Advertisement

Blood CO2 and pH Transients During Apnoea after O2 Breathing in Patients

  • Friedrich Mertzlufft
  • Ludwig Brandt
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 277)

Abstract

Endotracheal intubation always is combined with an apnoea the duration of which is dependent on the technique used, the skills of the intubator, and the anatomical situation. The resulting typical potential risks may be (among others) both hypoxaemia and hypercapnia. Therefore the tolerable apnoea time for an intubation procedure is limited in clinical practice to 1 – 2 minutes. It must be noted that the developing hypercapnia is inevitable, whereas hypoxaemia may be avoided even in prolonged apnoea (e.g. >2 min) with “adaequate” preoxygenation [Duda et al., 1988]. Using de-nitrogenation techniques (breathing pure oxygen for 30 to 60 min) “anaesthetized and curarized normal subjects tolerate total apnoea for up to 55 min” [Siggaard-Andersen, 1974]. According to Mertzlufft et al. (1987), paCO2 does not increase linearly during a short-termed (3 min) apnoea. A fast initial increase in the first minute is followed by a slower increase during the ensuing minutes. This fact inspired previous investigations on arterial and mixed-venous acid-base and oxygen status [Brandt et al., 1987]. It could be demonstrated that, in contrast to paCO2, the development of pv̄CO2 was almost linear from the onset of apnoea.

Keywords

Intubation Procedure Prolonged Apnoea Haldane Effect Peripheral Venous Line Apply Respiratory Physiology 
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. Brandt, L., 1988, Bedeutung des gemischtvenösen O2-Status als Ergänzung zum arteriellen O2-Status, in: “Der Sauerstoff-Status des arteriellen Blutes”, R. Zander and F. Mertzlufft, eds., Karger, Basel; p. 238–255.Google Scholar
  2. Brandt, L., Mertzlufft, F., Rudlof, B., and Dick, W., 1988, In vivo-Nachweis des Christiansen-Douglas-Haldane-Effektes unter klinischen Bedingungen, Anaesthesist, 37:529.PubMedGoogle Scholar
  3. Brandt, L., Mertzlufft, F., and Dick, W., 1989, Verhalten des arteriellen und gemischtvenösen Blutgasstatus in der Initialphase der Intubationsapnoe, Anaesthesist, 38:167.PubMedGoogle Scholar
  4. Christiansen J., Douglas, C. G., and Haidane J. S., 1914, The absorption and dissociation of carbon dioxide by human blood, J Physiol, 48:244.PubMedGoogle Scholar
  5. Duda, D., Brandt, L., Rudlof, B., Mertzlufft, F., and Dick, W., 1988, Der Einfluß unterschiedlicher Präoxygenationsverfahren auf den arteriellen Sauerstoffstatus, Anaesthesist, 37:408.PubMedGoogle Scholar
  6. Hohmann, C., Zander, R., 1988, Vergleich verschiedener Pulsoxymeter unter Hypoxie bei Rauchern und Nichtrauchern, Anaesthesist (Suppl.), 37:93.Google Scholar
  7. Mertzlufft, F. O., 1988, Nichtinvasive kontinuierliche Messung der arteriellen O2-Sättigung, in.: “Der Sauerstoff-Status des arteriellen Blutes”, R. Zander and F.O. Mertzlufft, eds., Karger, Basel; p. 109–119.Google Scholar
  8. Mertzlufft, F. O., Rudlof, B., Jantzen A. H., Brandt, L., and Dick, W., 1987, Christiansen-Douglas-Haldane-Effekt: Auch in vivo? Anaesthesist (Suppl.), 36:374.Google Scholar
  9. Müller-Plathe, O., Schlehbusch, H., 1988, Gewinnung und Aufbewahrung von arteriellem Blut, in: “Der Sauerstoff-Status des arteriellen Blutes”, R. Zander and F.O. Mertzlufft, eds., Karger, Basel; p. 12–18.Google Scholar
  10. Nunn, J. F., 1987, “Applied Respiratory Physiology”, Butterworth & Co Ltd, London; pp. 295.Google Scholar
  11. Siggaard-Andersen, O., 1974, “The acid-base status of the blood”, Munksgaard, Copenhagen (4th ed.), p. 115–117.Google Scholar

Copyright information

© Plenum Press, New York 1990

Authors and Affiliations

  • Friedrich Mertzlufft
    • 1
  • Ludwig Brandt
    • 1
  1. 1.Department of Anaesthesiology, University HospitalJohannes Gutenberg University MainzMainzGermany

Personalised recommendations