During anaesthesia the combination of breathing at low lung volume, the administration of nitrous oxide and high inspired oxygen concentrations produces conditions that favour absorption atelectasis. Measures such as adding nitrogen to the inspired mixture and avoiding high inspired oxygen concentrations would reduce the amount of perioperative atelectasis if gas absorption was important in the genesis of perioperative pulmonary collapse. Experimental results demonstrate that these measures do not protect against atelectasis. This indicates that absorption atelectasis does not play a significant role in the genesis of perioperative pulmonary collapse. Compression atelectasis may be the underlying mechanism.
BenjaminJJ, CascadePN, RubenfireM, WajszczukW, KerinNZ.Left lower lobe atelectasis and consolidation following cardiac surgery: The effect of topical cooling on the phrenic nerve. Radiology1982; 142:11–14.
2.
GoodmanLR.Postoperative chest radiograph: 1. Alterations after abdominal surgery. Am J Roentgenology1980; 134: 533–541.
3.
RahnH, FarhiLE.Gaseous environment and atelectasis. Fed Proc1963; 22:1035–1041.
4.
LoringSH, ButlerJP.Gas exchange in body cavities. In: FarhiLE, TenneySM, eds. Handbook of physiology. Section 3, The respiratory system. Volume 4, Gas exchange. Chapter 15, Ed. Am Physiol Soc, Bethesda Maryland1987; 283–295.
5.
PiiperJ.Physiological equilibria of gas cavities in the body. In: FennWO, RahnH, eds. Handbook of physiology. Section 3, Respiration. Volume 2, Gas exchange. Chapter 48, Ed. Am Physiol Soc, Washington D.C.1965; 1205–1218.
6.
DantzkerDR, WagnerPD, WestJB.Instability of lung units with low VA/Q ratios during O2 breathing. J Appl Physiol1975; 38:886–895.
7.
CoryllosPN, BimbaumGL.Studies in pulmonary gas absorption in bronchial obstruction. Am J Med Sci1932; 183:317–359.
8.
DaleWA, RahnH.Rate of gas absorption during atelectasis. Am J Physiol1952; 170:606–615.
9.
JoyceCJ, BakerAB, KennedyRR.Gas uptake from an unventilated area of lung: computer model of absorption atelectasis. J Appl Physiol1993; 74:1107–1116.
10.
LichtheimL.Versuche über Lungenatelektase. Arch Experiment Pathol Pharmakol1879; 10:54–100.
11.
ErnstingJ.Rate of gas absorption from the lung during rebreathing in the dog. J Physiol1965; 181:42P–43P.
12.
JoyceCJ.A breath of fresh air. A study of the kinetics of absorption atelectasis and its role in the genesis of perioperative pulmonary collapse. Ph.D. Thesis. University of Otago Medical School, 1993.
13.
WestJB, WagnerPD.Pulmonary gas exchange. In: WestJB, eds. Bioengineering aspects of the lung. Chapter 5, Ed. Marcel Decker, Inc., New York1977; 361–457.
14.
BakerAB, McGinnA, JoyceCJ.Effect on lung volumes of oxygen concentration when breathing is restricted. Br J Anaesth1993; 70:259–266.
15.
BakerAB, RestallR.Changes in residual volume following oxygen breathing. Br J Anaesth1983; 55:817–824.
16.
DahlbackGO, BalldinUI.Positive pressure oxygen breathing and pulmonary atelectasis during immersion. Undersea Biomed Res1983; 10:39–44.
17.
NunnJF, WilliamsIP, JonesJG, HewlettAM, HulandsGH, MintyBD.Detection and reversal of pulmonary absorption collapse. Br J Anaesth1978; 50:91–99.
18.
TackerWA, BalldinUI, BurtonRR, GlaisterDH, GillinghamKK, MercerJR.Induction and prevention of acceleration atelectasis. Aviation, Space, and Environmental Medicine1987; 58:69–75.
19.
BurgerEJ, MeadJ.Static properties of lungs after oxygen exposure. J Appl Physiol1969; 27:191–197.
20.
DuBoisAB, TuraidsT, MammenRE, NobregaFT.Pulmonary atelectasis in subjects breathing oxygen at sea level or at simulated altitude. J Appl Physiol1966; 21:828–836.
DonHF, WahbaM, CuadradoL.Kelkar K. The effect of anesthesia and 100 per cent oxygen on the functional capacity of the lungs. Anesthesiology1970; 32:521–529.
23.
DonHF, WahbaWM, CraigDB.Airway Closure, Gas Trapping, and the Functional Residual Capacity during Anesthesia. Anesthesiology1972; 36:533–539.
24.
DueckR, PrutowRJ, DaviesNJH, ClausenJL, DavidsonTM.The lung volume at which shunting occurs with inhalation anesthesia. Anesthesiology1988; 69:854–861.
25.
HedenstiernaG.Gas exchange during Anaesthesia. Acta Anaesthesiol Scand1990; 34:27–31.
26.
HedenstiernaG, StrandbergA, BrismarB, LundquistH, SvenssonL, TokicsL.Functional residual capacity, thoracoabdominal dimensions and central blood volume during general anesthesia with muscle paralysis and mechanical ventilation. Anesthesiology1985; 62:247–254.
27.
HewlettAM, HulandsGH, NunnJH, HeathJR.Functional residual capacity during anaesthesia. II Spontaneous respiration. Br J Anaesth1974; 46:486–494.
28.
HewlettAM, HulandsGH, NunnJH, MilledgeJR.Functional residual capacity during anaesthesia. III Artificial ventilation. Br J Anaesth1974; 46:495–503.
