechanically ventilated Shetland ponies.