Scott P V, Haden R M, Jones R P
Alexandra Hospital, Redditch, Worcestershire.
Anaesthesia. 1996 Aug;51(8):752-6. doi: 10.1111/j.1365-2044.1996.tb07890.x.
We have described a method for control of end-tidal carbon dioxide tension during intermittent positive pressure ventilation in a model lung and in 19 adults during general anaesthesia supplemented by central or peripheral neural blockade. The inspiratory and expiratory limbs of an open or a circle anaesthesia system were interconnected and ventilated simultaneously in a variable manner during inspiration. The flow of mixed-expired gas, normally one-way, became to-and-fro (variable functional apparatus deadspace, or "virtual' deadspace). At minute volume ventilation > or = 100 ml.kg-1.min-1 (patients), the value of end-tidal carbon dioxide tension was varied reproducibly within the range 4.1-6.5 (SD 0.1)kPa independently of fresh gas flow or other prescribed patterns of ventilation. At a steady state, stable nominated values of end-tidal carbon dioxide tension within the range were attained. By how much any given intra-operative value of end-tidal carbon dioxide tension may be said to affect peri-operative outcome is debatable, but during surgery any change in a nominated value may usefully indicate a change in the steady state.
我们已经描述了一种在模型肺以及19名接受全身麻醉并辅以中枢或外周神经阻滞的成年人中，在间歇正压通气期间控制呼气末二氧化碳分压的方法。开放或循环麻醉系统的吸气和呼气支路相互连接，并在吸气期间以可变方式同时通气。通常为单向的混合呼出气体流变成了往复式（可变功能性装置死腔，或“虚拟”死腔）。在分钟通气量≥100 ml·kg⁻¹·min⁻¹（患者）时，呼气末二氧化碳分压值可在4.1 - 6.5（标准差0.1）kPa范围内可重复变化，与新鲜气体流量或其他规定的通气模式无关。在稳定状态下，可达到该范围内指定的稳定呼气末二氧化碳分压值。任何给定的术中呼气末二氧化碳分压值对围手术期结果的影响程度尚存在争议，但在手术期间，指定值的任何变化可能有效地表明稳定状态的改变。
