Carbon dioxide added late in inspiration reduces ventilation-perfusion heterogeneity without causing respiratory acidosis

2004 ◽  
Vol 96 (5) ◽  
pp. 1894-1898 ◽  
Author(s):  
Thomas V. Brogan ◽  
H. Thomas Robertson ◽  
Wayne J. E. Lamm ◽  
Jennifer E. Souders ◽  
Erik R. Swenson
Keyword(s):  
Carbon Dioxide ◽  
Gas Exchange ◽  
Respiratory Acidosis ◽  
Respiratory Cycle ◽  
Inert Gas ◽  
Arterial Oxygenation ◽  
Arterial Ph ◽  
Mixed Breed ◽  
Conducting Airways ◽  
Area Difference

We have shown previously that inspired CO2 (3-5%) improves ventilation-perfusion (V̇a/Q̇) matching but with the consequence of mild arterial hypercapnia and respiratory acidosis. We hypothesized that adding CO2 only late in inspiration to limit its effects to the conducting airways would enhance V̇a/Q̇ matching and improve oxygenation without arterial hypercapnia. CO2 was added in the latter half of inspiration in a volume aimed to reach a concentration of 5% in the conducting airways throughout the respiratory cycle. Ten mixed-breed dogs were anesthetized and, in a randomized order, ventilated with room air, 5% CO2 throughout inspiration, and CO2 added only to the latter half of inspiration. The multiple inert-gas elimination technique was used to assess V̇a/Q̇ heterogeneity. Late-inspired CO2 produced only very small changes in arterial pH (7.38 vs. 7.40) and arterial CO2 (40.6 vs. 39.4 Torr). Compared with baseline, late-inspired CO2 significantly improved arterial oxygenation (97.5 vs. 94.2 Torr), decreased the alveolar-arterial Po2 difference (10.4 vs. 15.7 Torr) and decreased the multiple inert-gas elimination technique-derived arterial-alveolar inert gas area difference, a global measurement of V̇a/Q̇ heterogeneity (0.36 vs. 0.22). These changes were equal to those with 5% CO2 throughout inspiration (arterial Po2, 102.5 Torr; alveolar-arterial Po2 difference, 10.1 Torr; and arterial-alveolar inert gas area difference, 0.21). In conclusion, we have established that the majority of the improvement in gas exchange efficiency with inspired CO2 can be achieved by limiting its application to the conducting airways and does not require systemic acidosis.

Respiration in man during metabolic alkalosis

1962 ◽  
Vol 17 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Daniel J. Stone
Keyword(s):  
Carbon Dioxide ◽  
Steady State ◽  
Lung Function ◽  
Gas Exchange ◽  
Metabolic Alkalosis ◽  
Time Lag ◽  
Respiratory Compensation ◽  
Arterial Ph ◽  
Oral Sodium ◽  
Ventilation Response

A steady state metabolic alkalosis was induced in two subjects over a period of several days utilizing oral sodium bicarbonate in dosages of 50 g/day. The purpose of inducing steady state metabolic alkalosis was to study the effects of such a state on the respiratory center responses to inspired gas mixtures, containing carbon dioxide, and to contrast these results with the control studies. The experiment was so designed that the arterial pH in both subjects tended to return toward normal in the presence of significant increases in blood bicarbonate. Repeated study of ventilation responses with room air and 4% and 6% carbon dioxide in inspired air revealed a definite and significant decrease in ventilation response to carbon dioxide during the periods of steady state alkalosis as compared to the control periods. Normal responses returned after some time lag. A consistent rise in paCOCO2 occurred with alkalosis, thus demonstrating respiratory compensation. In neither subject was total lung function or gas exchange affected by the alkalosis. The experiment was confirmed on several occasions with reproducible results. Note: (With the Research Assistance of Mary Di Lieto) Submitted on May 22, 1961

