Lockwood G G, White D C
Department of Anaesthesia, Hammersmith Hospital, London.
Br J Anaesth. 1991 Apr;66(4):519-26. doi: 10.1093/bja/66.4.519.
We have investigated the influences of ventilation and cardiac output on uptake of anaesthetic with different breathing systems, by analysis of simple equations and by computer simulation. Increases in cardiac output and ventilation increased uptake from those systems which provided a constant inspired concentration, but not from completely closed systems with the vaporizer out of the circle (VOC), or when using the technique described by Lowe and Ernst. When the vaporizer was inside the circle, uptake increased with ventilation but not with cardiac output. With servo control of endtidal concentration, uptake increased with cardiac output but not with ventilation. When the fresh gas flow to VOC systems was increased from basal, independence of uptake from ventilation was well maintained until fresh gas flow approached alveolar ventilation, but the independence of uptake from cardiac output was lost much sooner.
我们通过对简单方程的分析和计算机模拟,研究了通气和心输出量对不同呼吸系统吸入麻醉药的影响。心输出量和通气量的增加会使那些能提供恒定吸入浓度的系统的摄取量增加,但对于蒸发器置于环路外的完全紧闭系统(VOC),或使用Lowe和Ernst所描述的技术时,摄取量不会增加。当蒸发器置于环路内时,摄取量随通气量增加而增加,但不随心输出量增加。采用呼气末浓度的伺服控制时,摄取量随心输出量增加而增加,但不随通气量增加。当VOC系统的新鲜气体流量从基础值增加时,摄取量与通气的独立性在新鲜气体流量接近肺泡通气量之前能很好地维持,但摄取量与心输出量的独立性丧失得要早得多。