Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses.

OBJECTIVE: To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (VTalv), airway (VDaw) and physiological (VDphys) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO2) elimination per breath (Vco2br-1), PaCO2, and the ratio of PaO2-to-fractional inspired oxygen (PaO2:FiO2). STUDY DESIGN: Prospective research study. ANIMALS: A group of eight healthy research horses undergoing laparotomy. METHODS: Anesthetized horses were mechanically ventilated as follows: 6 breaths minute-1, tidal volume (VT) 13 mL kg-1, inspiratory-to-expiratory time ratio 1:2, positive end-expiratory pressure 5 cmH2O and EIP 0%. Vco2br-1 and expired tidal volume (VTE) of 10 consecutive breaths were recorded 30 minutes after induction, after adding 30% EIP and upon EIP removal to construct volumetric capnograms. A stabilization period of 15 minutes was allowed between phases. Data were analyzed using a mixed-effect linear model. Significance was set at p < 0.05. RESULTS: The EIP decreased VDaw from 6.6 (6.1-6.7) to 5.5 (5.3-6.1) mL kg-1 (p < 0.001) and increased VTalv from 7.7 ± 0.7 to 8.6 ± 0.6 mL kg-1 (p = 0.002) without changing the VTE. The VDphys to VTE ratio decreased from 51.0% to 45.5% (p < 0.001) with EIP. The EIP also increased PaO2:FiO2 from 393.3 ± 160.7 to 450.5 ± 182.5 mmHg (52.5 ± 21.4 to 60.0 ± 24.3 kPa; p < 0.001) and Vco2br-1 from 0.49 (0.45-0.50) to 0.59 (0.45-0.61) mL kg-1 (p = 0.008) without reducing PaCO2. CONCLUSIONS AND CLINICAL RELEVANCE: The EIP improved oxygenation and reduced VDaw and VDphys, without reductions in PaCO2. Future studies should evaluate the impact of different EIP in healthy and pathological equine populations under anesthesia.

Thoracic Electrical Impedance Tomography-The 2022 Veterinary Consensus Statement.

Electrical impedance tomography (EIT) is a non-invasive real-time non-ionising imaging modality that has many applications. Since the first recorded use in 1978, the technology has become more widely used especially in human adult and neonatal critical care monitoring. Recently, there has been an increase in research on thoracic EIT in veterinary medicine. Real-time imaging of the thorax allows evaluation of ventilation distribution in anesthetised and conscious animals. As the technology becomes recognised in the veterinary community there is a need to standardize approaches to data collection, analysis, interpretation and nomenclature, ensuring comparison and repeatability between researchers and studies. A group of nineteen veterinarians and two biomedical engineers experienced in veterinary EIT were consulted and contributed to the preparation of this statement. The aim of this consensus is to provide an introduction to this imaging modality, to highlight clinical relevance and to include recommendations on how to effectively use thoracic EIT in veterinary species. Based on this, the consensus statement aims to address the need for a streamlined approach to veterinary thoracic EIT and includes: an introduction to the use of EIT in veterinary species, the technical background to creation of the functional images, a consensus from all contributing authors on the practical application and use of the technology, descriptions and interpretation of current available variables including appropriate statistical analysis, nomenclature recommended for consistency and future developments in thoracic EIT. The information provided in this consensus statement may benefit researchers and clinicians working within the field of veterinary thoracic EIT. We endeavor to inform future users of the benefits of this imaging modality and provide opportunities to further explore applications of this technology with regards to perfusion imaging and pathology diagnosis.

Influence of 2 Veress needles and 4 insertion sites on Veress needle penetration depth: A comparative study in cadaveric dogs.

