A simple method to provide positive end expiratory pressure to treat hypoxaemia in an anaesthetised Asian Elephant (Elephas maximus)

Authors

  • Jessica Leung The University of Melbourne
  • Thierry Beths The University of Melbourne
  • Michael Lynch Zoos Victoria
  • Sarah Frith Zoos Victoria
  • Sebastien H Bauquier The University of Melbourne

Abstract

Hypoxaemia is a common complication in anaesthetised or immobilised elephants. It is presumably because of hypoventilation and ventilation-perfusion mismatch. To prevent hypoxaemia, orotracheal intubation and positive pressure ventilation are recommended. This case report describes a hypoxaemic period despite positive pressure ventilation in a 46-year-old female Asian elephant (Elephas maximus) anaesthetised with azaperone-etorphine, medetomidine and an etorphine constant rate infusion in lateral recumbency for a dental procedure. The hypoxaemia was corrected utilising positive end-expiratory pressure (PEEP)
of 5 cm – 10 cm H2 O, a technique that has not previously been reported in the management of anaesthetised elephants. PEEP decreases atelectasis, shunt fraction, and increases lung compliance. Positive end-expiratory pressure was achieved by partial occlusion of the tailpiece of a manually triggered demand valve ventilator during expiration. This is a simple effective method of generating PEEP and correcting hypoxaemia without the need for any additional specialised equipment. However, PEEP decreased arterial blood pressure and should be implemented with caution if arterial blood pressure is not monitored. Keywords: anaesthesia; Asian elephant; Elephas maximus; hypoxaemia; Positive endexpiratory pressure; ventilation.

Author Biographies

Jessica Leung, The University of Melbourne

UVet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Australia

Thierry Beths, The University of Melbourne

UVet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne,
Werribee, Australia

Michael Lynch, Zoos Victoria

Faculty of Veterinary and Agricultural Sciences, Zoos Victoria, Parkville, Australia

Sarah Frith, Zoos Victoria

Faculty of Veterinary and Agricultural Sciences, Zoos Victoria, Parkville, Australia

Sebastien H Bauquier, The University of Melbourne

UVet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne,
Werribee, Australia

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Published

2021-12-09

Issue

Section

Case Report