Successful Cardiopulmonary Resuscitation in a Sevoflurane Anaesthetized Horse That Suffered Cardiac Arrest at Recovery.
Authors: Conde Ruiz Clara, Junot Stéphane
Journal: Frontiers in veterinary science
Summary
# Editorial Summary A 17-year-old mare collapsed into cardiac arrest during the critical transition from theatre to recovery following routine dental surgery under sevoflurane anaesthesia, but prompt recognition and aggressive intervention—comprising external thoracic compressions, intermittent positive pressure ventilation, and adrenaline administration—successfully restored cardiac function and ultimately saved the horse's life. Although the underlying cause could not be definitively established, the authors propose a Bezold-Jarisch reflex triggered by compromised venous return during positional changes, potentially compounded by drug interactions affecting the sympatho-vagal balance. This case highlights that peri-recovery cardiac arrest, whilst rare, demands immediate recognition and action; clinicians should be particularly vigilant during position changes and patient transfers, when haemodynamic instability is most likely to manifest in anaesthetised horses. The practical takeaway for anaesthetic teams is clear: position transitions should be performed gradually and deliberately, and administration of cardiovascular-active or sympathomimetic drugs should be timed carefully to avoid coinciding with recumbency changes. Given the successful outcome through standard CPR protocols, this report reinforces the value of rapid intervention and supports continued investment in resuscitation training and equipment within equine anaesthetic practice.
Read the full abstract on PubMed
Practical Takeaways
- •Monitor cardiovascular status carefully during positional changes in anaesthetized horses, especially when moving patients from theatre to recovery
- •Avoid administering drugs that affect cardiovascular hemodynamics or sympatho-vagal balance during changes in patient recumbency
- •Be prepared to initiate immediate CPR if cardiac arrest occurs; external thoracic compressions combined with ventilation and adrenaline can be effective even in equine patients
Key Findings
- •Cardiac arrest in a 17-year-old mare was successfully reversed using external thoracic compressions, intermittent positive pressure ventilation, and adrenaline administration
- •Bezold-Jarisch reflex triggered by postural change and decreased venous return was hypothesized as the underlying cause
- •Early diagnosis and prompt initiation of cardiopulmonary resuscitation enabled successful recovery