OBJECTIVE: To evaluate the penetration depth (VNPD) of 2 disposable Veress needles (VN) at 4 insertion sites in the abdomen. STUDY DESIGN: Descriptive study. SAMPLE POPULATION: Canine cadavers (n = 22, 6 for confirmation of the test methods and 16 for the comparative study). METHODS: Two disposable VN (VN A and VN B) were inserted at 4 sites (9th intercostal space [ICS] and preumbilical, paraumbilical, and subumbilical sites) in dorsally recumbent dogs by using a hand-cranked jig. The VNPD was measured as the distance traveled by the VN between the subcutaneous tissue and the perforation of the peritoneum on the basis of audible clicks and visible feedback from the VN. The effects of the VN type and insertion site on the VNPD were analyzed by using a linear mixed-effects model. RESULTS: VNPD varied between insertion sites (P = .01) and VN (P < .01). The VNPD was less at the 9th ICS than at the preumbilical, paraumbilical, and subumbilical sites. The maximal magnitude of change was 7.4 mm. Veress needle B (with a low spring rate, lower forces, and a back-cut bevel design) penetrated farther than VN A (with a high spring rate, high forces, and a lancet-type bevel) at 3 of 4 insertion sites. The maximal magnitude of change was 6.8 mm. CONCLUSION: Veress needle penetration depth varied between VN designs but was the least at the 9th ICS in canine cadavers. CLINICAL SIGNIFICANCE: Insertion of a VN at the 9th ICS is recommended to minimize its penetration into the abdomen. Associations between VNPD and mechanical factors, such as the sharpness and spring rate of VN, warrant additional research.

Physiologic Factors Influencing the Arterial-To-End-Tidal CO2 Difference and the Alveolar Dead Space Fraction in Spontaneously Breathing Anesthetised Horses.

The arterial to end-tidal CO2 difference (P(a-ET)CO2) and alveolar dead space fraction (VDalvfrac = P(a-ET)CO2/PaCO2), are used to estimate Enghoff's "pulmonary dead space" (V/QEng), a factor which is also influenced by venous admixture and other pulmonary perfusion abnormalities and thus is not just a measure of dead space as the name suggests. The aim of this experimental study was to evaluate which factors influence these CO2 indices in anesthetized spontaneously breathing horses. Six healthy adult horses were anesthetized in dorsal recumbency breathing spontaneously for 3 h. Data to calculate the CO2 indices (response variables) and dead space variables were measured every 30 min. Bohr's physiological and alveolar dead space variables, cardiac output (CO), mean pulmonary pressure (MPP), venous admixture [Formula: see text], airway dead space, tidal volume, oxygen consumption, and slope III of the volumetric capnogram were evaluated (explanatory variables). Univariate Pearson correlation was first explored for both CO2 indices before V/QEng and the explanatory variables with rho were reported. Multiple linear regression analysis was performed on P(a-ET)CO2 and VDalvfrac assessing which explanatory variables best explained the variance in each response. The simplest, best-fit model was selected based on the maximum adjusted R2 and smallest Mallow's p (Cp). The R2 of the selected model, representing how much of the variance in the response could be explained by the selected variables, was reported. The highest correlation was found with the alveolar part of V/QEng to alveolar tidal volume ratio for both, P(a-ET)CO2 (r = 0.899) and VDalvfrac (r = 0.938). Venous admixture and CO best explained P(a-ET)CO2 (R2 = 0.752; Cp = 4.372) and VDalvfrac (R2 = 0.711; Cp = 9.915). Adding MPP (P(a-ET)CO2) and airway dead space (VDalvfrac) to the models improved them only marginally. No "real" dead space variables from Bohr's equation contributed to the explanation of the variance of the two CO2 indices. P(a-ET)CO2 and VDalvfrac were closely associated with the alveolar part of V/QEng and as such, were also influenced by variables representing a dysfunctional pulmonary perfusion. Neither P(a-ET)CO2 nor VDalvfrac should be considered pulmonary dead space, but used as global indices of V/Q mismatching under the described conditions.

Determination of physiological dead space in anaesthetized horses: a method-comparison study.

