Summary
Because anaesthesia and artificial ventilation may be associated with reduction of FRC leading to hypoxaemia, we measured changes in FRC and compliance during anaesthesia (0.5 per cent to 1 per cent methoxyflurane) and artificial ventilation in children with normal respiratory function undergoing operation on the limbs and in children with congenital cardiac anomalies undergoing surgical correction. After induction of anaesthesia in the normal children FRC fell in 35 per cent and remained at a fairly steady level throughout the operation. The lesser post-induction fall of 20 per cent observed in the children undergoing cardiac surgery was followed by a continued decrease in FRC during the surgical operation. At the end of operation the reduction in FRC was of similar magnitude in each group of children.
The post-induction fall in FRC was greater than that reported for anaesthetized adults during artificial ventilation, and was inversely, proportional to the size of the child.
CLs in the normal children was slightly greater at the beginning of operation than at the end, the final value being close to the reported normal figure for conscious subjects.
In the children with congenital cardiac anomalies CLs was less than in the normal children both at the beginning of operation and at the end.
Both normal children and those with congenital cardiac anomalies would benefit from measures designed to maintain FRC during anaesthesia and artificial ventilation.
Résumé
Du fait que l'anesthésie et la ventilation artificielle peuvent participer à la réduction de C.R.F. et conduire à l'hypoxémie, nous avons mesuré les changements de la C.R.F. et de la compliance durant l'anesthésie (0.5 à 1 pour cent de méthoxyflurane) et la fonction respiratoire était normale et qui subissaient une opération sur les members et nous avons fait les mêmes mesures chez des enfants porteurs d'anomalies cardiaques congénitales soumis à la chirurgie pour corrrection. Après induction de l'anesthésie chez les enfants normaux, la C.R.F. a diminué chez 35 pour cent des cas et elle est demeurée à un niveau assez uniforme durant toute l'opération. La plus faible diminution de 20 pour cent après l'induction, observée chez les enfants soumis à la chirurgie cardiaque, a été suivie par une diminution continue de C.R.F. durant la chirurgie. A la fin de l'opération, la diminution de C.R.F. était de la même importance dans chaque groupe d'enfants.
La diminution de C.R.F. post-induction était plus considérable que celle rapportée chez les adultes anesthésiés durant la ventilation artificielle et elle était inversement proportionnelle au poids de l'enfant.
CLs, chez les enfants normaux, était légèrement plus grande au début de l'opération qu'à la fin; la valeur finale était très voisine des chiffres normaux rapportés chez les sujets conscients.
Chez les enfants porteurs d'anomalies cardiaques congénitales, CLs était inférieure à celle des enfants normaux aussi bien au début qu'à la fin de l'opération.
Les deux groupes: les enfants normaux aussi bien que les porteurs d'anomalies cardiaques congénitales bénéficieraient des mesures destinées à maintenir la C.R.F. durant l'anesthésie et la ventilation artificielle.
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This work was supported by a grant from the Physicians' Services Incorporated Foundation. Some of the apparatus used in this investigation was purchased with the aid of a grant from the Canadian Red Cross Youth (Ontario).
Paper read by T.L. Dobbinson at the Royal Australasian College of Surgeons 45th General Scientific Meeting, Hobart, Tasmania, 1972; and in part by Dr. H.I.A. Nisbet at the 5th World Congress of Anaesthesiologists, Kyoto, Japan, September 1972.
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Dobbinson, T.L., Nisbet, H.I.A., Pelton, D.A. et al. Functional residual capacity (FRC) and compliance in anaesthetized paralysed childrenpart II. clinical results . Canad. Anaesth. Soc. J. 20, 322–333 (1973). https://doi.org/10.1007/BF03027170
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DOI: https://doi.org/10.1007/BF03027170