Graphical analysis of multiple inert gas elimination data

1983 ◽  
Vol 55 (1) ◽  
pp. 32-36 ◽  
Author(s):  
W. E. Stewart ◽  
S. M. Mastenbrook
Keyword(s):  
Gas Exchange ◽  
Companion Paper ◽  
Graphical Analysis ◽  
Inert Gases ◽  
Inert Gas ◽  
Additional Test ◽  
Multicompartmental Model ◽  
Simple Rules ◽  
Gas Measurements ◽  
Mixed Venous

A plot of measured retention-excretion ratios [(Ri/Ei)obs] vs. reciprocal solubility (1/lambda i) for selected inert gases allows quick detection of shunt and ventilation-perfusion (V/Q) inhomogeneity in the lung. We derive simple rules for constructing a smooth R/E function from the data, using a multicompartmental model of the lung. If mixed venous inert gas measurements are available, the values [lambda i(1-Ri)/Ei]obs for the infused gases can be used to estimate the overall VT/QT ratio and provide an additional test of the consistency of the data. For any set of equilibrium compartments ventilated and perfused in parallel, we show that d(R/E)/d(1/lambda) cannot be negative, nor can d2(R/E)/d(1/lambda)2 be greater than zero. A rectilinear R/E function implies a narrow distribution of V/Q among the gas exchange compartments, whereas a downward-concave curve implies a broader distribution. The shunt perfusion and dead-space ventilation can be estimated from the asymptotes of the R/E function. The range of V/Q for the gas exchange compartments can also be bracketed if a well-defined region of curvature is present in the graph. Finally, from the R/E vs. 1/lambda graph and (if mixed venous data are available) from the lambda(1-R)/E values, we can determine quickly whether the data deserve the detailed numerical analysis outlined in our companion paper.

Multiple inert gas elimination technique

1984 ◽  
Vol 56 (1) ◽  
pp. 1-7 ◽  
Author(s):  
M. P. Hlastala
Keyword(s):  
Gas Exchange ◽  
Mathematical Models ◽  
Dead Space ◽  
Experimental Error ◽  
General Pattern ◽  
Pulmonary Gas Exchange ◽  
Inert Gases ◽  
Inert Gas ◽  
Biological Phenomena ◽  
Mixed Venous

The understanding of pulmonary gas exchange has undergone several major advances since the early 1900‣s. One of the most significant was the development of the multiple inert gas elimination technique for assessing the ventilation-perfusion (VA/Q) distribution in the lung. By measuring the mixed venous, arterial, and mixed expired concentrations of six infused inert gases, it is possible to distinguish shunt, dead space, and the general pattern of VA/Q distribution. As with all mathematical models of complex biological phenomena, there are limitations that can result in errors of interpretation if the technique is applied uncritically. In addition, methodological limitations also can lead to both experimental error and errors of interpretation. Despite these limitations, the multiple inert gas elimination technique remains the most powerful tool developed to date to analyze pulmonary gas exchange.

Respiratory and inert gas exchange during high-frequency ventilation

1982 ◽  
Vol 52 (3) ◽  
pp. 683-689 ◽  
Author(s):  
H. T. Robertson ◽  
R. L. Coffey ◽  
T. A. Standaert ◽  
W. E. Truog
Keyword(s):  
Gas Exchange ◽  
High Frequency ◽  
Gas Flow ◽  
Inert Gases ◽  
Inert Gas ◽  
High Frequency Ventilation ◽  
Physiological Dead Space ◽  
Volume Ventilation ◽  
Frequency Ventilation ◽  
Carrier Gases

Pulmonary gas exchange during high-frequency low-tidal volume ventilation (HFV) (10 Hz, 4.8 ml/kg) was compared with conventional ventilation (CV) and an identical inspired fresh gas flow in pentobarbital-anesthetized dogs. Comparing respiratory and infused inert gas exchange (Wagner et al., J. Appl. Physiol. 36: 585--599, 1974) during HFV and CV, the efficiency of oxygenation was not different, but the Bohr physiological dead space ratio was greater on HFV (61.5 +/- 2.2% vs. 50.6 +/- 1.4%). However, the elimination of the most soluble inert gas (acetone) was markedly enhanced by HFV. The increased elimination of the soluble infused inert gases during HFV compared with CV may be related to the extensive intraregional gas mixing that allows the conducting airways to serve as a capacitance for the soluble inert gases. Comparing as exchange during HFV with three different density carrier gases (He, N2, and Ar), the efficiency of elimination of Co2 or the intravenously infused inert gases was greatest with He-O2. However, the alveolar-arterial partial pressure difference for O2 on He-O2 exceeded that on N2-O2 by 5.4 Torr during HFV. The finding agrees with similar observations during CV, suggesting that this aspect of gas exchange is not substantially altered by HFV.

