British Journal of Anaesthesia, Vol 76, Issue 6 760-766, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
A. Reber, G. Engberg, B. Sporre, L. Kviele, H. U. Rothen, G. Wegenius, U. Nylund and G. Hedenstierna
Spiral computed tomography (CT) allows volumetric analysis of formation of
atelectasis and aeration of the lungs during anaesthesia. We studied 26
premedicated patients undergoing elective surgery allocated to group 1
(conscious, spontaneous breathing, investigating inspiration and
expiration), group 2 (general anaesthesia with mechanical ventilation,
investigating inspiration and expiration) or group 3 (general anaesthesia
with mechanical ventilation, investigating changes over time). Using spiral
CT, the lungs were studied either before or during general anaesthesia. CT
scans were grouped into the following areas: overaeration, normal aeration,
reduced aeration, poor aeration and atelectasis. The mechanism of
atelectasis appeared to be both gravitational forces and a
diaphragm-related force that acts regionally in caudal lung regions. Mean
atelectasis formation and poorly aerated regions comprised approximately 4%
of the total lung volume between the diaphragm and carina, giving a mean
value of 16-20% of the normal aerated lung tissue being either collapsed or
poorly aerated. The vertical ventilation distribution was more even during
anaesthesia than in the awake state.
CLINICAL INVESTIGATIONS
Volumetric analysis of aeration in the lungs during general anaesthesia
Department of Anaesthesiology and Intensive Care, and Department of Clinical Physiology, University Hospital, Uppsala, Sweden and Department of Anaesthesia, University of Basel/Kantonsspital, Basel, Switzerland; Department of Radiology, University Hospital, Uppsala, Sweden; Department of Medical Technology, University Hospital, Uppsala, Sweden
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