Inhalation anesthesia increases V/Q regional heterogeneity during spontaneous breathing in healthy subjects

Anesthesiology

Volumn 113, Issue 6, 2010, Pages 1370-1375

  Nyrén, Sven ^a   Radell, Peter ^a   Mure, Margareta ^a   Petersson, Johan ^a   Jacobsson, Hans ^a   Lindahl, Sten G E ^a   Sánchez Crespo, Alejandro ^a  

^a KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

CARBON TC 99M; HUMAN ALBUMIN MACROAGGREGATE IN 113M; OXYGEN; RADIOPHARMACEUTICAL AGENT; SEVOFLURANE; TECHNEGAS TC 99M; UNCLASSIFIED DRUG;

ADULT; AEROSOL; ARTICLE; ATELECTASIS; BREATHING; BREATHING RATE; FEMALE; HUMAN; HUMAN EXPERIMENT; INHALATION ANESTHESIA; LUNG PERFUSION; LUNG VENTILATION DISTRIBUTION; LUNG VENTILATION PERFUSION RATIO; LUNG VOLUME; MALE; NORMAL HUMAN; OXYGENATION; PRIORITY JOURNAL; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; SUPINE POSITION; VOLUNTEER; WAKEFULNESS;

EID: 78650178286     PISSN: 00033022     EISSN: 15281175     Source Type: Journal    
DOI: 10.1097/ALN.0b013e3181fc5788     Document Type: Article

References (36)

