The key points you can't miss · Anesthesiology Advanced Course Anesthesia and Respiratory System (1)

Chapter 7 Anesthesia and Respiratory System (1)

by Chen Lingjun

1.

2.

Section 2, ventilation of the lungs

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2.

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3.

Section 3, Pulmonary Circulation Physiology

Section 4.

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2.

3.
The maximum spontaneous ventilation volume MVV: refers to the maximum gas volume that the human body can breathe in 1 minute
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Generally, MVV40L or MVV accounting for 50%-60% of the predicted value is used as the surgical safety index, and less than 50% is low lung function; less than 30%, surgery is contraindicated
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4.
Forced vital capacity (FVC), also known as time vital capacity, refers to the volume of air that can be inhaled as much as possible, exhaled as soon as possible, and exhaled as much as possible
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5.
Maximum mid-expiratory flow rate MMFR: The expiratory flow rate has nothing to do with the force, and reflects the elastic recoil force of the alveoli and airway resistance
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2.
Alveolar ventilation and dead space

1.
Physiological dead space = anatomical dead space + alveolar dead space

2.
The ratio of void volume/tidal volume (V _D / V _T ) in healthy adults is less than 0.
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3.
Breathe with a mask, etc.
The inner cavity of the mask belongs to the mechanical invalid space
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Section 5.
Gas Exchange

1.
Intrapulmonary gas distribution and closed volume

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Gas distribution in the alveoli: The lower lung has more ventilation distribution than the upper lung
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2.
Closing volume: refers to the volume of air exhaled after the small bronchi at the bottom of the lung begin to close
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Sensitive indicator for early detection of small airway obstruction lesions
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The closed volume plus the residual volume is called the closed volume
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2.
Pulmonary ventilation and the cause of hypoxemia

1.
V/Q ratio of ventilation and blood flow: in the upright position of normal people, the upper part of the lung has less ventilation and blood flow
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The total V/Q ratio of normal people is 0.
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2.
Intrapulmonary shunt: Intrapulmonary blood flow is directly mixed with oxygenated and arterialized blood without oxygenation, resulting in a decrease in blood oxygen
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Including airway obstruction, pneumonia, atelectasis, pulmonary edema,
etc.

3.
Intrapulmonary diffusion: The gas exchange between the alveoli and blood depends on the gas partial pressure difference, the pulmonary blood flow velocity, the thickness of the alveolar-pulmonary capillary wall, the total alveolar area and the gas diffusing capacity
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During anesthesia, carbon dioxide accumulation is more common than hypoxia
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4.
Causes of hypoxia and hypoxemia: V/Q ratio imbalance; increased right-to-left shunt in the lung; oxygen diffusion disorder; pulmonary hypoventilation
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