Fluid Flow and Particle Dispersion in Acini During Asynchronous Ventilation

2008 ◽  
Author(s):  
Sudhaker Chhabra ◽  
Ajay K. Prasad
Keyword(s):  
Carbon Dioxide ◽  
Fluid Flow ◽  
Gas Exchange ◽  
Surface Area ◽  
Opposite Direction ◽  
Respiratory System ◽  
Human Lung ◽  
Alveolar Epithelium ◽  
Particle Dispersion ◽  
Conducting Airways

The human lung comprises 24 generations of dichotomously branching tubes known as bronchi [1]. Functionally, these generations can be categorized as: (1) conducting airways which are non-alveolated and comprise the first 16 generations, and (2) the acini which consist of flexible, alveolated airways and are responsible for gas exchange. The alveoli are the most important units of the human respiratory system and provide large surface area (about 70–80 m2) for efficient gas exchange; oxygen diffuses into the blood through the alveolar epithelium, whereas carbon dioxide diffuses in the opposite direction from the blood to the lung.

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.

Pulmonary vagal innervation is required to establish adequate alveolar ventilation in the newborn lamb

1998 ◽  
Vol 85 (3) ◽  
pp. 849-859 ◽  
Author(s):  
Kevin A. Wong ◽  
Ather Bano ◽  
Anita Rigaux ◽  
Bing Wang ◽  
Baikhunth Bharadwaj ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Respiratory Acidosis ◽  
Postnatal Period ◽  
Perivascular Edema ◽  
Arterial Ph ◽  
Lung Histology ◽  
Vagal Nerves ◽  
Minimum Surface Tension ◽  
Vagal Innervation ◽  
Stimulation Of

To investigate the effects of bilateral intrathoracic vagotomy on the establishment of continuous breathing and effective gas exchange at birth, we studied 8 chronically instrumented, unanesthetized, sham-operated and 14 vagotomized newborn lambs after a spontaneous, unassisted vaginal delivery. Fetal lambs were instrumented in utero to record sleep states, diaphragmatic electromyogram, blood pressure, arterial pH, and blood-gas tensions. Six of eight sham-operated lambs established effective gas exchange within 10 min of birth, whereas 12 of 14 vagotomized animals developed respiratory acidosis and hypoxemia ( P= 0.008). Breathing frequency in vagotomized newborns was significantly lower during the entire postnatal period compared with sham-operated newborns. Vagotomized subjects also remained hypothermic during the entire postnatal period ( P < 0.05). Bronchoalveolar lavage indicated an increased minimum surface tension, whereas lung histology showed perivascular edema and partial atelectasis in the vagotomized group. We conclude that stimulation of breathing and effective gas exchange are critically dependent on intact vagal nerves during the transition from fetal to neonatal life.

Embolus size affects gas exchange in canine autologous blood clot pulmonary embolism

1993 ◽  
Vol 74 (3) ◽  
pp. 1140-1148 ◽  
Author(s):  
M. Delcroix ◽  
C. Melot ◽  
P. Vanderhoeft ◽  
R. Naeije
Keyword(s):  
Pulmonary Hypertension ◽  
Gas Exchange ◽  
Blood Clot ◽  
Autologous Blood ◽  
Inert Gas ◽  
Experimental Conditions ◽  
Arterial Ph ◽  
Pulmonary Arterial ◽  
Vascular Obstruction ◽  
Autologous Blood Clot

