Advertisement

Veränderungen der Lungenfunktion während und nach Narkose und Operation

  • E. Voigt
  • R. Schorer
Part of the Klinische Anästhesiologie und Intensivtherapie book series (KAI, volume 12)

Zusammenfassung

Mit der Verfügbarkeit von Elektroden zur Messung der arteriellen Blutgase sind zahlreiche Publikationen erschienen, die sich mit der Veränderung der Lungenfunktion und damit ihrer Rückwirkung auf die arteriellen Blutgase befassen. Die frühen Beobachtungen von BJORK (5), MAIER (18) und BERGGREN (4), welche nachweisen konnten, daß der arterielle PO2 bei hospitalisierten Patienten häufig niedriger als erwartet lag und durch Thorakotomien weiter gesenkt wurde, konnten durch viele nachfolgende Untersuchungen bestätigt werden, wobei die Ursachen dieser Veränderungen komplexer Natur sind und zu vielfältigen Diskussionen Anlaß geben.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    ANTHONISEN, N. R., DANSON, J., ROBERTSON, P. C.: Airway closure as a function of age. Resp. Physiol. 8, 58 (1969/1970).CrossRefGoogle Scholar
  2. 2.
    BEECHER, H. K.: Effect of laparotomy on lung volume. Demonstration of a new type of pulmonary collapse. J. clin. Invest. 12, 651 (1933).PubMedCrossRefGoogle Scholar
  3. 3.
    BERGMAN, N. A.: Components of alveolar-arterial öxygen tension difference in anesthetized man. Anesthesiology 28, 517 (1967).PubMedGoogle Scholar
  4. 4.
    BERGGREN, S. M.: The oxygen deficiency of arterial blood caused by nonventilated parts of the lung. Acta physiol. scand., Suppl. 11 (1942).Google Scholar
  5. 5.
    BJORK, V. O., HILTY, H. J.: The arterial oxygen and carbon dioxide tension during the postoperative period in cases of pulmonary resections and thoracoplastics. J. thorac. Surg. 27, 455 (1954).PubMedGoogle Scholar
  6. 6.
    CAMPBELL, E. J. M., NUNN, J. F., PECKETT, B. W.: A comparison of artificial Ventilation and spontaneous respiration with particular reference to ventilation-blood-flow relationship. Brit. J. Anaesth. 30, 166 (1958).PubMedCrossRefGoogle Scholar
  7. 7.
    CRAIG, D. B., WHABA, W. M., DON, H. F.: The effect of posture on airway closure and gas exchange. Clin. Res. 18, 742 (1970).Google Scholar
  8. 8.
    DALEN, J. E., EVANS, G. L., BANAS, J. S.: The hemodynamic and respiratory effects of diazepam (ValiumR). Anesthesiology 30, 259 (1969).PubMedCrossRefGoogle Scholar
  9. 9.
    DON, H. F., CRAIG, D. B., WHABA, W. M.: The measurement of gas trapped in the lungs at functional residual capacity and the effect of posture. Anesthesiology 35, 582 (1971).PubMedCrossRefGoogle Scholar
  10. 10.
    DON, H. F., ROBSON, J. G.: The mechanics of the respiratory system during anesthesia: the effect of atropine and carbon dioxide. Anesthesiology 26, 168 (1965).PubMedCrossRefGoogle Scholar
  11. 11.
    DON, H. F., WHABA, W. M., CUADRADO, L.: The effects of anesthesia and 100 % oxygen on the functional residual capacity of the lungs. Anesthesiology 32, 521 (1970).PubMedCrossRefGoogle Scholar
  12. 12.
    DOBKIN, A. B., SU, J. P. G., BYLES, P. H.: “Normal” paO2 and SaO2 in elderly patients and the effect of premedication with atropine and meperidine. Acta anaesth. scand. 10, Suppl. 23, 542 (1966).CrossRefGoogle Scholar
  13. 13.
    FROESE, A. B., BRYAN, A. C.: Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology 41, 242 (1974).PubMedCrossRefGoogle Scholar
  14. 14.
    GARDINER, A. J. S., PALMER, K. N. V.: Effect of premedication and general anaesthesia on arterial blood gases. Brit. Med. J. 2, 1433 (1964).PubMedCrossRefGoogle Scholar
  15. 15.
    GREENFIELD, L. J., EBERT, P. A., BENSON, D. W.: Effect of positive pressure Ventilation on surface tension properties of lung extracts. Anesthesiology 25, 312 (1964).PubMedCrossRefGoogle Scholar
  16. 16.
    HILPERT, P.: Kollaterale Ventilation. Habil. Schrift, Tübingen (1970).Google Scholar
  17. 17.
    MACKLEM, P. T.: Airway obstruction and collateral Ventilation. Physiol. Rev. 51, 368 (1971).PubMedGoogle Scholar
  18. 18.
    MAIER, H. C., COURNAND, A.: Studies of arterial oxygen Saturation in the postoperative period after pulmonary resections. Surg. 13, 199 (1954).Google Scholar
