Anatomy and physiology of respiratory system relevant to anaesthesia (original) (raw)
Related papers
Current concepts of protective ventilation during general anaesthesia
Swiss medical weekly, 2015
Mechanical ventilation with high tidal volumes (VT) has been common practice in operating theatres because this strategy recruits collapsed lung tissue and improves ventilation-perfusion mismatch, thus decreasing the need for high inspired oxygen concentrations. Positive end-expiratory pressure (PEEP) was not used routinely because it was thought to impair cardiovascular function. Over the past two decades there have been advances in our understanding of the causes and importance of ventilation-induced lung injury based on studies in animals with healthy lungs, and trials in critically ill patients with and without acute respiratory distress syndrome. Recent data from randomised controlled trials in patients receiving ventilation during general anaesthesia for surgery have demonstrated that lung-protective strategies (use of low VT, use of PEEP if indicated, and avoidance of excessive oxygen concentrations) are also of importance during intraoperative ventilation.
Acta Anaesthesiologica Scandinavica, 1977
Investigations during the last two decades have revealed a tendency to impaired pulmonary gas exchange in patients during general anesthesia. In the awake state, arterial hypoxemia is counteracted by a mechanism which tends to normalize the ventilation/perfusion ratio of the lungs by wayofa hypoxia-induced vasoconstriction in poorly ventilated areas. This results in a redistribution of perfusion to more adequately ventilated lung regions. Recent observations suggest, however, that this beneficial mechanism is blunted by some commonly used inhalation anesthetics.
Ventilatory management during routine general anaesthesia
European Journal of Anaesthesiology, 2009
Intraoperative hypoxaemia and postoperative respiratory complications remain the challenges of modern anaesthetic practice. Anaesthesia causes both depression of respiratory centres and profound changes of respiratory mechanics. Most anaesthetized patients consequently require mechanical ventilation and supplemental oxygen. Recent data suggest that intraoperative respiratory management of a patient can affect postoperative outcome. In this review, we briefly describe the mechanisms responsible for the impairment of intraoperative gas exchange and provide guidelines to prevent or manage hypoxaemia. Moreover, we discuss several aspects of mechanical ventilation that can be employed to improve patients' outcome.
Anesthesia and Respiratory Diseases
Thai Journal of Anesthesiology, 2024
In patients with underlying respiratory pathology, the changes in respiratory physiology may lead to additional clinical problems during the conduct of anesthesia and in the perioperative period. An understanding of the disease permits the anesthetic personnel to comprise the potential complications and manage the anesthesia consequently. Failure to recognize patients who are at increased risk may result in patients not receiving optimal perioperative care. Patient monitoring and support are also critical and should be directed toward normalizing respiratory function and supporting the goal of the respiratory system, which is to deliver oxygen to and remove carbon dioxide from tissues and organs throughout the body. Importantly, risk identification, pre-operative optimization, and appropriate anesthetic management could reduce the risks of developing postoperative complications in patients with respiratory disease.
Anesthesiology, 2019
Editor’s PerspectiveWhat We Already Know about This TopicWhat This Article Tells Us That Is NewBackgroundOptimal management of anesthesia-induced respiratory depression requires identification of the neural pathways that are most effective in maintaining breathing during anesthesia. Lesion studies point to the brainstem retrotrapezoid nucleus. We therefore examined the respiratory effects of common anesthetic/analgesic agents in mice with selective genetic loss of retrotrapezoid nucleus neurons (Phox2b27Alacki/+ mice, hereafter designated “mutants”).MethodsAll mice received intraperitoneal ketamine doses ranging from 100 mg/kg at postnatal day (P) 8 to 250 mg/kg at P60 to P62. Anesthesia effects in P8 and P14 to P16 mice were then analyzed by administering propofol (100 and 150 mg/kg at P8 and P14 to P16, respectively) and fentanyl at an anesthetic dose (1 mg/kg at P8 and P14 to P16).ResultsMost mutant mice died of respiratory arrest within 13 min of ketamine injection at P8 (12 of ...