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British Journal of Anaesthesia, 1988, Vol. 60, No. 2 198-206
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

EFFECTS OF ALTERED PATTERNS OF VENTILATION AND OF INCREASED CARDIAC OUTPUT ON BLOOD FLOW TO A COLLAPSED LUNG IN ANAESTHETIZED, CLOSED-CHEST DOGS

D. J. NIBLETT, M.B., B.S., F.F.A.R.C.S., D. CANNON, B.SC., D.PHIL. and M. K. SYKES, M.A., M.B., B.CHIR, F.F.A.R.C.S., F.F.A.R.A.C.S. (HON)

Nuffield Department of Anaesthetics Radcliffe Infirmary, Oxford OX2 6HE

Correspondence to M. K. S.

Right-to-left shunt (Qs/Qt) was measured by the SF6 and oxygen methods in 13 anaesthetized closed-chest dogs intubated with a double-lumen endobronchial tube. Collapse of the left lung increased Qs/Qt from 10% to 23%, suggesting that blood flow to the left lung had been reduced by about 60%. Increasing right lung mean airway pressure by the alteration of the inspiratory:expiratory time ratio or the application of PEEP produced a small but non-significant increase in Qs/Qt with significant increases in arterial and mixed venous carbon dioxide tensions, and arterial to right lung end-tidal carbon dioxide tension difference. Fluid loading during collapse increased cardiac output and pulmonary vascular pressures, but Qs/Qt did not differ significantly from the normovolaemic collapsed state. Increasing the right mean airway pressure in this condition had no effect on Qs/Qt or carbon dioxide tensions.


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