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Changes in respiratory physiological dead space and compliance during non-abdominal, upper abdominal and lower abdominal surgery under general anaesthesia

Published online by Cambridge University Press:  23 December 2004

T. Unoki ,
T. Mizutani  and
H. Toyooka
T. Unoki
Affiliation:
University of Tsukuba, Department of Anesthesiology, Tsukuba, Ibaraki, Japan
T. Mizutani
Affiliation:
University of Tsukuba, Department of Critical Care Medicine, Institute of Clinical Medicine, Tsukuba, Ibaraki, Japan
H. Toyooka
Affiliation:
University of Tsukuba, Department of Anesthesiology, Tsukuba, Ibaraki, Japan
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Extract

Summary

Background and objective: To evaluate the temporal changes in respiratory physiological dead space and dynamic compliance of the respiratory system during non-abdominal, upper abdominal and lower abdominal surgery under general anaesthesia with intermittent positive pressure ventilation.

Methods: Thirty-four adult patients were studied (non-abdominal surgery, n = 8; upper abdominal surgery, n = 13 and lower abdominal surgery in lithotomy position, n = 13). Physiological dead space was measured using the single breath carbon dioxide test. The physiological dead space to tidal volume ratio (VD/VT), dynamic compliance of respiratory system, expiratory tidal volume and respiratory rate were measured 10 min after tracheal intubation, and 30, 60 and 120 min later.

Results: In lower abdominal surgery group, VD/VT was significantly increased at 120 min compared with 0 min (P = 0.005) and 30 min (P = 0.009). There were no significant differences in VD/VT between the three groups at any time point. Compliance decreased significantly in patients with upper abdominal (120 min) and lower abdominal surgery (60 and 120 min), but there were no significant changes during non-abdominal surgery.

Conclusions: We found that the VD/VT increased in patients undergoing lower abdominal surgery in lithotomy and head down tilt, and compliance decreased in those undergoing upper abdominal and lower abdominal surgery over time.

Keywords

ANAESTHESIARESPIRATORY MECHANICS, respiratory dead space, lung complianceSURGERY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 4 , April 2004 , pp. 302 - 308
Copyright
2004 European Society of Anaesthesiology

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References

Lumb AB. Anaesthesia. In: Lumb AB, ed. Nunn's Applied Respiratory Physiology.Oxford: Butterworth-Heinemann, 2000: 420–451.
Hedenstierna G, McCarthy G. The effect of anaesthesia and intermittent positive pressure ventilation with different frequencies on the anatomical and alveolar deadspace. Br J Anaesth 1975; 47: 847–852.Google Scholar
Campbell EJM, Nunn JF, Peckett BW. A comparison of artifical ventilation and spontaneous respiration with particular references to ventilation–bloodflow relations. Br J Anaesth 1958; 30: 166–175.Google Scholar
Lumley J, Morgan M, Sykes MK. Changes in arterial oxygenation and physiological deadspace under anaesthesia. Br J Anaesth 1969; 41: 279–287.Google Scholar
Miyazaki H. Changes in physiological venous admixture, physiological dead space, pulmonary alveolar–arterial oxygen tension difference during general anesthesia. Masui 1971; 20: 847–854.Google Scholar
Fletcher R, Jonson B, Cumming G, Brew J. The concept of deadspace with special reference to the single breath test for carbon dioxide. Br J Anaesth 1981; 53: 77–88.Google Scholar
Arnold JH, Thompson JE, Arnold LW. Single breath CO2 analysis: description and validation of a method. Crit Care Med 1996; 24: 96–102.Google Scholar
Wenzel U, Wauer RR, Wagner MH, Schmalisch G. In vitro and in vivo assessment of the Ventrak 1550/Capnogard 1265 for single breath carbon dioxide analysis in neonates. Br J Anaesth 1999; 83: 503–510.Google Scholar
Fletcher R, Werner O, Nordstrom L, Jonson B. Sources of error and their correction in the measurement of carbon dioxide elimination using the Siemens–Elema CO2 analyzer. Br J Anaesth 1983; 55: 177–185.Google Scholar
Jaffe MB. Flow measurement with Respironics Novametrix series 3 flow sensors. White paper.Wallingfold, CT, USA: Respironics Novametrix Inc, 2002.
Fahy BG, Barnas GM, Nagle SE, Flowers JL, Njoku MJ, Agarwal M. Effects of Trendelenburg and reverse Trendelenburg postures on lung and chest wall mechanics. J Clin Anesth 1996; 8: 236–244.Google Scholar
Strandberg A, Tokics L, Brismar B, Lundquist H, Hedenstierna G. Atelectasis during anaesthesia and in the postoperative period. Acta Anaesthesiol Scand 1986; 30: 154–158.Google Scholar
Lundquist H, Hedenstierna G, Strandberg A, Tokics L, Brismar B. CT-assessment of dependent lung densities in man during general anaesthesia. Acta Radiol 1995; 36: 626–632.Google Scholar
Fletcher R, Larsson A. Gas exchange in the partially atelectatic lung. Anaesthesia 1985; 40: 1186–1188.Google Scholar
Ryniak S, Brannstedt S, Blomqvist H. Effects of exaggerated lithotomy position on ventilation and hemodynamics during radical perineal prostatectomy. Scand J Urol Nephrol 1998; 32: 200–203.Google Scholar
Nunn JF, Hill DW. Respiratory dead space and arterial to end-tidal CO2 tension difference in anesthetized man. J Appl Physiol 1960; 15: 383–389.Google Scholar
Fletcher R, Jonson B. Deadspace and the single breath test for carbon dioxide during anaesthesia and artificial ventilation. Effects of tidal volume and frequency of respiration. Br J Anaesth 1984; 56: 109–119.Google Scholar
Tanskanen P, Kytta J, Randell T. The effect of patient positioning on dynamic lung compliance. Acta Anaesthesiol Scand 1997; 41: 602–606.Google Scholar
Hewlett AM, Hulands GH, Nunn JF, Milledge JS. Functional residual capacity during anaesthesia III: artificial ventilation. Br J Anaesth 1974; 46: 495–503.Google Scholar
Hewlett AM, Hulands GH, Nunn JF, Heath JR. Functional residual capacity during anaesthesia. II. Spontaneous respiration. Br J Anaesth 1974; 46: 486–494.Google Scholar
Larsson A, Jonmarker C, Werner O. Lung mechanics during upper abdominal surgery. Acta Chir Scand 1989; 155: 329–332.Google Scholar
Brooks-Brunn JA. Predictors of postoperative pulmonary complications following abdominal surgery. Chest 1997; 111: 564–571.Google Scholar
Simonneau G, Vivien A, Sartene R, et al. Diaphragm dysfunction induced by upper abdominal surgery. Role of postoperative pain. Am Rev Respir Dis 1983; 128: 899–903.Google Scholar
Obeid F, Saba A, Fath J, et al. Increases in intra-abdominal pressure affect pulmonary compliance. Arch Surg 1995; 130: 544–547.Google Scholar
Fletcher R. Deadspace during anaesthesia. Acta Anaesthesiol Scand Suppl 1990; 94: 46–50.Google Scholar
Hachenberg T, Holst D, Ebel C, et al. Effect of thoracic epidural anaesthesia on ventilation–perfusion distribution and intrathoracic blood volume before and after induction of general anaesthesia. Acta Anaesthesiol Scand 1997; 41: 1142–1148.Google Scholar