British Journal of Anaesthesia, 2000, Vol. 85, No. 3 371-378
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia
Estimation of pulmonary blood flow from sinusoidal gas exchange during anaesthesia: a theoretical study
1Department of Anaesthesia, The University of Sydney, NSW 2060, Australia. 2Drägerwerk AG, Moislinger Allee 5355, D-23542 Lübeck, Germany*Corresponding author
We simulated the use of simultaneous
sinusoidal changes of inspired O2 and N2O
(Williams et al., J Appl Physiol, 1994;
76: 21309) at fractional concentrations up to 0.3 and 0.7,
respectively, to estimate FRC and pulmonary blood flow (PBF) during
anaesthesia, using O2 as an insoluble indicator. Hahns
approximate equations, which neglect the effect of pulmonary uptake and
excretion on expiratory flow, estimate dead space and alveolar volume
(VA) with systematic errors less than 10%, but
yield systematic errors in PBF which are approximately proportional to
FIN2O in magnitude. A
correction factor
(1
)1
for Hahns equations for PBF (where
is the mean partial pressure of
the soluble indicator) reduces the dependence of PBF estimates on
FIN2O, and the
solution of equations describing the simultaneous mass balance of both
indicators yields accurate results for a wide range of mean
FIN2O. However, PBF
estimates are sensitive to measurement errors and a third gas must be
present to ensure that the indicator gases behave
independently.
Br J Anaesth 2000; 85: 3718