OBJECTIVE: To compare two methods of Bohr-Enghoff physiological dead space to tidal volume ratio (Vd/VtBohr-Enghoff) determination using a mixing chamber and an E-CAiOVX metabolic monitor. STUDY DESIGN: Prospective, clinical, method-comparison study. ANIMALS: Twenty horses anaesthetized for elective orthopaedic procedures. METHODS: Horses were anaesthetized with isoflurane in oxygen and the lungs were mechanically ventilated (Vt 15±2 mL kg-1). Arterial blood was sampled to provide arterial partial pressure of carbon dioxide (PaCO2) for dead space calculation using a metabolic monitor. Mixed expired partial pressure of carbon dioxide (PeCO2) obtained from the custom-made mixing chamber was recorded at the time of arterial blood sampling. Dead space fraction was calculated using the Enghoff modification of the Bohr equation. Agreement between the methods was assessed by Bland-Altman test. A clinically acceptable error was defined to be ≤ 10%. RESULTS: Forty-nine simultaneous Vd/VtBohr-Enghoff results were obtained. There was no clinically significant bias between the mixing chamber and E-CAiOVX. The limits of agreement were within a priori defined error (bias±95% limits of agreement: -0.022±0.078). CONCLUSIONS AND CLINICAL RELEVANCE: Acceptable agreement was found between the two methods. The E-CAiOVX metabolic monitor might be a suitable device for measuring Vd/VtBohr-Enghoff in anaesthetized horses.

Regional ventilation distribution and dead space in anaesthetized horses treated with and without continuous positive airway pressure: novel insights by electrical impedance tomography and volumetric capnography.

OBJECTIVE: The aim of this study was to evaluate the effect of continuous positive airway pressure (CPAP) on regional distribution of ventilation and dead space in anaesthetized horses. STUDY DESIGN: Randomized, experimental, crossover study. ANIMALS: A total of eight healthy adult horses. METHODS: Horses were anaesthetized twice with isoflurane in 50% oxygen and medetomidine as continuous infusion in dorsal recumbency, and administered in random order either CPAP (8 cmH2O) or NO CPAP for 3 hours. Electrical impedance tomography (and volumetric capnography (VCap) measurements were performed every 30 minutes. Lung regions with little ventilation [dependent silent spaces (DSSs) and nondependent silent spaces (NSSs)], centre of ventilation (CoV) and dead space variables, as well as venous admixture were calculated. Statistical analysis was performed using multivariate analysis of variance and Pearson correlation. RESULTS: Data from six horses were statistically analysed. In CPAP, the CoV shifted to dependent parts of the lungs (p < 0.001) and DSSs were significantly smaller (p < 0.001), while no difference was seen in NSSs. Venous admixture was significantly correlated with DSS with the treatment time taken as covariate (p < 0.0001; r = 0.65). No differences were found for any VCap parameters. CONCLUSIONS AND CLINICAL RELEVANCE: In dorsally recumbent anaesthetized horses, CPAP of 8 cmH2O results in redistribution of ventilation towards the dependent lung regions, thereby improving ventilation-perfusion matching. This improvement was not associated with an increase in dead space indicative for a lack in distension of the airways or impairment of alveolar perfusion.

Impact of four different recumbencies on the distribution of ventilation in conscious or anaesthetized spontaneously breathing beagle dogs: An electrical impedance tomography study.

The aim was to examine the effects of recumbency and anaesthesia on distribution of ventilation in beagle dogs using Electrical Impedance Tomography (EIT). Nine healthy beagle dogs, aging 3.7±1.7 (mean±SD) years and weighing 16.3±1.6 kg, received a series of treatments in a fixed order on a single occasion. Conscious dogs were positioned in right lateral recumbency (RLR) and equipped with 32 EIT electrodes around the thorax. Following five minutes of equilibration, two minutes of EIT recordings were made in each recumbency in the following order: RLR, dorsal (DR), left (LLR) and sternal (SR). The dogs were then positioned in RLR, premedicated (medetomidine 0.01, midazolam 0.1, butorphanol 0.1 mg kg-1 iv) and pre-oxygenated. Fifteen minutes later anaesthesia was induced with 1 mg kg-1 propofol iv and maintained with propofol infusion (0.1-0.2 mg kg-1 minute-1 iv). After induction, the animals were intubated and allowed to breathe spontaneously (FIO2 = 1). Recordings of EIT were performed again in four recumbencies similarly to conscious state. Centre of ventilation (COV) and global inhomogeneity (GI) index were calculated from the functional EIT images. Repeated-measures ANOVA and Bonferroni tests were used for statistical analysis (p < 0.05). None of the variables changed in the conscious state. During anaesthesia left-to-right COV increased from 46.8±2.8% in DR to 49.8±2.9% in SR indicating a right shift, and ventral-to-dorsal COV increased from 49.8±1.7% in DR to 51.8±1.1% in LLR indicating a dorsal shift in distribution of ventilation. Recumbency affected distribution of ventilation in anaesthetized but not in conscious dogs. This can be related to loss of respiratory muscle tone (e.g. diaphragm) and changes in thoracic shape. Changing position of thoraco-abdominal organs under the EIT belt should be considered as alternative explanation of these findings.