Embolic pulmonary hypertension is associated with alterations in gas exchange of variable severity, which we hypothesized to be related to embolus size. We therefore examined the effects of different-size autologous blood clot embolization on pulmonary arterial pressure-cardiac output relationships (Ppa/Q) and on the distribution of ventilation-perfusion ratios (VA/Q) in 18 intact anesthetized and ventilated (inspired fraction of O2 0.4) dogs. Multipoint Ppa/Q plots were generated by a manipulation of venous return before and 60 min after sufficient amounts of small (1 mm, n = 6 dogs), medium (5 mm, n = 6 dogs), or large (10 mm, n = 6 dogs) clots to increase Ppa to 50 mmHg. The distribution of VA/Q was determined by the multiple inert gas elimination technique at the same intermediate Q in each of these experimental conditions. All three sizes of emboli resulted in an 82–92% mean angiographic pulmonary vascular obstruction and increased both the extrapolated pressure intercepts and the slopes of the linear Ppa/Q plots. Gas exchange was altered the most after large clots, which were associated with lower arterial pH, higher physiological and inert gas dead spaces, higher dispersion of ventilation, and also lower mean VA/Q of perfusion distributions. In contrast, inert gas dead space was decreased after small clots. We conclude that, in autologous blood clot embolic pulmonary hypertension, Ppa/Q characteristics are unaffected by embolus size but that gas exchange is affected differently, mainly in high-VA/Q regions and most often after the largest clots.

Effect of Geometric and Dynamic Parameters on Fluid Flow and Particle Dispersion in Human Lung Acini

2009 ◽  
Author(s):  
Sudhaker Chhabra ◽  
Ajay K. Prasad
Keyword(s):  
Carbon Dioxide ◽  
Fluid Flow ◽  
Gas Exchange ◽  
Surface Area ◽  
Respiratory System ◽  
Human Lung ◽  
Alveolar Epithelium ◽  
Particle Dispersion ◽  
Dynamic Parameters ◽  
Conducting Airways

Breathing, defined as the exchange of gases between the respiratory system and the environment, is an essential process for life. The human respiratory system can be divided into three parts: (i) nose, mouth, and nasopharynx, (ii) trachea, and (iii) lungs. The human lung can be further subdivided into conducting airways which are non-alveolated and comprise the upper part of lung, and the acini which consist of flexible, alveolated airways and are responsible for gas exchange [1]. The alveoli collectively provide a large surface area (∼70 m2) for efficient gas exchange [1]; oxygen diffuses into the blood through the alveolar epithelium, whereas carbon dioxide diffuses in the opposite direction from the blood to the lung.

scholarly journals Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 2049
Author(s):  
Elżbieta Stefanik ◽  
Olga Drewnowska ◽  
Barbara Lisowska ◽  
Bernard Turek
Keyword(s):  
Gas Exchange ◽  
General Anaesthesia ◽  
Near Infrared ◽  
Respiratory Acidosis ◽  
Monitoring Methods ◽  
Arterial Blood Gas ◽  
Complementary Method ◽  
Arterial Blood ◽  
Operative Complications ◽  
Post Operative Complications

Horses, due to their unique anatomy and physiology, are particularly prone to intraoperative cardiopulmonary disorders. In dorsally recumbent horses, chest wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the collapse of the alveoli. This results in hypoventilation, leading to hypercapnia and respiratory acidosis as well as impaired tissue oxygen supply (hypoxia). The most common mechanisms disturbing gas exchange are hypoventilation, atelectasis, ventilation–perfusion (V/Q) mismatch and shunt. Gas exchange disturbances are considered to be an important factor contributing to the high anaesthetic mortality rate and numerous post-anaesthetic side effects. Current monitoring methods, such as a pulse oximetry, capnography, arterial blood gas measurements and spirometry, may not be sufficient by themselves, and only in combination with each other can they provide extensive information about the condition of the patient. A new, promising, complementary method is near-infrared spectroscopy (NIRS). The purpose of this article is to review the negative effect of general anaesthesia on the gas exchange in horses and describe the post-operative complications resulting from it. Understanding the changes that occur during general anaesthesia and the factors that affect them, as well as improving gas monitoring techniques, can improve the post-aesthetic survival rate and minimize post-operative complications.

