Effect of tidal volume on respiratory system elastance and resistance during anesthesia and paralysis.
Recent studies have shown that the mechanical properties of the respiratory system at normal breathing frequency in awake humans depend on tidal volume. Few measurements of respiratory system properties during anesthesia have accounted for this dependence. From measurements of airway pressure, flow and esophageal pressure, we calculated elastances and resistances of the total respiratory system (Ers and Rrs), chest wall (Ecw and Rcw), and lungs (El and Rl) in supine human volunteers during quasisinusoidal volume forcing in a normal range of breathing (250 to 800 ml) at normal breathing frequency (0.2 Hz). Measurements were made (1) with subjects awake and voluntarily relaxed; (2) after isoflurane-N2O anesthesia (end-tidal isoflurane concentration 0.3 to 0.5%); and (3) after complete muscle paralysis with vecuronium. In all conditions, Ers, Ecw, El, Rrs, and Rcw decreased at 800 ml tidal volume compared with 250 ml; Rl showed a similar decrease in awake measurements only. Compared with awake measurements, each elastance tended to increase after anesthesia, but only the increase in Ers was significant. Compared with anesthesia, there was no effect of paralysis on any measurement. We conclude that (1) tidal volume dependence of respiratory system properties in the normal range of breathing occurs in the absence of muscle activity; (2) anesthesia increases Ers and (3) respiratory muscle activity appears to be inhibited by isoflurane-N2O anesthesia at end-tidal isoflurane concentration of 0.3 to 0.5% during normocapnia.
Barnas
G M
GM
Department of Anesthesiology, University of Maryland, Baltimore 21201.
Mills
P J
PJ
Mackenzie
C F
CF
Fletcher
S J
SJ
Green
M D
MD
D000328:Adult; D000403:Airway Resistance / Q000502:physiology*; D000770:Anesthesia, Endotracheal; D004548:Elasticity; D006801:Humans; D008297:Male; D009407:Nerve Block; D012016:Reference Values; D012133:Respiratory Paralysis / Q000503:physiopathology*; D012143:Respiratory Physiological Phenomena; D013990:Tidal Volume / Q000502:physiology*; D014851:Wakefulness / Q000502:physiology