Evaluation of three tidal volumes (10, 12 and 15 mL kg-1) in dogs for controlled mechanical ventilation assessed by volumetric capnography: a randomized clinical trial.

OBJECTIVE: To evaluate three routinely used tidal volumes (VT; 10, 12 and 15 mL kg-1) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VTalv) and dead space (DS). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 36 client-owned dogs. METHODS: Dogs were randomly allocated to a VT of 10 (G10), 12 (G12) or 15 (G15) mL kg-1. After induction CMV was started. End-tidal carbon dioxide tension was maintained at 4.7-5.3 kPa by changing the respiratory frequency (fR; 630. VTalv kg-1 (p=0.001) increased and VDBohr (p=0.002) decreased with greater VT. VTCO2,br (p=0.017) increased and VDaw/VT (p=0.006), VDBE (p=0.008) and fR (p=0.002) decreased between G10 and G15. PIP (p=0.013) was significantly higher in G15 compared with that in G10 and G12. No changes were observed in MawP. CONCLUSIONS AND CLINICAL RELEVANCE: A VT of 15 mL kg-1 is most appropriate for CMV in lung-healthy dogs (as evaluated by respiratory mechanics and VCap) and does not impair cardiovascular variables.

Comparison of design features and mechanical properties of commercially available Veress needles.

OBJECTIVE: To compare design features and mechanical properties of 13 commercially available Veress needles (VN). STUDY DESIGN: In vitro biomechanical study. SAMPLE POPULATION: Veress needles from 9 manufacturers (6 reusable, 6 disposable, and 1 with a reusable stylet combined with a disposable cannula) were included in the study. METHODS: Veress needles are designed with a spring-loaded stylet to protect the tip of the cannula following insertion into the abdomen. Stylet forces were measured with a scale in a test jig by moving the stylet in 0.5 mm steps into the hollow cannula. Forces and spring rates were derived from force-displacement plots. Mass, mechanical dimensions, and the bevel angle and geometry were assessed. Differences between VN models were analyzed with a univariate analysis of variance. Results are reported as mean ± SD or median (range). RESULTS: Physical and mechanical parameters differed between models. The exposed stylet length was 3.5 mm (2-7). Three bevel geometries (bias, lancet type, and back-cut) with angles between 20° and 40° were identified. Reusable VN weigh more (24.9 ± 2.2 g) than disposable designs (6.0 ± 2.3 g). The mean values for the spring rate and the residual stylet force were 0.23 ± 0.08 Nmm-1 and 0.94 ± 0.28 N, respectively. The mean force required to move the stylet to the cannula tip was 1.81 ± 0.29 N and 2.77 ± 0.54 N to move to the proximal end of the bevel. CONCLUSION: Commercially available VN use diverse bevel geometries and have different mechanical characteristics. Studies investigating laparoscopic entry complications should explicitly report the type of VN model used.

Influence of xylazine on the function of the LiDCO sensor in isoflurane anaesthetized horses.

