The Lung Volume at Which Shunting Occurs with Inhalation Anesthesia

Dueck, Ronald; Prutow, R. J.; Davies, N.J.H.; Clausen, John A.; Davidson, Terence M.

doi:10.1097/00000542-198812000-00009

Cited by 48 publications

(14 citation statements)

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“…The observed shifts in the lung PV curve to the right are similar to those observed after chest binding and may be secondary to changes in lung surface forces associated with periods of low-volume breathing [6]. Decreases in inspiratory muscle tone, airway closure and subsequent atelectasis, cephalad movement of the diaphragm, and decreases in compliance of both the lung and chest wall have also been suggested as causes [130][131][132]134]. The smaller changes in thoracic cage dimensions after anaesthesia, observed utilizing measures of thoracic dimensions [135] and computed tomography (CT) estimates of thoracic cage volume [136], suggest that increases in intrathoracic fluid may play a contributory or dominant role.…”

Section: Changes In Frc During Anaesthesia Mechanical Ventilation Anmentioning

confidence: 53%

Pathophysiology of changes in absolute lung volumes

Bancalari

Clausen

1998

Eur Respir J

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Changes in absolute lung volumes are common in lung disease and result in significant impacts on gas exchange, respiratory muscle function, the sensation of dyspnoea, and limitations to maximal exercise. Though our knowledge regarding the magnitude and determinants of changes in lung volumes in health and disease has increased in the past 20 years, a number of important questions remain unanswered. Consideration of the limitations of specific methods for measuring lung volumes is essential when analysing published studies regarding absolute lung volumes in infants, children and adults. Though functional residual capacity is most commonly measured in children and adults with the subject awake and at rest, increasingly attention is being directed to making these measurements under clinically more relevant conditions (e.g. during exercise, sleep, anesthesia, or mechanical ventilation). The relationships between dynamic changes in functional residual capacity, flow limitation during tidal breaths, sensation of dyspnoea and exercise limitation are important to understand, and are the focus of current and future research. Improved understanding of these relationships may lead to improvements in therapy of patients with acute and chronic lung disease and are likely to be particularly important for evaluating the efficacy of and optimal patient selection for new modes of therapy, such as lung volume reduction surgery.

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Section: Changes In Frc During Anaesthesia Mechanical Ventilation Anmentioning

confidence: 53%

Pathophysiology of changes in absolute lung volumes

Bancalari

Clausen

1998

Eur Respir J

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“…However, it could not be assured that mechanical ventilation maintained for longer periods is exempt of respiratory system changes. Shunt seems to be directly related to larger lung-dependent areas and lower functional residual capacity 14 . It might be useful to investigate how higher VT, associated or not to PEEP, may influence the development of such areas and also the presence of ventilation/perfusion ratio deviations.…”

Section: Equationmentioning

confidence: 88%

“…No entanto, não se poderia afirmar com certeza que a ventilação mecâni-ca mantida por intervalos de tempo mais elevados deva estar isenta de alterações sobre o sistema respiratório. A ocorrên-cia de shunt parece estar relacionada diretamente à existên-cia de maiores áreas de dependência pulmonar e com menor capacidade residual funcional 14 . Pode ser interessante investigar como maior VC associado ou não à PEEP pode influenciar a formação destas áreas e também a ocorrência de desvios da relação ventilação/perfusão.…”

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Padrões de ventilação em anestesia: estudo retrospectivo

Vieira

Silva

Júnior

2002

Rev. Bras. Anestesiol.

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Justificativa e Objetivos IMC < 20 com 10,74 ± 1,39;67 ± 1,08;54 ± 1,09; IMC > 30 com 7,86 ± 1,26 (p < 0,001, ANOVA) . Não houve diferença entre esses grupos para a freqüência respiratória instalada. No momento dos registros, homens (n = 123) e mulheres (n = 117) apresentaram semelhantes SpO 2 e P ET CO 2 . O IMC foi semelhante em ambos os grupos. Utilizou-se pressão positiva no final da expiração (PEEP) em 78 dos procedimentos (33%). Conclusões

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“…The effect of airway negative pressure, which increases the gradient between capillary pressure and alveolar pressure, producing transudation may be another possibility. 20 …”

Section: Respiratory Embarrassmentmentioning

confidence: 99%

Death during or following surgical procedure and the allegation of medical negligence: An overview

Sharma

2007

Journal of Forensic and Legal Medicine

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The Lung Volume at Which Shunting Occurs with Inhalation Anesthesia

Cited by 48 publications

References 0 publications

Pathophysiology of changes in absolute lung volumes

Pathophysiology of changes in absolute lung volumes

Padrões de ventilação em anestesia: estudo retrospectivo

Death during or following surgical procedure and the allegation of medical negligence: An overview

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