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The effects of blood solubility, cardiac output and ventilation on the rise of the alveolar towards the inspired concentration, the FA/F I  curve, of an inhaled anaesthetic are often thought to reflect how these factors affect wash-in of the central nervous system compartment and, therefore, speed of induction because If is the partial pressure ultimately attained in the central nervous system (F VRG ). These classical F A /F I  curves assumed a constant F I . We used GasMan® to examine whether changes in solubility, cardiac output and ventilation affect the relationship between the F A /F I  curve and F VRG  differently while either F I  or F A  are kept constant.    Using GasMan®, we studied the effects of solubility (desflurane vs isoflurane), cardiac output (5 vs 10 l.min -1 ) and minute ventilation (4 vs 8 l.min -1 ) on F A , F I  F A /F I . and F VRG  with either F I  kept constant or F A  kept constant (at 1 minimum alveolar concentration). High fresh gas flows were used to avoid rebreathing, so that the delivered concentration matched F I .    Despite similar effects on the F A /F I  curve, the effects on F VRG  differed. With constant F I , lower solubility or higher ventilation results in a higher F VRG  and a higher cardiac output results in a lower F VRG  With constant F A , solubility has only a minimal effect on F VRG ; an increase in cardiac output hastens the rise of F VRG  to the same plateau value; and a change in ventilation has minimal effect on F VRG .    Despite similar effects on the F A /F I  curve, the effects of solubility, cardiac output and ventilation on the F VRG  are different when either F I  or F A  are kept constant. With the F I  kept constant, induction of anaesthesia is slower with a higher cardiac output, but with F A  kept constant, induction of anaesthesia is faster with a higher cardiac output. The introduction of an end-expired closed-loop feedback administration of inhaled anaesthetics makes this distinction clinically relevant.

Effect of the Mode of Administration of Inhaled Anaesthetics on the Interpretation of the FA/FI Curve – a GasMan® Simulation

Effect of the Mode of Administration of Inhaled Anaesthetics on the Interpretation of the F_A/F_I Curve – a GasMan® Simulation