  19. 19.
    MARSHALL, B. E., MILLAR, R. A.: Some factors influencing postoperative hypoxaemia. Anaesthesia 20, 408 (1965).PubMedCrossRefGoogle Scholar
  20. 20.
    MARSHALL, B. E., WYCHE, M. Q.: Hypoxemia during and after anesthesia. Anesthesiology 37, 178 (1972).PubMedCrossRefGoogle Scholar
  21. 21.
    MEAD, J., COLLIER, C.: Relation of volume history of lungs to respiratory mechanics in anaesthetized dogs. J. appl. Physiol. 14, 669 (1959).Google Scholar
  22. 22.
    MICHENFELDER, J. D., FOWLER, W. S., THEYE, E. A.: CO2-levels and pulmonary shunting in anaesthetized man. J. appl. Physiol. 21, 1471 (1966).PubMedGoogle Scholar
  23. 23.
    MOSTERT, J. W., EVERS, J. L., HOBIKA, G. H.: Cardiorespiratory effects of anaesthesia with morphine or fentanyl in chronic renal failure and cerebral toxicity after morphine. Brit. J. Anaesth. 43, 1053 (1971).PubMedCrossRefGoogle Scholar
  24. 24.
    MULLER, G. P., OVERHOLT, R. H., PENDERGRASS, E. P.: The effects of scopolamine on the.airways of man. Anesthesiology 30, 12 (1969).CrossRefGoogle Scholar
  25. 25.
    NUNN, J. F.: Hypoxemia after general anesthesia. Lancet II, 631 (1962).CrossRefGoogle Scholar
  26. 26.
    PANDY, J., NUNN, J. F.: Failure to demonstrate progressive falls of arterial pO2 during anaesthesia. Anaesthesia 23, 38 (1968).CrossRefGoogle Scholar
  27. 27.
    PIERCE, J. A., CAROFALO, M. L.: Preoperative medication and its effects on blood gases. JAMA 194, 487 (1965).PubMedCrossRefGoogle Scholar
  28. 28.
    PRICE, H. L., COOPERMAN, L. H., WARDEN, J. C., MORRIS, J. J., SMITH, TH. C.: Pulmonary hemodynamics during general anesthesia in man. Anesthesiology 30, 629 (1960).CrossRefGoogle Scholar
  29. 29.
    PRYS-ROBERTS, C., KELMAN, G. R., GREENBAUM, R., KAIN, M. L., BAY, J.: Hemodynamics and alveolar-arterial pO2-differences at varying paCO2 in anesthetized man. J. appl. Physiol. 25, 80 (1968).PubMedCrossRefGoogle Scholar
  30. 30.
    RHEDER, K., HATCH, D. J., SESSLER, A. D.: Effects of general anesthesia, muscle paralysis, and mechanical Ventilation on pulmonary nitrogen clearance. Anesthesiology 35, 591 (1971).CrossRefGoogle Scholar
  31. 31.
    STARK, D. C. H., SMITH, H.: Pulmonary vascular changes during anaesthesia. Brit. J. Anaesth. 32, 460 (1960).CrossRefGoogle Scholar
  32. 32.
    SMITH, T. C., DuBOIS, A. B.: The effects of scopolamine on the airways of man. Anesthesiology 30, 12 (1969).PubMedCrossRefGoogle Scholar
  33. 33.
    SYKES, M. K., YOUNG, W. E., ROBINSON, B. E.: Oxygenation during anaesthesia with controlled Ventilation. Brit. J. Anaesth. 37, 314 (1965).PubMedGoogle Scholar
  34. 34.
    TOMLIN, P. J., CONWAY, C. M., PAYNE, J. P.: Hypoxemia due to atropine. Lancet I, 14 (1964).CrossRefGoogle Scholar
  35. 35.
    VOIGT, E.: Die Beurteilung von Ventilatorischen Verteilungsstörungen anhand von Stickstoffauswaschkurven der Lunge und einem daraus abgeleiteten inspiratorischen Gasverteilungs-Index (IDI). Habil.-Schrift, Tübingen (1975).Google Scholar
  36. 36.
    Voigt, E., Braun, U., Schorer, R.: Closing volume and ventilatorische Verteilungsstörungen. Anaesthesist 25, 112 (1976).PubMedGoogle Scholar
  37. 37.
    Voigt, E., Weitzäcker, W.: Gasaustausch und Lungenmechanik unter Narkosebeatmung. Anaesthesist 24, 166 (1975).PubMedGoogle Scholar
  38. 38.
    WATSON, W. E.: Observations on physiological deadspace during intermittent positive pressure respiration. Brit. J. Anaesth. 34, 502 (1962).PubMedCrossRefGoogle Scholar
  39. 39.
    WEST, J. B.: Ventilation-perfusion inequality and overall gas exchange in Computer models of the lung. Resp. Physiol. 7, 88 (1969)CrossRefGoogle Scholar
  40. 40.
    WEST, J. B.: Ventilation/Blood-flow and Gas Exchange. Philadelphia F. A. Davies Co. 1970.Google Scholar
  41. 41.
    WOO, S. W., BERLIN, D., HEDLEY-WHITE, J.: Surfactant function and anaesthetic agents. J. appl. Physiol. 26, 571 (1969).PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1976

Authors and Affiliations

  • E. Voigt
  • R. Schorer

There are no affiliations available

Personalised recommendations