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Arterial Oxygenation During Artificial Ventilation: The Effect of Airway Closure and of its Prevention by Positive End‐Expiratory Pressure
Author(s) -
McCarthy G.S.,
Hedenstierna G.
Publication year - 1978
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1978.tb01339.x
Subject(s) - medicine , oxygenation , functional residual capacity , positive end expiratory pressure , anesthesia , airway , ventilation (architecture) , arterial blood , mean airway pressure , tidal volume , lung volumes , artificial ventilation , lung , respiratory system , mechanical ventilation , respiratory disease , mechanical engineering , engineering
Airway closure and arterial blood gases were measured in 11 healthy subjects, both before and during anaesthesia with artificial ventilation, prior to routine surgery. The functional residual capacity was then increased by positive end‐expiratory pressure (PEEP), so that ventilation took place at a lung volume where no airway closure was present, and the effect on arterial oxygenation was again investigated. A significant increase in alveolar‐arterial oxygen gradient occurred in the group of seven patients in whom airway closure within a tidal breath could be demonstrated during anaesthesia, but there was no significant change in the four patients in whom airway closure could not be demonstrated. There was no improvement in arterial oxygenation on increasing functional residual capacity (FRC) in either group. It may well be that this failure to improve oxygenation was due to a deleterious effect of PEEP on the circulation, even though the PEEP was the minimum required to abolish airway closure.