Clinical evaluation of an end-tidal target-controlled infusion closed-loop system for isoflurane administration in horses undergoing surgical procedures.

A new volatile anaesthetic agent delivery system was tested in 15 horses undergoing scheduled surgical procedures. The delivery system consisted of a laptop computer (with dedicated software), a computer-controlled syringe driver (loaded with liquid isoflurane) connected to the inspiratory arm of a large-animal circle breathing system and a respiratory gas monitor, providing isoflurane end-tidal concentrations (ET(measured)) every 20 s to the computer. Following induction and connection to the breathing system, mechanical ventilation was started. The bodyweight (BW), fresh gas flow, breathing system and ventilator volume, and end-tidal isoflurane target (ET(target)) were entered into the computer. Using Lowe's equation, the software calculated the prime dose to be delivered by the syringe driver over 2 min. After this, the system delivered each minute the amount of isoflurane as determined by the following equation: Isoflurane (mL) = {2 × λ(B/G) × (200 × BW(0.75)) × (ET(target) - ET(measured)) + (fresh gas flow - (BW(0.75) × 0.07)) × (ET(measured))}/206. A fresh gas flow of 4 L oxygen min(-1) was administered until the inspired fraction of oxygen reached 0.7, and was then decreased. A target of 1.5% end-tidal isoflurane was initially used and subsequently adjusted to the clinical requirements. The system performance was evaluated using the median prediction error (MDPE) and the median absolute performance error (MDAPE), which were -3.6% and 5.29%, respectively. It was concluded that this system was useful to achieve end-tidal target-controlled infusion of isoflurane during equine anaesthesia.

New technologies for application to veterinary therapeutics.

The purpose of this contribution is to review new technologies and make an educated prediction as to how they will impact veterinary pharmacology over the coming decades. By examining past developments, it becomes evident that change is incremental and predictable unless either a transforming discovery or a change in societal behaviour occurs. In the last century, both discoveries and behaviours have dramatically changed medicine, pharmacology and therapeutics. In this chapter, the potential effects of six transforming technologies on veterinary therapeutics are examined: continued advances in computer technology, microfluidics, nanotechnology, high-throughput screening, control and targeted drug delivery and pharmacogenomics. These should lead to the more efficacious and safer use of existing medicants, and the development of novel drugs across most therapeutic classes through increases in our knowledge base, as well as more efficient drug development. Although this growth in technology portends major advances over the next few decades, economic and regulatory constraints must still be overcome for these new drugs or therapeutic approaches to become common practise.