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J Appl Physiol 91: 3-9, 2001;
8750-7587/01 $5.00
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Vol. 91, Issue 1, 3-9, July 2001

Ventilation-perfusion inhomogeneity increases gas uptake: theoretical 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 gas exchange in the presence of inspired mixtures of two soluble gases using a two-compartment computer model. Theoretical studies involving a mixture of hypothetical gases with equal solubility in blood showed that the effect of increasing inhomogeneity of distributions of either ventilation or blood flow is to paradoxically increase uptake of the gas with the lowest overall uptake in relation to its inspired concentration. This phenomenon is explained by the concentrating effects that uptake of soluble gases exert on each other in low VA/Q compartments. Repeating this analysis for inspired mixtures of 30% O2 and 70% nitrous oxide (N2O) confirmed that, during "steady-state" N2O anesthesia, uptake of N2O is predicted to paradoxically increase in the presence of worsening VA/Q inhomogeneity.

alveolar-arterial difference; oxygen uptake


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