Tracheal gas exchange: perfusion-related differences in inert gas elimination

1995 ◽  
Vol 79 (3) ◽  
pp. 918-928 ◽  
Author(s):  
J. E. Souders ◽  
S. C. George ◽  
N. L. Polissar ◽  
E. R. Swenson ◽  
M. P. Hlastala
Keyword(s):  
Gas Exchange ◽  
Partial Pressure ◽  
Positive Function ◽  
Inert Gases ◽  
Inert Gas ◽  
Blood Gas ◽  
Fluorescent Microspheres ◽  
Conducting Airways ◽  
Airway Gas Exchange

Exchange of inert gases across the conducting airways has been demonstrated by using an isolated dog tracheal preparation and has been characterized by using a mathematical model (E. R. Swenson, H. T. Robertson, N. L. Polissar, M. E. Middaugh, and M. P. Hlastala, J. Appl. Physiol. 72: 1581–1588, 1992). Theory predicts that gas exchange is both diffusion and perfusion dependent, with gases with a higher blood-gas partition coefficient exchanging more efficiently. The present study evaluated the perfusion dependence of airway gas exchange in an in situ canine tracheal preparation. Eight dogs were studied under general anesthesia with the same isolated tracheal preparation. Tracheal perfusion (Q) was altered from control blood flow (Qo) by epinephrine or papaverine instilled into the trachea and was measured with fluorescent microspheres. Six inert gases of differing blood-gas partition coefficients were used to measure inert gas elimination. Gas exchange was quantified as excretion (E), equal to exhaled partial pressure divided by arterial partial pressure. Data were plotted as ln [E/(l-E)] vs. In (Q/Qo), and the slopes were determined by least squares. Excretion was a positive function of Q, and the magnitude of the response of each gas to changes in Q was similar and highly significant (P < or = 0.0002). These results confirm a substantial perfusion dependence of airway gas exchange.

Cardiac output and mixed venous oxygen content measurements by a tracer bolus method: theory

1997 ◽  
Vol 83 (3) ◽  
pp. 884-896 ◽  
Author(s):  
Justin S. Clark ◽  
Yuxiang J. Lin ◽  
Michael J. Criddle ◽  
Antonio G. Cutillo ◽  
Adelbert H. Bigler ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Oxygen Content ◽  
Practical Method ◽  
Parameter Extraction ◽  
Extraction Process ◽  
Inert Gases ◽  
Inert Gas ◽  
Venous Oxygen Content ◽  
Sinusoidal Input ◽  
Mixed Venous

Clark, Justin S., Yuxiang J. Lin, Michael J. Criddle, Antonio G. Cutillo, Adelbert H. Bigler, Fred L. Farr, and Attilio D. Renzetti, Jr. Cardiac output and mixed venous oxygen content measurements by a tracer bolus method: theory. J. Appl. Physiol. 83(3): 884–896, 1997.—We present a bolus method of inert-gas delivery to the lungs that facilitates application of multiple inert gases and the multiple inert-gas-exchange technique (MIGET) model to noninvasive measurements of cardiac output (CO) and central mixed venous oxygen content[Formula: see text]Reduction in recirculation error is made possible by 1) replacement of sinusoidal input functions with impulse inputs and 2) replacement of steady-state analyses with transient analyses. Recirculation error reduction increases the inert-gas selection to include common gases without unusually high (and difficult to find) tissue-to-blood partition coefficients for maximizing the systemic filtering efficiency. This paper also presents a practical method for determining the recirculation contributions to inert expired profiles in animals and determining their specific contributions to errors in the calculations of CO and[Formula: see text] from simulations applied to published ventilation-perfusion ratio (V˙/Q˙) profiles. Recirculation errors from common gases were found to be reducible to the order of 5% or less for both CO and[Formula: see text] whereas simulation studies indicate that measurement bias contributions from recirculation, V˙/Q˙ mismatch, and the V˙/Q˙ extraction process can be limited to 15% for subjects with severeV˙/Q˙ mismatch and high inspired oxygen fraction levels. These studies demonstrate a decreasing influence of V˙/Q˙ mismatch on parameter extraction bias as the number of inert gases are increased. However, the influence of measurement uncertainty on parameter extraction error limits improvement to six gases.

