Active inspiratory impedance and load compensation: effects of duration of anesthesia. 1986

A Baydur, and C S Sassoon, and C M Stiles

General anesthesia results in increases in respiratory elastance and flow resistance within 10-15 min after induction. Stabilization (compensation) of the respiratory system in the face of this added load is related to the addition of active (contractile) force-length and force-velocity properties to its internal impedance during inspiration. The difference between active (inspiratory) and passive (relaxation-exhalation) values of elastance and resistance can be used as an index of load compensation. We therefore evaluated the effects of duration of anesthesia on respiratory impedance and stabilization by comparing active elastance (E'rs) and flow resistance (R'rs) to their corresponding passive values (Ers, Rrs) at the beginning and end of steady-state breathing in ten young, healthy anesthetized adults undergoing orthopedic surgery (anesthesia approximately 1.5 MAC of a halogenated anesthetic in 60% N2O-40% O2). Occlusion pressure (P0.1) and components of ventilation also were measured. Duration of anesthesia did not correlate with changes in active or passive mechanics or with control of ventilation. Mean Rrs increased by 76% (P less than 0.025), probably due to a decline of atropine effect; however, R'rs increased by only 17%, indicating near-maximum stabilization of flow-resistive properties at the end. Passive elastance increased 6%, whereas E'rs increased 3.8%, indicating essentially constant volume-elastic stabilization throughout. Occlusion pressure increased 20% and VT/TI 22%, probably due to a decline in effects of sedation and neuromuscular blockade. We conclude that after induction of anesthesia, the reserve available to overcome flow resistance (intrinsic plus equipment) diminishes but is not related to duration of anesthesia. The reserve available to overcome elastic properties remains essentially constant throughout anesthesia.

UI MeSH Term Description Entries
D008170 Lung Compliance The capability of the LUNGS to distend under pressure as measured by pulmonary volume change per unit pressure change. While not a complete description of the pressure-volume properties of the lung, it is nevertheless useful in practice as a measure of the comparative stiffness of the lung. (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p562) Compliance, Lung,Compliances, Lung,Lung Compliances
D008297 Male Males
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D012123 Pulmonary Ventilation The total volume of gas inspired or expired per unit of time, usually measured in liters per minute. Respiratory Airflow,Ventilation Tests,Ventilation, Pulmonary,Expiratory Airflow,Airflow, Expiratory,Airflow, Respiratory,Test, Ventilation,Tests, Ventilation,Ventilation Test
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000777 Anesthetics Agents capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. Anesthetic,Anesthetic Agents,Anesthetic Drugs,Anesthetic Effect,Anesthetic Effects,Agents, Anesthetic,Drugs, Anesthetic,Effect, Anesthetic,Effects, Anesthetic
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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