Effect of body position
As mentioned above, placing a horse in dorsal recumbency will lead to
increases in hydrostatic pressure within the tracheal mucosa. This is
especially true for the Trendelenburg position. This effect could
contribute to the formation of tracheal oedema thus increasing the
tracheal-cuff interface pressure. Another effect of body position is the
degree of neck flexion and how it impacts endotracheal cuff pressures
(J. H. Park, Lee, Lee, & Kim, 2021; S. Park, Kwon, & Kim, 2023; Seol,
Jin, Oh, Byun, & Jeon, 2022). Changes in neck position will change the
cuff pressure. This effect was greater in tapered cuffs as compared to
cylindrical shaped cuffs (J. H. Park et al., 2021; Seol et al., 2022).
It is interesting to speculate what would have been the effect of neck
flexion on the “tight’ fit of the endotracheal tube in this clinical
case since theoretically this should lead to longitudinal shortening of
the tracheal and a slight increase in diameter of the tracheal.