Pulmonary gas exchange during exercise in athletes. I. Ventilation-perfusion mismatch and diffusion limitation

1994 ◽  
Vol 77 (2) ◽  
pp. 912-917 ◽  
Author(s):  
S. R. Hopkins ◽  
D. C. McKenzie ◽  
R. B. Schoene ◽  
R. W. Glenny ◽  
H. T. Robertson
Keyword(s):  
Gas Exchange ◽  
Aerobic Capacity ◽  
Maximal Exercise ◽  
Cycle Ergometer ◽  
Pulmonary Gas Exchange ◽  
Inert Gases ◽  
Inert Gas ◽  
Diffusion Limitation ◽  
Maximal Aerobic Capacity ◽  
Arterial Blood

To investigate pulmonary gas exchange during exercise in athletes, 10 high aerobic capacity athletes (maximal aerobic capacity = 5.15 +/- 0.52 l/min) underwent testing on a cycle ergometer at rest, 150 W, 300 W, and maximal exercise (372 +/- 22 W) while trace amounts of six inert gases were infused intravenously. Arterial blood samples, mixed expired gas samples, and metabolic data were obtained. Indexes of ventilation-perfusion (VA/Q) mismatch were calculated by the multiple inert gas elimination technique. The alveolar-arterial difference for O2 (AaDO2) was predicted from the inert gas model on the basis of the calculated VA/Q mismatch. VA/Q heterogeneity increased significantly with exercise and was predicted to increase the AaDO2 by > 17 Torr during heavy and maximal exercise. The observed AaDO2 increased significantly more than that predicted by the inert gas technique during maximal exercise (10 +/- 10 Torr). These data suggest that this population develops diffusion limitation during maximal exercise, but VA/Q mismatch is the most important contributor (> 60%) to the wide AaDO2 observed.

Elevated alveolar PCO2 relative to predicted values during normal gas exchange

1977 ◽  
Vol 43 (2) ◽  
pp. 357-364 ◽  
Author(s):  
H. T. Robertson ◽  
M. P. Hlastala
Keyword(s):  
Gas Exchange ◽  
Dead Space ◽  
Anomalous Behavior ◽  
Inert Gases ◽  
Solubility Data ◽  
Inert Gas ◽  
Solubility Curve ◽  
Predicted Values ◽  
Respiratory Dead Space ◽  
Haldane Effect

A negative aADCO2 has been demonstrated during ventilation with hypercarbic gas mixtures and during rebreathing, but has never been demonstrated during normal gas exchange. This anomalous behavior of CO2 was studied by comparing it to the behavior of five infused inert gases during normal gas exchange in 10 anesthetized mongrel dogs. The distribution of VA/Q heterogeneity and the respiratory dead space in the animals was quantitated using excretion-solubility data from the five infused inert gases. The predicted excretion fraction (PACO2/PVCO2) for CO2 was obtained from the inert gas excretion-solubility curve, using a measured solubility for CO2. The measured excretion fraction for CO2 (PACO2/PVCO2), even after correction for Haldane effect, was significantly greater than the predicted fraction (P less than 0.001). This corresponded to an alveolar PCO2 that exceeded the predicted value by a mean of 5.0 Torr.

Conducting airway gas exchange: diffusion-related differences in inert gas elimination

1992 ◽  
Vol 72 (4) ◽  
pp. 1581-1588 ◽  
Author(s):  
E. R. Swenson ◽  
H. T. Robertson ◽  
N. L. Polissar ◽  
M. E. Middaugh ◽  
M. P. Hlastala
Keyword(s):  
Gas Exchange ◽  
Exchange Capacity ◽  
Inert Gases ◽  
Inert Gas ◽  
Diffusion Resistance ◽  
Molecular Weights ◽  
Conducting Airway ◽  
Group 2 ◽  
Airway Gas Exchange ◽  
Group 1

We studied CO2 and inert gas elimination in the isolated in situ trachea as a model of conducting airway gas exchange. Six inert gases with various solubilities and molecular weights (MW) were infused into the left atria of six pentobarbital-anesthetized dogs (group 1). The unidirectionally ventilated trachea behaved as a high ventilation-perfusion unit (ratio = 60) with no appreciable dead space. Excretion of higher-MW gases appeared to be depressed, suggesting a MW dependence to inert gas exchange. This was further explored in another six dogs (group 2) with three gases of nearly equal solubility but widely divergent MWs (acetylene, 26; Freon-22, 86.5; isoflurane, 184.5). Isoflurane and Freon-22 excretions were depressed 47 and 30%, respectively, relative to acetylene. In a theoretical model of airway gas exchange, neither a tissue nor a gas phase diffusion resistance predicted our results better than the standard equation for steady-state alveolar inert gas elimination. However, addition of a simple ln (MW) term reduced the remaining residual sum of squares by 40% in group 1 and by 83% in group 2. Despite this significant MW influence on tracheal gas exchange, we calculate that the quantitative gas exchange capacity of the conducting airways in total can account for less than or equal to 16% of any MW-dependent differences observed in pulmonary inert gas elimination.