OBJECTIVE: Previous studies showed an influence of xylazine on the LiDCO sensor in vitro and in standing horses, but did not prove that this interaction caused error in LiDCO measurements. Therefore, agreement of cardiac output (CO) measurements by LiDCO and bolus-thermodilution (BTD) was determined in horses receiving xylazine infusions. STUDY DESIGN: Prospective, experimental study. ANIMALS: Eight Warmblood horses. METHODS: All horses were premedicated with xylazine. Anaesthesia was induced with midazolam and ketamine and was maintained with isoflurane in oxygen. During six hours of anaesthesia CO measurements and blood samples were taken before, during and after a 60 minute period of xylazine infusion. Pairs of LiDCO and bolus thermo-dilution (BTD) measurements of CO were performed. Sensor voltages exposed to blood and saline were measured before, during and after xylazine infusion and compared using Bland-Altman method of agreement with corrections for repeated measures. RESULTS: The CO values (mean ± SD) before xylazine were 34.8 ± 7.3 and 36.4 ± 8.1 L minute(-1) for BTD and LiDCO, respectively. After starting the xylazine infusion, the CO values for BTD decreased to 27.5 ± 6.1 L minute(-1) whereas CO values measured by LiDCO increased to 54.7 ± 18.4 L minute(-1) . One hour after discontinuing xylazine infusion, CO values were 33 ± 6.7 and 36.5 ±11.9 L minute(-1) for BTD and LiDCO, respectively. The difference between saline and blood exposed sensor voltages decreased during xylazine infusion and these differences were positive numbers before but negative during the infusion. There were correlations between xylazine plasma concentrations, CO differences and sensor voltage differences (saline - blood). CONCLUSIONS AND CLINICAL RELEVANCE: This study proved that xylazine infusion caused concentration dependent bias in LiDCO measurements leading to an overestimation of readings. Sensor voltage differences (saline - blood) may become valuable clinical tool to predict drug-sensor interactions.

Variety of non-invasive continuous monitoring methodologies including electrical impedance tomography provides novel insights into the physiology of lung collapse and recruitment ­ case report of an anaesthetized horse.

INTRODUCTION: The use of alveolar recruitment maneuvers during general anaesthesia of horses is a potentially useful therapeutic option for the ventilatory management. While the routine application of recruitments would benefit from the availability of dedicated large animal ventilators their impact on ventilation and perfusion in the horse is not yet well documented nor completely understood. CASE HISTORY: A healthy 533 kg experimental horse underwent general anaesthesia in lateral recumbency. During intermittent positive pressure ventilation a stepwise alveolar recruitment maneuver was performed. MANAGEMENT: Anaesthesia was induced with ketamine and midazolam and maintained with isoflurane in oxygen using a large animal circle system. Mechanical ventilation was applied in pressure ventilation mode and an alveolar recruitment maneuver performed employing a sequence of ascending and descending positive end expiratory pressures. Next to the standard monitoring, which included spirometry, additionally three non-invasive monitoring techniques were used: electrical impedance tomography (EIT), volumetric capnography and respiratory ultrasonic plethysmography. The functional images continuously delivered by EIT initially showed markedly reduced ventilation in the dependent lung and allowed on-line monitoring of the dynamic changes in the distribution of ventilation during the recruitment maneuver. Furthermore, continuous monitoring of compliance, dead space fraction, tidal volumes and changes in end expiratory lung volume were possible without technical difficulties. FOLLOW: up The horse made an unremarkable recovery. CONCLUSION: The novel non-invasive monitoring technologies used in this study provided unprecedented insights into the physiology of lung collapse and recruitment. The synergic information of these techniques holds promise to be useful when developing and evaluating new ventilatory strategies in horses.

Effect of a bandage or tendon boot on skin temperature of the metacarpus at rest and after exercise in horses.

OBJECTIVE: To determine the skin temperature of the metacarpus in horses associated with the use of bandages and tendon boots, compared with the bare limb, at rest and after 20 minutes of lunging. ANIMALS: 10 adult horses. PROCEDURES: Skin temperature on the bare metacarpus of both forelimbs was measured at rest and after lunging. Subsequently, a bandage was applied to the left metacarpus and a tendon boot to the right metacarpus and skin temperature was measured at rest and after lunging. Skin temperature was measured with fixed sensors and thermographically. RESULTS: Mean ± SD skin temperatures of the bare metacarpi were 14.1 ± 2.4°C (left) and 14.1 ± 3.4°C (right) at rest, and 14.4 ± 1.8°C (left) and 13.6 ± 2.6°C (right) after exercise. Skin temperatures under the bandage were 15.3 ± 1.6°C at rest and 24.8 ± 3.6°C after exercise. Skin temperatures under the tendon boot were 15.3 ± 2.6°C at rest and 20.6 ± 2.9°C after exercise. Skin temperatures under the bandage and tendon boot were significantly higher after exercise than at rest. Skin temperatures at rest were not significantly different with a bare limb, bandage, or tendon boot. CONCLUSIONS AND CLINICAL RELEVANCE: Skin temperature of the metacarpus in horses increased significantly during exercise but not at rest when a bandage or tendon boot was used. The authors speculate that both a bandage and a tendon boot accelerate the warm up phase of exercise. Further research should focus on the effects of warm up and maximum exercise on the temperature of other anatomic structures such as tendons.

