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Computerized tomography of the chest and gas exchange measurements during ketamine anaesthesia

Computerized tomography of the chest and gas exchange measurements during ketamine anaesthesia The effects of atelectasis on pulmonary gas exchange were studied in eight supine, clinically lung‐healthy patients. Atelectasis was studied by computerized tomography (CT), and gas exchange by blood gas analysis. The distribution of ventilation/perfusion ratios was assessed by a multiple inert gas elimination technique. No patient had any signs of atelectasis in the awake state, and gas exchange was normal. During ketamine anaesthesia and spontaneous breathing, lung ventilation and perfusion were well matched in most subjects. In one patient there was perfusion of poorly ventilated regions amounting to 14% of cardiac output, and in another there was a shunt of 4% of cardiac output; this patient was the only one who developed atelectasis in dependent lung regions. After muscular relaxation and commencement of mechanical ventilation, all patients but one developed both shunt (2–6% of cardiac output) and atelectasis. The shunt correlated to the size of atelectasis. It is concluded that the occurrence of shunt during anaesthesia is related to the development of atelectasis in dependent lung regions, which is consistent with the hypothesis that it is changes in chest‐wall mechanics that cause atelectasis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Anaesthesiologica Scandinavica Wiley

Computerized tomography of the chest and gas exchange measurements during ketamine anaesthesia

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References (42)

Publisher
Wiley
Copyright
© 1987 Acta Anaesthesiologica Scandinavica Fonden
ISSN
0001-5172
eISSN
1399-6576
DOI
10.1111/j.1399-6576.1987.tb02646.x
Publisher site
See Article on Publisher Site

Abstract

The effects of atelectasis on pulmonary gas exchange were studied in eight supine, clinically lung‐healthy patients. Atelectasis was studied by computerized tomography (CT), and gas exchange by blood gas analysis. The distribution of ventilation/perfusion ratios was assessed by a multiple inert gas elimination technique. No patient had any signs of atelectasis in the awake state, and gas exchange was normal. During ketamine anaesthesia and spontaneous breathing, lung ventilation and perfusion were well matched in most subjects. In one patient there was perfusion of poorly ventilated regions amounting to 14% of cardiac output, and in another there was a shunt of 4% of cardiac output; this patient was the only one who developed atelectasis in dependent lung regions. After muscular relaxation and commencement of mechanical ventilation, all patients but one developed both shunt (2–6% of cardiac output) and atelectasis. The shunt correlated to the size of atelectasis. It is concluded that the occurrence of shunt during anaesthesia is related to the development of atelectasis in dependent lung regions, which is consistent with the hypothesis that it is changes in chest‐wall mechanics that cause atelectasis.

Journal

Acta Anaesthesiologica Scandinavica – Wiley

Published: Nov 1, 1987

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