The Measurement of Gas Trapped in the Lungs at Functional Residual Capacity and the Effects of Posture

Don, H. F.; Craig, Douglas B.; Wahba, W. M.; Couture, Jacques

doi:10.1097/00000542-197112000-00007

Cited by 56 publications

(14 citation statements)

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“…The LP increases pressure on the diaphragm, leading to cephalad displacement which may influence the balance between abdominal and chest wall motion. 3 Tidal volume may be decreased by 3% and vital capacity by 18% 4 in LP, which may lead to respiratory failure in susceptible patients.…”

Section: A B Cmentioning

confidence: 99%

Non-invasive ventilation corrects alveolar hypoventilation during spinal anesthesia

Ferrandière¹,

Hazouard²,

Ayoub³

et al. 2006

Can J Anesth/J Can Anesth

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Purpose: To document and explain the beneficial effects of non-invasive ventilation in correcting hypoxemia and hypoventilation in severe chronic obstructive pulmonary disease, during spinal anesthesia in the lithotomy position. Clinical features:A morbidly obese patient with severe chronic obstructive pulmonary disease underwent prostate surgery in the lithotomy position under spinal anesthesia. Hypoxemia was encountered during surgery, and a profound decrease of forced vital capacity associated with alveolar hypoventilation and ventilation/perfusion mismatching were observed. In the operating room, an M-mode sonographic study of the right diaphragm was performed, which confirmed that after spinal anesthesia and assuming the lithotomy position, there was a large decrease (-30%) in diaphragmatic excursion. Hypoxemia and alveolar hypoventilation were successfully treated with non-invasive positive pressure ventilation. Conclusions:Intraoperative application of non-invasive positive pressure ventilation improved diaphragmatic excursion and overall respiratory function, and reduced clinical discomfort in this patient. A N obese patient suffering from severe chronic obstructive pulmonary disease (COPD) utilizing his "hypoxic drive", underwent surgery in the lithotomy position (LP) under spinal anesthesia (SA). The respiratory consequences of both the anesthetic technique and patient positioning were studied. Impending hypoxemic respiratory failure, potentially requiring endotracheal intubation and controlled ventilation, was successfully treated with non-invasive positive-pressure ventilation (NiPPV). In accordance with the Institutional Review Board, all details of this procedure were discussed with the patient, and his written informed consent was obtained for the procedure and the publication of his personal health information. Objectif Case reportA 58-yr-old obese man (105 kg, body mass index 34 kg·m -2 ) with severe COPD was scheduled for transurethral resection of the prostate under SA. He was a heavy smoker with a 40-pack-yr history of cigarette usage and consequent severe respiratory disability. During four previous surgeries, supplemental oxygen administration had produced a hypoventilatory

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Section: A B Cmentioning

confidence: 99%

Non-invasive ventilation corrects alveolar hypoventilation during spinal anesthesia

Ferrandière¹,

Hazouard²,

Ayoub³

et al. 2006

Can J Anesth/J Can Anesth

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“…9 The relatively large falls in FRC measured in the younger children during this investigation suggest considerable danger of hypoxaemia in these patients.…”

Section: Specific Lung Compliancementioning

confidence: 64%

“…. 9 It is known that the generally observed fall in FRC following induction of anaesthesia is related to the ratio of weight to height if the subjects are breathing spontaneously, a that body configuration plays an important part in determining the effect of the supine position upon pulmonary mechanics, TM that static elastic recoil of the lung at a given lung volume varies with age, 11 and that in young anaesthetized animals assuming the upright posture FRC increases less than it does in older animals. 12 To study the effects of anaesthesia and artificial ventilation upon FRC specifically in children, we used the technique of FRC measurement described in a companion paper, la Both lung compliance (CL) and FRC are proportionally reduced when conscious subjects change from the standing to the supine position, and so specific compliance (CL~) is unaltered by the change in posture, a4 To discover whether CL~ was within normal limits in anaesthetized children we measured CL and calculated CL.~ in some of our subjects.…”

Section: Introductionmentioning

confidence: 99%

Functional residual capacity (FRC) and compliance in anaesthetized paralysed childrenpart II. clinical results

Dobbinson

Nisbet

Pelton

et al. 1973

Canad. Anaesth. Soc. J.

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“…It is speculated that such findings induce a slight reduction in Pa02 related to postural change. 8 In the 7 patients we examined, hypoxemia might also be caused by a similar mechanism. Several factors may have made this condition as severe as could be detected on a scintigram, noticeably reducing Pa02.…”

Section: Discussionmentioning

confidence: 94%

Evaluation by ventilation and perfusion scintigraphy in patients who developed postural hypoxemia in the supine position

1998

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Ventilation and pulmonary perfusion scintigraphy were performed in 7 patients in whom postural change from the sitting position to the supine position decreased partial oxygen pressure in arteries (PaO2) by 15 mmHg or more. Six of these 7 patients were obese. Five patients had organic pulmonary disease or space occupying lesions of the liver. On lateral supine-position images taken by using the continuous inhalation method for 81mKr ventilation scintigraphy, ventilation was reduced in the dorsal area corresponding to a gravity-dependent area, but on pulmonary perfusion scintigrams, there were no marked changes compared to normal adults. The mismatch of ventilation to perfusion may have caused hypoxemia. Reduced ventilation was correlated with reduced PaO2. The distribution of 81mKr bolus gas inhalation suggested closure of the airway in the dorsal area at functional residual capacity (FRC), which means the resting expiratory level, in the supine position.

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The Measurement of Gas Trapped in the Lungs at Functional Residual Capacity and the Effects of Posture

Cited by 56 publications

References 0 publications

Non-invasive ventilation corrects alveolar hypoventilation during spinal anesthesia

Non-invasive ventilation corrects alveolar hypoventilation during spinal anesthesia

Functional residual capacity (FRC) and compliance in anaesthetized paralysed childrenpart II. clinical results

Evaluation by ventilation and perfusion scintigraphy in patients who developed postural hypoxemia in the supine position

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