Oxygen respiratory gas analysis by sine-wave measurement: a theoretical model

1996 ◽  
Vol 81 (2) ◽  
pp. 985-997 ◽  
Author(s):  
C. E. Hahn
Keyword(s):  
Gas Exchange ◽  
Dead Space ◽  
Venous Blood ◽  
Sine Wave ◽  
Inert Gas ◽  
Mixed Venous Blood ◽  
Arterial Blood ◽  
Partial Pressures ◽  
The Mean ◽  
Mixed Venous

A sinusoidal forcing function inert-gas-exchange model (C. E. W. Hahn, A. M. S. Black, S. A. Barton, and I. Scott. J. Appl. Physiol. 75: 1863–1876, 1993) is modified by replacing the inspired inert gas with oxygen, which then behaves mathematically in the gas phase as if it were an inert gas. A simple perturbation theory is developed that relates the ratios of the amplitudes of the inspired, end-expired, and mixed-expired oxygen sine-wave oscillations to the airways' dead space volume and lung alveolar volume. These relationships are independent of oxygen consumption, the gas-exchange ratio, and the mean fractional inspired (FIO2) and expired oxygen partial pressures. The model also predicts that blood flow shunt fraction (Qs/QT) is directly related to the oxygen sine-wave amplitude perturbations transmitted to end-expired air and arterial and mixed-venous blood through two simple equations. When the mean FIO2 is sufficiently high for arterial hemoglobin to be fully saturated, oxygen behaves mathematically in the blood like a low-solubility inert gas, and the amplitudes of the arterial and end-expired sine-wave perturbations are directly related to Qs/QT. This relationship is independent of the mean arterial and mixed-venous oxygen partial pressures and is also free from mixed-venous perturbation effects at high forcing frequencies. When arterial blood is not fully saturated, the theory predicts that QS/QT is directly related to the ratio of the amplitudes of the induced-saturation sinusoids in arterial and mixed-venous blood. The model therefore predicts that 1) on-line calculation of airway dead space and end-expired lung volume can be made by the addition of an oxygen sine-wave perturbation component to the mean FIO2; and (2) QS/QT can be measured from the resultant oxygen perturbation sine-wave amplitudes in the expired gas and in arterial and mixed-venous blood and is independent of the mean blood oxygen partial pressure and oxyhemoglobin saturation values. These calculations can be updated at the sine-wave forcing period, typically 2–4 min.

Information content of multiple inert gas elimination measurements

1987 ◽  
Vol 63 (2) ◽  
pp. 861-868 ◽  
Author(s):  
K. S. Kapitan ◽  
P. D. Wagner
Keyword(s):  
Information Content ◽  
Theoretical Basis ◽  
Experimental Error ◽  
Partition Coefficients ◽  
Data Interpretation ◽  
Inert Gases ◽  
Inert Gas ◽  
Logarithmic Scale ◽  
Independent Information ◽  
Gas Measurements

The multiple inert gas elimination technique provides a fundamental assessment of the distribution of ventilation-perfusion (VA/Q) ratios in the lung. The resolution of the finer structure of this distribution is limited however. This study examines the theoretical basis of this limitation and presents an objective method for evaluating the independence of inert gas measurements. It demonstrates the linear dependence of the inert gas kernels and their filtering characteristics to be the factors most limiting information content. The limited number of gases available for measurement and experimental error are lesser limitations. At usual levels of experimental error, no more than seven different inert gases having partition coefficients between those of SF6 and acetone will provide independent information, and information content will be maximized by choosing gases with partition coefficients spaced equally on a logarithmic scale. A fivefold reduction in experimental error will not significantly alter the information content of the measurements. The analysis applies equally to other methods of multiple inert gas elimination data interpretation.

Modelling Inert Gas Exchange in Tissue and Mixed–Venous Blood Return to the Lungs

2001 ◽  
Vol 209 (4) ◽  
pp. 431-443 ◽  
Author(s):  
J.P. WHITELEY ◽  
D.J. GAVAGHAN ◽  
C.E.W. HAHN
Keyword(s):  
Gas Exchange ◽  
Venous Blood ◽  
Inert Gas ◽  
Mixed Venous Blood ◽  
Mixed Venous
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