Prevalence and degree of orotracheal intubation-related tracheal lesions in horses.
Authors: Parente, Geburek, Kästner, Iversen, Hopster
Journal: Equine veterinary journal
Summary
Endotracheal intubation during equine general anaesthesia is routine practice for securing airways, yet the extent and timeline of mucosal damage has been poorly characterised in the literature. Parente and colleagues prospectively examined 40 adult Warmblood horses undergoing elective surgery, performing endoscopic assessments before intubation, immediately post-extubation, and at days 1, 3, 5 and 7, scoring tracheal lesions (redness, secretions, bleeding, erosions) on a severity scale of 0–4. Although median tracheal injury scores peaked at day 1 post-anaesthesia (11 out of a possible maximum of 16), complete healing occurred by day 7 in 90% of horses, with intubation duration emerging as the only significant predictor of damage severity (r² = 0.67). Importantly, no horses developed clinical signs of respiratory compromise during the healing period despite the documented inflammation, suggesting that focal tracheal trauma from silicone tubes inflated to 40 cmH₂O represents an expected but self-limiting consequence of routine anaesthetic management. For practitioners, this provides reassurance that uncomplicated intubation-related tracheal lesions resolve spontaneously within a week, though minimising intubation duration remains the most practical strategy for reducing mucosal injury in your anaesthetised patients.
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Practical Takeaways
- •Endotracheal intubation for general anaesthesia routinely causes tracheal inflammation in horses, but this resolves spontaneously within one week without clinical consequences in most cases
- •Minimizing intubation duration is important as longer anaesthesia time correlates directly with increased tracheal injury severity
- •Post-operative monitoring for clinical signs of tracheitis is warranted, though complications appear rare; most horses show no clinical signs despite endoscopic evidence of mucosal changes
Key Findings
- •Tracheal lesions occurred in horses following orotracheal intubation, with median scoring increasing from 6 immediately post-extubation to 11 at day 1 (p=0.021)
- •All lesions resolved within 7 days with only 4/40 horses showing mild tracheitis at day 7, and no clinical signs observed in any horse
- •Duration of intubation showed strong positive correlation with degree of tracheal damage (r²=0.67, p<0.001)
- •Focal tracheal inflammation is an expected consequence of orotracheal intubation but self-limiting and clinically benign in elective surgery cases