Carbon dioxide narcosis due to human error in a dog

2020 ◽  
Vol 8 (2) ◽  
pp. e001053
Author(s):  
Victoria Phillips ◽  
Alessandra Mathis
Keyword(s):  
Carbon Dioxide ◽  
Human Error ◽  
Visual Inspection ◽  
Carbon Dioxide Tension ◽  
Breathing System ◽  
Normal Limits ◽  
Inhalational Anaesthesia ◽  
Prolonged Recovery ◽  
End Tidal ◽  
Circle Breathing System

Incorrect assembly of a parallel Lack (Mapleson A) breathing system resulted in carbon dioxide narcosis in a dog due to rebreathing of expiratory gases. A seven-year-old, male neutered Rottweiler, weighing 49 kg, failed to recover after discontinuation of inhalational anaesthesia following a forequarter amputation for osteosarcoma. During recovery, the endotracheal tube had been connected to a parallel Lack anaesthetic breathing system delivering 100 per cent oxygen at 5 l/minute. Although a prolonged recovery, 30 minutes, all vital parameters were considered within normal limits until a severe increase in respiratory effort was noted. Capnography revealed rebreathing with an end-tidal carbon dioxide tension of >150 mm Hg (>19.9 kPa). The dog was transferred to a circle breathing system, and with normalisation of the capnogram, recovery proceeded without further complications. Visual inspection of the parallel Lack breathing system revealed misassembly which had resulted in rebreathing of expiratory gases, extreme hypercapnia causing prolonged recovery due to narcosis.

Effect of intravenous dopamine on hypercapnic ventilatory response in humans

1983 ◽  
Vol 55 (5) ◽  
pp. 1418-1425 ◽  
Author(s):  
D. S. Ward ◽  
J. W. Bellville
Keyword(s):  
Carbon Dioxide ◽  
Ventilatory Response ◽  
Carbon Dioxide Concentration ◽  
Carbon Dioxide Tension ◽  
Model Parameters ◽  
Loop Gain ◽  
Loop Contribution ◽  
Dopamine Infusion ◽  
Hypercapnic Ventilatory Response ◽  
End Tidal

This study assessed the effect of low-dose intravenous dopamine (3 micrograms X kg-1 X min-1) on the hypercapnic ventilatory response in humans. Six normal healthy subjects were studied. By manipulating the inspired carbon dioxide concentration, the end-tidal carbon dioxide tension was raised in a stepwise fashion from 41 to 49 Torr and held at this level for 4 min. The end-tidal CO2 tension was then lowered back to 41 Torr in a stepwise fashion. The end-tidal O2 tension was held constant at 106 Torr throughout the experiment. The ventilatory response to this normoxic hypercapnic stimulus was analyzed by fitting two exponential functions, allowing the response to be separated into slow and fast chemoreflex loops. Each loop is described by a gain, time constant, and time delay. A single eupneic threshold was used for both loops. Nine control experiments and eight experiments performed during dopamine infusion were analyzed. The dopamine infusion caused the fast loop gain to be significantly (P less than 0.05) reduced from 0.64 to 0.19 l X min-1 X Torr-1, while the slow loop gain was unchanged. The fast loop contribution was reduced from 28 to 11% of the total ventilatory response. None of the other model parameters were significantly affected by the dopamine infusion. Exogenously administered dopamine substantially reduces the sensitivity of the fast chemoreflex loop to carbon dioxide.

Arterial to end tidal carbon dioxide tension difference during Caesarean section anaesthesia

Anaesthesia ◽  
1986 ◽  
Vol 41 (7) ◽  
pp. 698-702 ◽  
Author(s):  
K. B. Shankar ◽  
H. MOSELEY ◽  
Y. KUMAR ◽  
V. VEMULA
Keyword(s):  
Carbon Dioxide ◽  
Caesarean Section ◽  
Carbon Dioxide Tension ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

End-tidal carbon dioxide tension during laparoscopic cholecystectomy.

Anaesthesia ◽  
1994 ◽  
Vol 49 (4) ◽  
pp. 304-306 ◽  
Author(s):  
A. BARAKA ◽  
S. JABBOUR ◽  
R. HAMMOUD ◽  
M. AOUAD ◽  
F. NAJJAR ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Carbon Dioxide Tension ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

The Pattern of Breathing Following a 10-Breath Voluntary Hyperventilation During Hyperoxic Rebreathing

1997 ◽  
Vol 22 (3) ◽  
pp. 256-267 ◽  
Author(s):  
Deep Chatha ◽  
James Duffin
Keyword(s):  
Carbon Dioxide ◽  
Carbon Dioxide Tension ◽  
Short Term ◽  
Voluntary Hyperventilation ◽  
Partial Pressures ◽  
Term Potentiation ◽  
Respiratory Chemoreflex ◽  
End Tidal ◽  
Peripheral Chemoreflex ◽  
Female Responses

The pattern of breathing following a 10-breath voluntary hyperventilation period during hyperoxic rebreathing was compared to that without hyperventilation in 6 subjects (3 male and 3 female). The aim was to measure the posthyperventilation short-term potentiation of ventilation without changes in respiratory chemoreflex drives induced by the voluntary hyperventilation. Hyperoxia was used to reduce the peripheral chemoreflex drive, and rebreathing to prevent the decrease in arterial carbon dioxide tension normally produced by hyperventilation. There were significant differences between the male and female responses. However, in all subjects, ventilation and heart rate were increased during hyperventilation but end-tidal partial pressures of carbon dioxide and oxygen were unchanged. Following hyperventilation, ventilation immediately returned to the values observed when hyperventilation was omitted. Hyperventilation did not induce a short-term potentiation of ventilation under these conditions: changes in chemoreflex stimuli brought about by cardiovascular changes induced by hyperventilation may play a role in the short-term potentiation observed under other circumstances. Key words: rebreathing, hyperventilation, short-term potentiation

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