Effects of Vaporized Perfluorocarbon on Pulmonary Blood Flow and Ventilation/Perfusion Distribution in a Model of Acute Respiratory Distress Syndrome

2001 ◽  
Vol 95 (6) ◽  
pp. 1414-1421 ◽  
Author(s):  
Matthias Hübler ◽  
Jennifer E. Souders ◽  
Erin D. Shade ◽  
Nayak L. Polissar ◽  
Carmel Schimmel ◽  
...  
Keyword(s):  
Blood Flow ◽  
Oleic Acid ◽  
Gas Exchange ◽  
Lung Injury ◽  
Repeated Measures ◽  
Pulmonary Blood Flow ◽  
Analysis Of Covariance ◽  
Inert Gas ◽  
Low Flow ◽  
Repeated Measures Analysis

Background Perfluorocarbon (PFC) liquids are known to improve gas exchange and pulmonary function in various models of acute respiratory failure. Vaporization has been recently reported as a new method of delivering PFC to the lung. Our aim was to study the effect of PFC vapor on the ventilation/perfusion (VA/Q) matching and relative pulmonary blood flow (Qrel) distribution. Methods In nine sheep, lung injury was induced using oleic acid. Four sheep were treated with vaporized perfluorohexane (PFX) for 30 min, whereas the remaining sheep served as control animals. Vaporization was achieved using a modified isoflurane vaporizer. The animals were studied for 90 min after vaporization. VA/Q distributions were estimated using the multiple inert gas elimination technique. Change in Qrel distribution was assessed using fluorescent-labeled microspheres. Results Treatment with PFX vapor improved oxygenation significantly and led to significantly lower shunt values (P &lt; 0.05, repeated-measures analysis of covariance). Analysis of the multiple inert gas elimination technique data showed that animals treated with PFX vapor demonstrated a higher VA/Q heterogeneity than the control animals (P &lt; 0.05, repeated-measures analysis of covariance). Microsphere data showed a redistribution of Qrel attributable to oleic acid injury. Qrel shifted from areas that were initially high-flow to areas that were initially low-flow, with no difference in redistribution between the groups. After established injury, Qrel was redistributed to the nondependent lung areas in control animals, whereas Qrel distribution did not change in treatment animals. Conclusion In oleic acid lung injury, treatment with PFX vapor improves gas exchange by increasing VA/Q heterogeneity in the whole lung without a significant change in gravitational gradient.

Eddy covariance flux measurements of momentum, heat and carbon dioxide in Hudson Bay at the onset of sea ice melt 

2021 ◽  
Author(s):  
Richard Sims ◽  
Brian Butterworth ◽  
Tim Papakyriakou ◽  
Mohamed Ahmed ◽  
Brent Else
Keyword(s):  
Carbon Dioxide ◽  
Gas Exchange ◽  
Sea Ice ◽  
Eddy Covariance ◽  
Open Water ◽  
The Arctic ◽  
Gas Transfer ◽  
Hudson Bay ◽  
Flux Measurements ◽  
Ice Fraction

&lt;p&gt;Remoteness and tough conditions have made the Arctic Ocean historically difficult to access; until recently this has resulted in an undersampling of trace gas and gas exchange measurements. The seasonal cycle of sea ice completely transforms the air sea interface and the dynamics of gas exchange. To make estimates of gas exchange in the presence of sea ice, sea ice fraction is frequently used to scale open water gas transfer parametrisations. It remains unclear whether this scaling is appropriate for all sea ice regions. Ship based eddy covariance measurements were made in Hudson Bay during the summer of 2018 from the icebreaker CCGS Amundsen. We will present fluxes of carbon dioxide (CO&lt;sub&gt;2&lt;/sub&gt;), heat and momentum and will show how they change around the Hudson Bay polynya under varying sea ice conditions. We will explore how these fluxes change with wind speed and sea ice fraction. As freshwater stratification was encountered during the cruise, we will compare our measurements with other recent eddy covariance flux measurements made from icebreakers and also will compare our turbulent CO&lt;sub&gt;2&amp;#160;&lt;/sub&gt;fluxes with bulk fluxes calculated using underway and surface bottle pCO&lt;sub&gt;2&lt;/sub&gt;&amp;#160;data.&amp;#160;&lt;/p&gt;&lt;p&gt;&amp;#160;&lt;/p&gt;

Sign in / Sign up

Export Citation Format

Share Document