Analysis of Respiratory Acidosis During Anesthesia

Ellison, Robert G.; Ellison, Lois T.; Hamilton, W. F.

doi:10.1097/00000658-195503000-00013

Cited by 29 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Before the advent of modern ventilatory assistance and monitoring techniques, acute severe hypercapnia was a common occurrence, especially during thoracic surgery; it is not clear in many early reports how this was tolerated by patients (162). In one series (163), severe respiratory acidosis (PaC0 2 up to 160 mm Hg, pH as low as 7.00) during halothane anesthesia was found as-sociated with potentially serious ventricular arrythmias (ventricular tachycardia, multifocal ventricular extrasystoles, bigeminy) in seven of 22 cases.…”

Section: Anesthesia Practicementioning

confidence: 99%

Permissive hypercapnia. How permissive should we be?

Feihl¹,

Perret²

1994

Am J Respir Crit Care Med

393

139

View full text Add to dashboard Cite

Section: Anesthesia Practicementioning

confidence: 99%

Permissive hypercapnia. How permissive should we be?

Feihl¹,

Perret²

1994

Am J Respir Crit Care Med

393

139

View full text Add to dashboard Cite

“…As abnormal baseline PaCO 2 can affect volume measures [10], awareness of its occurrence is important in the abundant longitudinal and cross-sectional studies that investigate brain volume changes. One example of an acute onset respiratory acidosis is the administration of sedative agents in patients undergoing MRI or exercise tasks during MRI [16][17][18]. In addition, respiratory acidosis can occur in restrictive or obstructive lung disease in which impaired respiratory exchange causes CO 2 retention, whereas metabolic acidosis may occur in patients with chronic kidney disease due to impaired H + excretion [19,20].…”

Section: Discussionmentioning

confidence: 99%

Arterial CO2 pressure changes during hypercapnia are associated with changes in brain parenchymal volume

et al. 2020

View full text Add to dashboard Cite

The Monro-Kellie hypothesis (MKH) states that volume changes in any intracranial component (blood, brain tissue, cerebrospinal fluid) should be counterbalanced by a co-occurring opposite change to maintain intracranial pressure within the fixed volume of the cranium. In this feasibility study, we investigate the MKH application to structural magnetic resonance imaging (MRI) in observing compensating intracranial volume changes during hypercapnia, which causes an increase in cerebral blood volume. Seven healthy subjects aged from 24 to 64 years (median 32), 4 males and 3 females, underwent a 3-T three-dimensional T1-weighted MRI under normocapnia and under hypercapnia. Intracranial tissue volumes were computed. According to the MKH, the significant increase in measured brain parenchymal volume (median 6.0 mL; interquartile range 4.5, 8.5; p = 0.016) during hypercapnia co-occurred with a decrease in intracranial cerebrospinal fluid (median-10.0 mL; interquartile range-13.5,-6.5; p = 0.034). These results convey several implications: (i) blood volume changes either caused by disorders, anaesthesia, or medication can affect outcome of brain volumetric studies; (ii) besides probing tissue displacement, this approach may assess the brain cerebrovascular reactivity. Future studies should explore the use of alternative sequences, such as three-dimensional T2-weighted imaging, for improved quantification of hypercapnia-induced volume changes.

show abstract

“…During thoracic surgery with assisted ventilation, levels of up to 133 mm Hg were reported by Beecher and Murphy (1950) and up to 170 mm Hg by Taylor and Roos (1950). In an excellent review of earlier work, Ellison, Ellison and Hamilton (1955) reported a maximum level of 236 mm Hg, and Horabein (1963) reported a level of 235 mm Hg in a small child with bronchopneumonia, despite artificial ventilation.…”

Section: Aetiology Of Gross Hypercapniamentioning

confidence: 99%

Accidental Severe Hypercapnia During Anaesthesia

Prys‐Roberts¹,

Smith²,

Nunn³

et al. 1967

British Journal of Anaesthesia

View full text Add to dashboard Cite

A case report is presented which describes the development, recognition and correction of gross hypercapnia occurring during anaesthesia. The cause of hypercapnia was a high concentration of carbon dioxide in the inspired gas caused by the accidental opening of the control valve for carbon dioxide. Certain structural features of the anaesthetic apparatus facilitated this, and the construction of the Rotameter resulted in the bobbin being concealed at the top of the tube. Recognition of the condition would have been difficult without analysis of arterial blood. The patient did not appear to suffer any overt harm from the incident or its rapid correction by withdrawal of the carbon dioxide from the inspired gas. The aetiology and effects of gross hypercapnia during anaesthesia have been reviewed and special attention has been paid to the problem of measurement of the acid-base abnormality.

show abstract

Analysis of Respiratory Acidosis During Anesthesia

Cited by 29 publications

References 4 publications

Permissive hypercapnia. How permissive should we be?

Permissive hypercapnia. How permissive should we be?

Arterial CO2 pressure changes during hypercapnia are associated with changes in brain parenchymal volume

Accidental Severe Hypercapnia During Anaesthesia

Contact Info

Product

Resources

About