Effects of Anesthetics on Pulmonary Gas Exchange

  • Bryan E. Marshall
Part of the Developments in Critical Care Medicine and Anaesthesiology book series (DCCA, volume 19)

Abstract

While much has been written about problems of gas exchange during anesthesia, not all the questions have been resolved. This complexity is well illustrated in the current controversy concerning the use of inhalational agents for the maintenance of anesthesia during one-lung ventilation and thoracic surgery. Most authors have suggested caution in the use of inhalational agents in these circumstances because inhibition of hypoxic pulmonary vasoconstriction (HPV) may contribute to hypoxemia (6,21,29); others have concluded that the inhibition does not occur or is unimportant in practice (5,13). The data on which these contrasting conclusions are based will be reviewed in an attempt to reconcile these viewpoints.

Keywords

Minimum Alveolar Concentration Hypoxic Pulmonary Vasoconstriction Arterial Oxygen Tension Inhalational Agent Dependent Lung 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bergofsky E.H. Am J Med 57:378–394, 1974.PubMedCrossRefGoogle Scholar
  2. 2.
    Bjertnaes L.J. Acta Anaesth Scand 21:113–147, 1977.CrossRefGoogle Scholar
  3. 3.
    Bjertnaes L.J. Acta Anaesth Scand 22:570–588, 1978.PubMedCrossRefGoogle Scholar
  4. 4.
    Benumof J.L. Anesthesiology 43:525–532, 1975.PubMedCrossRefGoogle Scholar
  5. 5.
    Benumof J.L. Anesthesiology 67:910–915, 1987.PubMedCrossRefGoogle Scholar
  6. 6.
    Bergman N.A. In: General Anesthesia, Vol. I, 4th edition (Eds. T.C. Gray, J.E. Utting, J.F. Nunn ), Butterworths, Boston, 1980, pp 477.Google Scholar
  7. 7.
    Capan L.M. Anesth Analg 59:847–851, 1980.PubMedGoogle Scholar
  8. 8.
    Carlsson A.J. Anesthesiology 66:312–316, 1987.PubMedCrossRefGoogle Scholar
  9. 9.
    Chen L. Anesthesiology 63:608–610, 1985.PubMedCrossRefGoogle Scholar
  10. 10.
    Domino K.B. Anesthesiology 64:423–429, 1986.PubMedCrossRefGoogle Scholar
  11. 11.
    Domino K.B. Anesthesiology 59:428–434, 1983.PubMedCrossRefGoogle Scholar
  12. 12.
    Fishman A.P. Circ Res 38:221–231, 1976.PubMedGoogle Scholar
  13. 13.
    Gothard J.W.W. In: A Practice of Anesthesia, 5th edition (Ed. H.C. Churchill–Davidson), Year Book Medical Publishers, Chicago, 1984, p. 389.Google Scholar
  14. 14.
    Inada K. J Thorac Surg 27:173–186, 1954.Google Scholar
  15. 15.
    Kaneko K. J Appl Physiol 21:767–777, 1966.PubMedGoogle Scholar
  16. 16.
    Katz J.A. Anesthesiology 56:164–171, 1982.PubMedCrossRefGoogle Scholar
  17. 17.
    Kerr L.H. Br J Anaesth 46:84–92, 1974.PubMedCrossRefGoogle Scholar
  18. 18.
    Marin J.L.B. Br J Anaesth 51:99–105, 1979.PubMedCrossRefGoogle Scholar
  19. 19.
    Marshall B.E. J Apply Physiol 51:1543–1551, 1981.Google Scholar
  20. 20.
    Marshall B.E. In: Clinical Physiology Series (Eds. B.G. Covino, H.A. Fozzard, K. Rehder, G. Strichartz), Williams and Wilkins Company, Baltimore, 1985.Google Scholar
  21. 21.
    Marshall B.E. In: Anesthesisa for Thoracic Procedures (Eds. B. E. Marshall, D.E. Longnecker, H.B. Fairley ), Blackwell Scientific Publications, Boston, 1987, pp. 73–118.Google Scholar
  22. 22.
    Marshall B.E. J Appl Physiol 64:68–77, 1988.CrossRefGoogle Scholar
  23. 23.
    Marshall BE: In: Effects of Anesthesia, Clinical Physiology Series (Eds. B.G. Covino, H.A. Fozzard, K. Rehder, G. Strichartz ), American Physiological Society, Bethesda, 1985, pp. 121–136.Google Scholar
  24. 24.
    Marshall B.E. In: Pulmonary Circulation in Health and Disease (Eds. J. Will, K. Weir, S. Cassin, C.A. Dawson, Academic Press, New York, 1987.Google Scholar
  25. 25.
    Marshall C. J Appl Physiol 55:711–716, 1983.Google Scholar
  26. 26.
    Marshall C. Anesthesiology 61:304–308, 1984.CrossRefGoogle Scholar
  27. 27.
    Mathers J. Anesthesiology 46:111–114, 1977.CrossRefGoogle Scholar
  28. 28.
    Miller F.L. Anesthesiology 63:22, 1985.CrossRefGoogle Scholar
  29. 29.
    Pavlin E.G. In: Anesthesia, Vol. I, 2nd edition (Ed. R.D. Miller ), Churchill-Livingstone, New York, 1986, p. 677.Google Scholar
  30. 30.
    Rogers S.N. Anesth Analg 64:946–954, 1985.CrossRefGoogle Scholar
  31. 31.
    Saidman L.J. Anesthesiology 57:A472, 1982.CrossRefGoogle Scholar
  32. 32.
    Sykes M.K. J Appl Physiol 39:103–108, 1975.PubMedGoogle Scholar
  33. 33.
    Sykes M.K. Br J Anaesth 50:1185–1196, 1978.PubMedCrossRefGoogle Scholar
  34. 34.
    Sykes M.K. Br J Anaesth 49:293–299, 1977.PubMedCrossRefGoogle Scholar
  35. 35.
    Sykes M.K. Br J Anaesth 49:301–307, 1977.PubMedCrossRefGoogle Scholar
  36. 36.
    Torda T.A. Anaesthesia 29:272–279, 1974.PubMedCrossRefGoogle Scholar
  37. 37.
    Voelkel N.F. Am Rev Resp Dis 133 :1186–1195, 1986.Google Scholar

Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Bryan E. Marshall
    • 1
  1. 1.Department of AnesthesiaUniversity of Pennsylvania School of MedicinePhiladelphiaUSA

Personalised recommendations