29.
KrayerS, RehderK, BeckKC, CameronPD, DidlerEP, HoffmanEA.Quantification of thoracic volumes by three-dimensional imaging. J Appl Physiol1987; 62:591–598.
30.
RehderK, MarshHM.Respiratory mechanics during anaesthesia and mechanical ventilation. In: FarhiLE, TenneySM, eds. Handbook of physiology. Section 3. The respiratory system. Volume 3, Mechanics of Breathing Part 2. Chapter 43, Ed. American Physiological Society, Bethesda Maryland1986; 737–752.
31.
WahbaRWM.Perioperative functional residual capacity. Can J Anaesth1991; 38:384–400.
32.
BergmanNA, TienYK.Contribution of the closure of pulmonary units to impaired oxygenation during anesthesia. Anesthesiology1983; 59:395–401.
33.
WeenigCS, PietakS, HickeyRF, FairleyHB.Relationship of preoperative closing volume to function residual capacity and alveolar-arterial oxygen difference during anesthesia with controlled ventilation. Anesthesiology1974; 41:3–7.
34.
HeneghanCPH, BergmanNA, JonesJG.Changes in lung volume and (PAO2-PaO2) during anaesthesia. Br J Anaesth1984; 56:437–445.
35.
WebbSJS, NunnJF.A comparison between the effect of nitrous oxide and nitrogen on arterial PO2. Anaesthesia1967; 22:69–81.
36.
BrismarB, HedenstiernaG, LundquistH, StrandbergA, SvenssonL, TokicsL.Pulmonary densities during anesthesia with muscular relaxation—A proposal of atelectasis. Anesthesiology1985; 62:422–428.
37.
HedenstiernaG.New aspects of atelectasis formation and gas exchange impairment during anaesthesia. Clin Physiol1989; 9:407.
38.
HedenstiernaG.Gas exchange during anaesthesia. Br J Anaesth1990; 64:507–514.
39.
HedenstiernaG, BrismarB, StrandbergA, LundquistH, TokicsL.New aspects on atelectasis during anaesthesia. Clinical Physiology1985; 5:127.
40.
HedenstiernaG, TokicsL, StrandbergA, LundquistH, BrismarB.Correlation of gas exchange impairment to development of atelectasis during anaesthesia and muscle paralysis. Acta Anaesthesiol Scand1986; 30:183–191.
41.
StrandbergA, TokicsL, BrismarB, LundquistH, HedenstiernaG.Atelectasis during anaesthesia and in the postoperative period. Acta Anaesthesiol Scan1986; 31:154–158.
42.
StrandbergA, HedenstiernaG, TokicsL, LundquistH, BrismarB.Densities in dependent lung regions during anaesthesia: atelectasis or fluid accumulation?Acta Anaesthesiol Scand1986; 30:256.
43.
TokicsL, HedenstiernaG, StrandbergA, BrismarB, LundquistH.Lung collapse and gas exchange during general anesthesia: Effects of spontaneous breathing, muscle paralysis, and positive and expiratory pressure. Anesthesiology1987; 66:157–167.
44.
TokicsL, StrandbergA, BrismarB, LundquistH, HedenstiernaG.Computerized tomography of the chest and gas exchange measurements during ketamine anaesthesia. Acta Anaesthesiol Scand1987; 31:684–692.
45.
MankikianB, CantineauJP, SarteneR, ClergueF, ViarsP.Ventilatory pattern and chest wall mechanics during ketamine anesthesia in humans. Anesthesiology1986; 65:492–499.
46.
ShulmanD, BeardsmoreCS, AronsonHB, GodfreyS.The effect of ketamine on the functional residual capacity in young children. Anesthesiology1985; 62:551–556.
47.
BicklerPE, DueckR, PrutowRJ.Effects of barbiturate anesthesia on functional residual capacity and ribcage/diaphragm contributions to ventilation. Anesthesiology1987; 66:147–152.
48.
DeryR, PelletierJ, JacquesA, ClavetM, HoudeJ.Alveolar collapse induced by denitrogenation. Can Anaesth Soc J1965; 12:531.
49.
DamiaG, MascheroniD, CrociM, TarenziL.Perioperative changes in functional residual capacity in morbidly obese patients. Br J Anaesth1988; 60:574–578.
50.
JonmarkerC, NordstromL, WernerO.Changes in functional residual capacity during cardiac surgery. Br J Anaesth1986; 58:428.
51.
HedenstiernaG.Mechanisms of postoperative pulmonary dysfunction. Acta Chir Scand1988; Suppl 550:152–158.
52.
BrowneDRG, RochfordJ, O'ConnellU, JonesGJ.The incidence of postoperative atelectasis in the dependent lung following thoracotomy: the value of added nitrogen. Br J Anaesth1970; 42:340–346.
53.
LoganDA, SpenceAA, SmithG.Postoperative pulmonary function. A comparison of ventilation with nitrogen or nitrous oxide during anaesthesia. Anaesthesia1977; 32:3–7.
54.
RobertsCJ, ParkeTJ, SykesMK.Effect of intraoperative inspired gas mixtures on postoperative nocturnal oxygen saturation. Br J Anaesth1993; 71:476–480.
55.
StevensWC, GossettJA, HamiltonWK, MoreheadRT.The relation of postoperative atelectasis to the solubility of gas filling the lungs at termination of anaesthesia. Anesthesiology1966; 27:163–167.
56.
WildsmithJAW, MassonAHB.Some effects of maintaining pulmonary nitrogenation during anaesthesia. Br J Anaesth1974; 46:680–684.
