Measurement of dead space in subjects under general anesthesia using standard anesthesia equipment

John J. Badal, Kyung J. Chen, Robert G Loeb

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: Pulmonary dead space is the volume of gas that is delivered to the lungs but does not participate in gas exchange. Knowing pulmonary dead space in patients under general anesthesia is clinically useful because it can aid in detecting disease processes such as pulmonary emboli or low cardiac output states. Dead space can be simply calculated by using the Bohr equation; however, it is difficult to measure mixed exhaled carbon dioxide (PECO2) with a standard anesthesia machine. Previously, a study at our institution demonstrated the carbon dioxide (CO2) concentration in the bellows of a standard anesthesia machine is an accurate approximation of PECO2. In this study, we used the bellows PECO2 measurement and arterial CO2 (PaCO2) to calculate pulmonary dead space. We verified the technique by adding known apparatus dead space volumes during anesthesia. METHODS: Subjects were under general endotracheal anesthesia. A sampling line was positioned inside the ventilator bellows and connected to a capnometer. Measurements of PECO2 and PaCO2 from an arterial catheter were taken at baseline and after adding 100 mL and 200 mL of dead space to the endotracheal tube. Dead space was calculated using the Bohr equation (alveolar dead space/tidal volume = [PaCO2 - PECO2]/PaCO 2) at baseline and after adding 100 mL and 200 mL of apparatus dead space. RESULTS: The dead space at baseline was 265 ± 47 mL (mean ± SD) in 10 study subjects. After adding 100 mL of dead space to the endotracheal tube, the measured dead space increased by 110 ± 46 mL. The measured dead space increased by 158 ± 39 mL after adding 200 mL. CONCLUSIONS: Our baseline dead space measurements were in the expected range under general anesthesia. When dead space was added, we were able to calculate that an increase in dead space occurred. Our calculation was more accurate after adding a 100-mL volume than after adding 200 mL. We present a simple way to detect trends in dead space in ventilated patients using a Narkomed GS anesthesia machine (Dräger Medical, Lübeck, Germany).

Original languageEnglish (US)
Pages (from-to)375-377
Number of pages3
JournalAnesthesia and Analgesia
Volume112
Issue number2
DOIs
StatePublished - Feb 2011

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General Anesthesia
Anesthesia
Equipment and Supplies
Lung
Carbon Dioxide
Endotracheal Anesthesia
Gases
Low Cardiac Output
Tidal Volume
Mechanical Ventilators
Embolism
Germany
Catheters

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Measurement of dead space in subjects under general anesthesia using standard anesthesia equipment. / Badal, John J.; Chen, Kyung J.; Loeb, Robert G.

In: Anesthesia and Analgesia, Vol. 112, No. 2, 02.2011, p. 375-377.

Research output: Contribution to journalArticle

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