1. Nunn's applied respiratory physiology, 6th ed. Edited by Lumb AB. Philadelphia, Elsevier/Butterworth-Heinemann, 2005, pp 310-5
2. Hlastala MP, Glenny RW: Vascular structure determines pulmonary blood flow distribution. News Physiol Sci 1999; 14:182-6
3. Beck KC, Rehder K: Differences in regional vascular conductances in isolated dog lungs. J Appl Physiol 1986; 61:530-8
4. Pelletier N, Robinson NE, Kaiser L, Derksen FJ: Regional differences in endothelial function in horse lungs: Possible role in blood flow distribution? J Appl Physiol 1998; 85: 537-42
5. West JB, Dollery CT, Naimark A: Distribution of blood flow in isolated lung; Relation to vascular and alveolar pressures. J Appl Physiol 1964; 19:713-24
6. Haas F, Bergofsky EH: Effect of pulmonary vasoconstric-tion on balance between alveolar ventilation and perfu-sion. J Appl Physiol 1968; 24:491-7
7. Rimeika D, Nyrén S, Wiklund NP, Koskela LR, Tørring A, Gustafsson LE, Larsson SA, Jacobsson H, Lindahl SG, Wik-lund CU: Regulation of regional lung perfusion by nitric oxide. Am J Respir Crit Care Med 2004; 170:450-5
8. Jones AT, Hansell DM, Evans TW: Pulmonary perfusion in supine and prone positions: An electron-beam computed tomography study. J Appl Physiol 2001; 90:1342-8
9. Nyrén S, Mure M, Jacobsson H, Larsson SA, Lindahl SG: Pulmonary perfusion is more uniform in the prone than in the supine position: Scintigraphy in healthy humans. J Appl Physiol 1999; 86:1135-41
10. Nyrén S, Radell P, Lindahl SG, Mure M, Petersson J, Larsson SA, Jacobsson H, Śanchez-Crespo A: Lung ventilation and perfusion in prone and supine postures with reference to anesthetized and mechanically ventilated healthy volunteers. ANESTHESIOLOGY 2010; 112:682-7
11. Mure M, Nyrén S, Jacobsson H, Larsson SA, Lindahl SG: High continuous positive airway pressure level induces ventilation/perfusion mismatch in the prone position. Crit Care Med 2001; 29:959-64
12. Milic-Emili J, Henderson JA, Dolovich MB, Trop D, Kaneko K: Regional distribution of inspired gas in the lung. J Appl Physiol 1966; 21:749-59
13. Glenny RW: Determinants of regional ventilation and blood flow in the lung. Intensive Care Med 2009; 35: 1833-42
14. Tokics L, Hedenstierna G, Svensson L, Brismar B, Ceder-lund T, Lundquist H, Strandberg A: V/Q distribution and correlation to atelectasis in anesthetized paralyzed humans. J Appl Physiol 1996; 81:1822-33
15. Nunn JF, Bergman NA, Coleman AJ: Factors influencing the arterial oxygen tension during anaesthesia with artificial ventilation. Br J Anaesth 1965; 37:898-914
16. Hedenstierna G: Contribution of multiple inert gas elimination technique to pulmonary medicine. 6. Ventilation-perfusion relationships during anaesthesia. Thorax 1995; 50:85-91
17. Bindslev L, Hedenstierna G, Santesson J, Gottlieb I, Carval-lhas A: Ventilation-perfusion distribution during inhalation anaesthesia. Effects of spontaneous breathing, mechanical ventilation and positive end-expiratory pressure. Acta An-aesthesiol Scand 1981; 25:360-71
18. Westbrook PR, Stubbs SE, Sessler AD, Rehder K, Hyatt RE: Effects of anesthesia and muscle paralysis on respiratory mechanics in normal man. J Appl Physiol 1973; 34:81-6
19. Hedenstierna G, J̈arnberg PO, Gottlieb I: Thoracic gas volume measured by body plethysmography during anesthesia and muscle paralysis: Description and validation of a method. ANESTHESIOLOGY 1981; 55:439-43
20. Takemura M, Shiokawa Y, Okamoto S, Uno H, Futagawa K, Koga Y: Volatile anesthetics constrict pulmonary artery in rabbit lung perfusion model. J Anesth 2005; 19:343-6
21. Marshall BE: Effects of anesthetics on pulmonary gas exchange, Anesthesia and the Lung. Edited by Stanley TH, Sperry RJ. London, Kluwer Academic Publishers, 1989, pp 117-25
22. Sykes MK, Loh L, Seed RF, Kafer ER, Chakrabarti MK: The effect of inhalational anaesthetics on hypoxic pulmonary vasoconstriction and pulmonary vascular resistance in the perfused lungs of the dog and cat. Br J Anaesth 1972; 44:776-88
23. Nunn's applied respiratory physiology, 6th ed. Edited by Lumb AB. Philadelphia, Elsevier/Butterworth-Heinemann, 2005, pp 297-326
24. Campbell EJ, Nunn JF, Peckett BW: A comparison of artificial ventilation and spontaneous respiration with particular reference to ventilation-bloodflow relationships. Br J Anaesth 1958; 30:166-75
25. Sinclair SE, Albert RK: Altering ventilation-perfusion relationships in ventilated patients with acute lung injury. Intensive Care Med 1997; 23:942-50
26. Sánchez-Crespo A, Petersson J, Nyren S, Mure M, Glenny RW, Thorell JO, Jacobsson H, Lindahl SG, Larsson SA: A novel quantitative dual-isotope method for simultaneous ventilation and perfusion lung SPET. Eur J Nucl Med Mol Imaging 2002; 29:863-75
27. Petersson J, Śanchez-Crespo A, Rohdin M, Montmerle S, Nyrén S, Jacobsson H, Larsson SA, Lindahl SG, Linnarsson D, Glenny RW, Mure M: Physiological evaluation of a new quantitative SPECT method measuring regional ventilation and perfusion. J Appl Physiol 2004; 96:1127-36
28. Arai TJ, Henderson AC, Dubowitz DJ, Levin DL, Friedman PJ, Buxton RB, Prisk GK, Hopkins SR: Hypoxic pulmonary vasoconstriction does not contribute to pulmonary blood flow heterogeneity in normoxia in normal supine humans. J Appl Physiol 2009; 106:1057-64
29. Amis TC, Crawford AB, Davison A, Engel LA: Distribution of inhaled 99mtechnetium labelled ultrafine carbon particle aerosol (Technegas) in human lungs. Eur Respir J 1990; 3:679-85
30. Taplin GV, MacDonald NS: Radiochemistry of macroaggre-gated albumin and newer lung scanning agents. Semin Nucl Med 1971; 1:132-52
31. Wagner HN Jr: Regional ventilation and perfusion, Principles of Nuclear Medicine. Edited by Wagner HN Jr., Szabo Z, Buchanan JW. Philadelphia, Saunders, 1995, pp 881-95
32. Casati A, Fanelli G, Torri G: Physiological dead space/tidal volume ratio during face mask, laryngeal mask, and cuffed oropharyngeal airway spontaneous ventilation. J Clin Anesth 1998; 10:652-5
33. Sánchez Crespo A, Hallberg J, Lundberg JO, Lindahl SG, Jacobsson H, Weitzberg E, Nyrén S: Nasal nitric oxide and regulation of human pulmonary blood flow in the upright position. J Appl Physiol 2010; 108:181-8
34. Rehder K, Knopp TJ, Sessler AD: Regional intrapulmonary gas distribution in awake and anesthetized-paralyzed prone man. J Appl Physiol 1978; 45:528-35
35. Lundh R, Hedenstierna G: Ventilation-perfusion relationships during halothane anaesthesia and mechanical ventilation. Effects of varying inspired oxygen concentration. Acta Anaesthesiol Scand 1984; 28:191-8
36. Anjou-Lindskog E, Broman L, Broman M, Holmgren A, Settergren G, Ohqvist G: Effects of intravenous anesthesia on VA/Q distribution: A study performed during ventilation with air and with 50% oxygen, supine and in the lateral position. ANESTHESIOLOGY 1985; 62:485-92