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Anaesthesia and the respiratory system.

K Rehder

    Canadian Anaesthetists' Society Journal
    |November 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    General anaesthesia impairs pulmonary gas exchange, affecting oxygenation and carbon dioxide removal. Changes in chest wall mechanics and altered ventilation-perfusion matching lead to impaired lung function during anesthesia.

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    Area of Science:

    • Anesthesiology
    • Respiratory Physiology
    • Thoracic Mechanics

    Background:

    • General anesthesia significantly impacts respiratory function.
    • Pulmonary gas exchange, including oxygenation and CO2 elimination, is compromised under anesthesia.
    • Anesthesia-induced paralysis alters chest wall mechanics and lung volumes.

    Purpose of the Study:

    • To elucidate the sequence of physiological events affecting pulmonary gas exchange during general anesthesia.
    • To understand how anesthesia-paralysis influences chest wall and lung mechanics.
    • To investigate the development of ventilation-perfusion (V/Q) mismatch and shunt during anesthesia.

    Main Methods:

    • The study likely involved physiological measurements in subjects undergoing general anesthesia and mechanical ventilation.

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  • Analysis of chest wall shape and motion changes.
  • Assessment of lung and chest wall mechanical properties.
  • Evaluation of inspired gas distribution and pulmonary blood flow patterns.

    • Main Results:

    • Anesthesia-paralysis alters chest wall shape and motion, affecting lung mechanics and potentially reducing functional residual capacity (FRC).
    • Inspired gas distribution changes, leading to increased ventilation-perfusion mismatch.
    • Pulmonary blood flow distribution does not adapt to altered ventilation, exacerbating V/Q mismatch.
    • Development of low V/Q regions, progressing to shunt, and high V/Q regions contribute to impaired gas exchange.

    Conclusions:

    • General anesthesia initiates a cascade of respiratory changes, starting with chest wall alterations.
    • These changes lead to V/Q mismatch and shunt, impairing oxygenation.
    • Inefficient CO2 elimination is linked to the development of high V/Q regions.