Journal of Applied Physiology
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J Appl Physiol 91: 10-16, 2001;
8750-7587/01 $5.00
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Vol. 91, Issue 1, 10-16, July 2001

Ventilation-perfusion inhomogeneity increases gas uptake in anesthesia: computer modeling of gas exchange

Philip J. Peyton1, Gavin J. B. Robinson2, and Bruce Thompson3

Departments of 1 Anaesthesia and 3 Respiratory Medicine, Austin and Repatriation Medical Centre, Heidelberg 3084; and 2 Department of Anaesthesia and Pain Medicine, The Alfred, Prahan 3181, Melbourne, Victoria, Australia

Ventilation-perfusion (VA/Q) inhomogeneity was modeled to measure its effect on overall gas exchange during maintenance-phase N2O anesthesia with an inspired O2 concentration of 30%. A multialveolar compartment computer model was used based on physiological log normal distributions of VA/Q inhomogeneity. Increasing the log standard deviation of the distribution of perfusion from 0 to 1.75 paradoxically increased O2 uptake (VO2) where a low mixed venous partial pressure of N2O [high N2O uptake (VN2O)] was specified. With rising mixed venous partial pressure of N2O, a threshold was observed where VO2 began to fall, whereas VN2O began to rise with increasing VA/Q inhomogeneity. This phenomenon is a magnification of the concentrating effects that VO2 and VN2O have on each other in low VA/Q compartments. During "steady-state" N2O anesthesia, VN2O is predicted to paradoxically increase in the presence of worsening VA/Q inhomogeneity.

alveolar-arterial difference; oxygen uptake


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