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麻醉医师呼吸生理学

Respiratory Physiology for the Anesthesiologist.

机构信息

From the Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts (L.B.) the Department of Emergency, Anesthesia and Critical Care, Foundation IRCCS Ospedale Maggiore Policlinico, and Department of Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy (A.P.).

出版信息

Anesthesiology. 2019 Jun;130(6):1064-1077. doi: 10.1097/ALN.0000000000002666.

Abstract

Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic support, and return to the preoperative state. The current work provides a review of classic physiology and emphasizes features important to the anesthesiologist. The material is divided in two main sections, gas exchange and respiratory mechanics; each section presents the physiology as the basis of abnormal states. We review the path of oxygen from air to the artery and of carbon dioxide the opposite way, and we have the causes of hypoxemia and of hypercarbia based on these very footpaths. We present the actions of pressure, flow, and volume as the normal determinants of ventilation, and we review the resulting abnormalities in terms of changes of resistance and compliance.

摘要

呼吸功能在麻醉实践中至关重要。了解呼吸的基本生理原理有助于正确实施全麻诱导和维持、机械通气、机械和药物支持的终止以及恢复术前状态等日常操作。本工作回顾了经典生理学,并强调了对麻醉师重要的特征。内容分为气体交换和呼吸力学两个主要部分;每个部分都根据异常状态介绍生理学基础。我们回顾了氧气从空气到动脉和二氧化碳从相反方向的路径,并且根据这些基本路径,我们了解了低氧血症和高碳酸血症的原因。我们介绍了压力、流量和容量作为正常通气决定因素的作用,并根据阻力和顺应性的变化来回顾由此产生的异常。

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