Equis ISSN 2398-2977

Trachea: transtracheal aspiration / washing

Synonym(s): Transtracheal wash or aspirate, percutaneous transtracheal wash or aspirate, TTA / TTW

Contributor(s): Tim Brazil, Christopher Brown, Paddy Dixon, Prof Derek Knottenbelt, Timothy Mair, Vetstream Ltd, James Wood - Director

Introduction

  • Aseptic collection of samples from the lower respiratory tract for cytologic evaluation and bacteriologic analysis, by means of a catheter inserted percutaneously directly into the tracheal lumen.
  • Useful in foals where transendoscopic collection of tracheal samples may not be feasible due to the size of endoscopes available.

Uses

  • A useful and simple diagnostic test for investigation of infectious and non-infectious airway and pulmonary disease in the horse.
  • Obtaining uncontaminated samples for bacteriological analysis, which may be difficult to obtain by endoscopic sampling.

Advantages

  • Can be performed in the standing adult horse with no sedation.
  • Only minimal and simple equipment needed. Purpose made kits are available but are expensive and have few clear advantages.
  • Is the most accurate way of collecting samples for bacteriology in the horse, without any contamination from the upper respiratory tract.

Disadvantages

  • Damage to the tracheal rings can occur if technique is not performed carefully.
  • Breakage of the catheter in the tracheal lumen can occur, especially if a wide gauge hypodermic needle is used as the trochar.
  • Is a surgical procedure (though very simple) and thus normal complications can occur, eg cellulitis at the site of puncture, local abscess formation, subcutaneous emphysema and pneumomediastinum.
  • Direct visualization of the respiratory tract is not achieved and so ampling simply reflects the overall changes occurring within the airway.
  • Sampling can sometimes be difficult if the catheter fails to engage a pool of fluid at the thoracic inlet, even following introduction of sterile saline.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Rendle D (2012) Making the most of samples from the equine respiratory tract - a clinician's perspective on clinical pathology. UK Vet 17 (4), 4-9 VetMedResource.
  • Dixon P (1995) Collection of tracheal respiratory secretions in the horse. In Pract 17 (2), 66-70 (a very good practical review of this subject) VetMedResource.
  • Wood J L N & Chanter N (1994) Can washing help to keep the lungs clean? Equine Vet Educ (4), 220-222 (interesting background reading on the significance of bacteria isolated from tracheal washes, essential for any vets involved in racing practice) VetMedResource.

Other sources of information

  • Rose R J & Hodgson D R (1993)Manual of Equine Practice. W B Saunders Co. pp 140-141. ISBN: 0-7216-3739-6 (useful overview of this technique from a different perspective).


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