Some of the adverse physiological effects of hypocarbia are described and the methods available to maintain the PaCO2within or near the normal range during controlled ventilation are reviewed.
References
1.
AyreT. P. (1937): “Anaesthesia for Intracranial Operation. A New Technique”, Lancet, 1, 561.
2.
BainJ. A., and SpoerelW. E. (1972): “A Streamlined Anaesthetic System”, Canad. Anaesth. Soc. J., 19, 426.
3.
BainJ. A., and SpoerelW. E. (1973): “Flow Requirements for a Modified Mapleson D System During Controlled Ventilation”, Canad. Anaesth. Soc. J., 20, 629.
4.
BarakaA. (1969): “PCO2 Control by Fresh Gas Flow During Controlled Ventilation with a Semi-open Circuit”, Brit. J. Anaesth., 41, 527.
5.
BensonD. W., GraffT. D., HurtH. H., and LimH. S. (1968): “The Circle Semi-closed System Control of PaCO2 by Inflow Rates of Anaesthetic Gases and Hyperventilation”, Anesthesiology, 29, 174.
6.
BlenkarnG. D., BriggsG., BellJ., and SugiokaR. (1972): “Cognitive Function after Hypocapnic Hyperventilation”, Anesthesiology, 37, 381.
7.
Clutton-BrockJ. (1957): “The Cerebral Effects of Overventilation”, Brit. J. Anaesth., 29, 111.
8.
ConwayC. M. (1976): “A Theoretical Study of Gaseous Homeostasis in the Magill Circuit”, Brit. J. Anaesth., 48, 441.
9.
ConwayC. M., DavisF. M., KnightH. J., LeighJ. M., PrestonT. D., and TennantR. (1976): “An Experimental Study of Gaseous Homeostasis and the Magill Circuit Using Low Fresh Gas Flows”, Brit. J. Anaesth., 48, 447.
10.
CullenD. J., and EgerE. I. (1974): “Cardiovascular Effects of Carbon Dioxide in Man”, Anesthesiology, 41, 345.
11.
DrummondG. B. (1975): “The Assessment of Postoperative Mental Function”, Brit. J. Anaesth., 47, 130.
12.
Editorial (1969): “Hyperventilation”, Brit. J. Anaesth., 41, 563.
13.
FeldmanS. A. (1974): Muscle Relaxants.W. B. Saunders, 1973 Edition, Page 53 ff.
14.
FeldmanS. A., and TyrrellM. F. (1970): “A New Theory of the Termination of Action of the Muscle Relaxants”, Proc. Roy. Soc. Med., 63, 692.
15.
FoëxP., and Prys-RobertsC. (1975): “The Effect of CO2 on Myocardial Contractility and Aortic Input Impedance During Anaesthesia”, Brit. J. Anaesth., 47, 669.
16.
GrayT. C., and ReesG. J. (1952): “The Role of Apnoea in Anaesthesia for Major Surgery”, Brit. Med. J., 2, 891.
17.
HarpJ. R., and WollmanH. (1973): “Cerebral Metabolic Effects of Hyperventilation and Deliberate Hypotension”, Brit. J. Anaesth., 45, 256.
18.
HarrisonG. A. (1964a): “Ayres T-piece: A Review of its Modifications”, Brit. J. Anaesth., 36, 115.
19.
HarrisonG. A. (1964b): “The Effect of Respiratory Flow Pattern on Rebreathing in a T-piece System”, Brit. J. Anaesth., 36, 206.
20.
HenvilleJ. D., and AdamsA. P. (1976): “The Bain Anaesthetic System. An Assessment During Controlled Ventilation”, Anaesthesia, 31, 247.
21.
InksterJ. S. (1956): “The T-piece Technique in Anaesthesia”, Brit. J. Anaesth., 28, 512.
22.
KainM. L., and NunnJ. F. (1968): “Fresh Gas Economics of the Magill Circuit”, Anesthesiology, 29, 964.
23.
KetyS. S., and SchmidtC. F. (1948): “The Effects of Altered Arterial Tensions of Carbon Dioxide and Oxygen on Cerebral Blood Flow and Cerebral Oxygen Consumption of Normal Young Men”, Journal of Clinical Investigation, 27, 484.
LeeJ. A., and AtkinsonR. S. (1975): A Synopsis of Anaesthesia.Bristol: John Wright and Son Ltd., 141.
26.
LewisG. M., and SalamonsenR. F. (1970): “Correspondence”, Brit. J. Anaesth., 42, 362.
27.
MaplesonW. W. (1954): “The Elimination of Rebreathing in Various Semiclosed Anaesthetic Systems”, Brit. J. Anaesth., 26, 323.
28.
