首页   按字顺浏览 期刊浏览 卷期浏览 Human Chest Wall Function while Awake and during Halothane AnesthesiaI. Quiet Breathing
Human Chest Wall Function while Awake and during Halothane AnesthesiaI. Quiet Breathing

 

作者: David Warner,   Mark Warner,   Erik Ritman,  

 

期刊: Anesthesiology  (OVID Available online 1995)
卷期: Volume 82, issue 1  

页码: 6-19

 

ISSN:0003-3022

 

年代: 1995

 

出版商: OVID

 

数据来源: OVID

 

摘要:

BackgroundData concerning chest wall configuration and the activities of the major respiratory muscles that determine this configuration during anesthesia in humans are limited. The aim of this study was to determine the effects of halothane anesthesia on respiratory muscle activity and chest wall shape and motion during spontaneous breathing.MethodsSix human subjects were studied while awake and during 1 MAC halothane anesthesia. Respiratory muscle activity was measured using fine‐wire electromyography electrodes. Chest wall configuration was determined using images of the thorax obtained by three‐dimensional fast computed tomography. Tidal changes in gas volume were measured by integrating respiratory gas flow, and the functional residual capacity was measured by a nitrogen dilution technique.ResultsWhile awake, ribcage expansion was responsible for 25 plus/minus 4% (mean plus/minus SE) of the total change in thoracic volume (Delta Vth) during inspiration. Phasic inspiratory activity was regularly present in the diaphragm and parasternal intercostal muscles. Halothane anesthesia (1 MAC) abolished activity in the parasternal intercostal muscles and increased phasic expiratory activity in the abdominal muscles and lateral ribcage muscles. However, halothane did not significantly change the ribcage contribution to Delta Vth(18 plus/minus 4%). Intrathoracic blood volume, measured by comparing changes in total thoracic volume and gas volume, increased significantly during inspiration both while awake and while anesthetized (by approximately 20% of Delta Vth, P < 0.05). Halothane anesthesia significantly reduced the functional residual capacity (by 258 plus/minus 78 ml), primarily via an inward motion of the end‐expiratory position of the ribcage. Although the diaphragm consistently changed shape, with a cephalad displacement of posterior regions and a caudad displacement of anterior regions, the diaphragm did not consistently contribute to the reduction in the functional residual capacity. Halothane anesthesia consistently increased the curvature of the thoracic spine measured in the sagittal plane.ConclusionsThe authors conclude that (1) ribcage expansion is relatively well preserved during halothane anesthesia despite the loss of parasternal intercostal muscle activity; (2) an inward displacement of the ribcage accounts for most of the decrease in functional residual capacity caused by halothane anesthesia, accompanied by changes in diaphragm shape that may be related to motion of its insertions on the thoracoabdominal wall; and (3) changes in intrathoracic blood volume constitute a significant fraction of Delta Vthduring tidal breathing.

 

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