A novel flow partition device for spirometry during large animal anaesthesia.

OBJECTIVE: We describe and test a novel device for large animal anaesthesia monitoring that uses standard human medicine spirometry sensors. STUDY DESIGN: In-vitro study. METHODS: The device consists of two adapters that enable the flow to be split evenly into four tubes in parallel, each tube containing a D-lite sensor. The performance of this flow partitioning device (FPD) over a range of flows from 100 to 700 L minute⁻¹ was determined and the pressure versus flow relation, resistance and dead space was compared with a Horse-lite (Moens 2010). RESULTS: Equipped with four D-lite sensors, and a flow of 700 L minute⁻¹ the pressure drop of the FPD was 13.5 cm H2O, resistance 1.17 cm H2O second L⁻¹ and volume (potential dead space) 182 mL, compared to 2.8 cm H2O, 0.24 cm H2O second L⁻¹ and 54 mL respectively for the Horse-lite. The predicted value of the flow partition of » could be confirmed. Limits of agreement were found to be 4.2% in inspiratory direction and 7.1% in expiratory direction. CONCLUSIONS AND CLINICAL RELEVANCE: The FPD is an affordable device that extends the specification of any commercially available human spirometry sensors to large animal applications. However, an increase in total resistance and dead space has to be taken into account. Therefore, the new device could be useful during equine anaesthesia.

Effects of infrared camera angle and distance on measurement and reproducibility of thermographically determined temperatures of the distolateral aspects of the forelimbs in horses.

OBJECTIVE: To assess effects of camera angle and distance on measurement and reproducibility of thermographically determined temperatures of the distolateral aspect of the forelimbs in horses. DESIGN: Evaluation study. ANIMALS: 10 adult horses. PROCEDURES: Thermographic images of both forelimbs were obtained at 3 times during the day (replicates 1, 2, and 3); maximum surface temperature over 1 region (distolateral aspect of the third metacarpal bone and metacarpophalangeal joint) was measured. Standard images were obtained every 5 minutes for 1 hour with the camera positioned at an angle of 90° and a distance of 1.0 m from the forelimb; additional images were obtained at changed (± 20°) angles or at a 1.5-m distance. At the end of each replicate, 4 sets of additional images were obtained at 2-minute intervals to assess short-term reproducibility. RESULTS: Mean ± SD temperature difference between left and right forelimbs was 0.32° ± 0.27°C (0.58° ± 0.49°F) in standard images. Temperatures measured via standard images were highly correlated with those measured with the camera positioned at changed angles or distance. Mean ± SD differences between temperatures measured via standard images and those measured from changed angles or distance were considered small (≤ 0.22° ± 0.18°C [0.40° ± 0.32°F] for all comparisons). The degree of short-term reproducibility was high. CONCLUSIONS AND CLINICAL RELEVANCE: Thermographically determined temperatures were unaffected by 20° changes in camera angle or a 0.5-m increase in camera distance from the forelimb. Minor temperature differences between left and right forelimbs were detected in the study and should be considered during diagnostic investigations.

Measurement of tidal volume using respiratory ultrasonic plethysmography in anaesthetized, mechanically ventilated horses.

OBJECTIVE: To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. STUDY DESIGN: Prospective randomized experimental study. ANIMALS: Five experimental horses. METHODS: Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H(2)O). Baseline ventilation mode (tidal volume=15 mL kg(-1), PEEP=0 cm H(2)O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R(2)) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses. RESULTS: The highest correlation of RUP and spirometric tidal volume (R(2)=0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ±2 SD was 0±2.66 L when RUP was calibrated for collective data, but decreased to 0±0.87 L when RUP was calibrated with individual data. CONCLUSIONS AND CLINICAL RELEVANCE: A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ±20%.