MaplesonW. W. (1958): “Theoretical Considerations of the Effect of Rebreathing in Various Semi-closed Anaesthetic Systems”, Brit. Med. Bull., 14, 64.
29.
MarshallM., and HendersonG. A. (1968): “Positive Pressure Ventilation Using a Semi-closed System: A Reassessment”, Brit. J. Anaesth., 40, 265.
30.
MichenfelderJ. D., and TheyeR. A. (1969): “The Effects of Profound Hypocapnia and Dilutional Anaemia on Canine Cerebral Metabolism and Blood Flow”, Anesthesiology, 31, 449.
31.
NightingaleD. A., RichardsC. C., and GlassA. (1965): “An Evaluation of Rebreathing in a Modified T-piece System During Controlled Ventilation of Anaesthetized Children”, Brit. J. Anaesth., 37, 762.
32.
NormanJ., AdamsA. P., and SykesM. K. (1968): “Rebreathing with the Magill Attachment”, Anaesthesia, 23, 75.
33.
NunnJ. F. (1960): “Prediction of Carbon Dioxide Tension During Anaesthesia”, Anaesthesia, 15, 123.
34.
NunnJ. F. (1962): “Predictors for Oxygen and Carbon Dioxide Levels During Anaesthesia”, Anaesthesia, 17, 182.
OnchiY., HayashiT., and UeyamaH. (1957): “Studies on the Ayre's T-piece Technique”, Far East J. Anaesth., 1, 30.
37.
Prys-RobertsC., KelmanG. R., GreenbaumR., and RobinsonR. H. (1967): “Circulatory Influences of Artificial Ventilation During Nitrous Oxide Anaesthesia in Man. II: Results: The Relative Influence of Mean Intrathoracic Pressure and Arterial Carbon Dioxide Tension”, Brit. J. Anaesth., 39, 533.
38.
RadfordE. P. (1955): “Ventilation Standards for Use in Artificial Respiration”, J. Applied Physiology, 7, 451.
39.
ReesG. J. (1959): General Anaesthesia (EvansF. T., and GrayT. C.,) London, Butterworths, 2, 191.
40.
ReivichM. (1964): “Arterial PCO2 and Cerebral Hemodynamics”, Am. J. Physiol., 206, 25.
41.
ScholfieldE. J., and WilliamsN. E. (1975): “Prediction of Arterial Carbon Dioxide Tension Using a Circle System Without Carbon Dioxide Absorption”, Brit. J. Anaesth., 46, 442.
42.
SnowdonS. L., PowellD. L., FadlE. T., and UttingJ. E. (1975): “The Circle System Without Absorber”, Anaesthesia, 30, 323.
43.
SpurrG. B., and LiuC. T. (1966): “Intra- and Extra-Cellular K+ Concentration of Cardiac and Skeletal Muscle During Acute Respiratory Acid-base Alterations”, Amer. J. Med. Sci., 252, 413.
44.
SullivanS. F., and PattersonR. W. (1968): “Post-hyperventilation Hypoxia”, Anesthesiology, 29, 981.
45.
SuwaK., and BendixenH. H. (1968): “Change in PaCO2 with Mechanical Dead Space During Artificial Ventilation”, J. Applied Physiology, 24, 556.
46.
SuwaK., GeffinB., PontoppidanH., and BendixenH. H. (1968): “A Nomogram for Dead Space Requirement During Prolonged Artificial Ventilation”, Anesthesiology, 29, 1206.
47.
SuwaK., and YamamuraH. (1970): “The Effect of Gas Inflow on the Regulation of CO2 Levels with Hyperventilation During Anaesthesia”, Anesthesiology, 33, 440.
48.
TheyeR. A., MildeJ. H., and MichenfelderJ. D. (1966): “Effect of Hypocapnia on Cardiac Output During Anaesthesia”, Anesthesiology, 27, 778.
49.
VisickW. D., FairleyH. B., and HickeyR. F. (1973): “The Effect of Tidal Volume and End-expiratory Pressure on Pulmonary Gas Exchange During Anesthesia”, Anesthesiology, 39, 285.
50.
WatersD. J., and MaplesonW. W. (1961): “Rebreathing During Controlled Respiration with Various Semi-closed Anaesthetic Systems”, Brit. J. Anaesth., 33, 374.
51.
WollmanH., AlexanderS. C., CohenP. J., SmithT. C., ChaseP. E., and van der MolenR. A. (1965): “Cerebral Circulation During General Anesthesia and Hyperventilation in Man”, Anesthesiology, 26, 329.
52.
WollmanS. B., and OrkinL. R. (1968): “Postoperative Human Reaction Time and Hypocarbia During Anaesthesia”, Brit. J. Anaesth., 40, 920.