Artificial hyperventilation during 21 years in three cases of complete respiratory paralysis
| Autor: | E. Lyders Hansen, H. Sund Kristensen, M. Stig Christensen |
|---|---|
| Rok vydání: | 1975 |
| Předmět: |
Adult
Male Pulmonary Circulation Partial Pressure Respiratory paralysis Hypocapnia Hyperventilation Internal Medicine medicine Tidal Volume Humans Expiration Tidal volume business.industry Carbon Dioxide Middle Aged medicine.disease Cannula Long-Term Care Respiration Artificial Respiratory Paralysis Respiratory alkalosis Anesthesia Child Preschool Arterial blood medicine.symptom business Poliomyelitis |
| Zdroj: | Acta medica Scandinavica. 198(5) |
| ISSN: | 0001-6101 |
| Popis: | Three patients with paralytic poliomyelitis have been ventilated via tracheostomy with uncuffed silver cannula for 21 years, with high tidal volumes of atmospheric air (8.3, 7.2, and 5.4 ml/kg b.wt.), at a frequency of 20, passive expiration, and without periodic hyperinflation. No pulmonary complications were seen during the whole of this period. The total compliance was significantly decreased. The pulmonary physiological shunt relative to the total pulmonary blood flow (Qs/Qt) was slightly increased. PaO2 was nevertheless normal, probably due to a high alveolar PO2 caused by the hyperventilation. The physiological dead space relative to the tidal volume (VD/VT) was within the normal range, but VD was high in one case. Two of the patients disclosed an extremely low CO2 production and a PaCO2 averaging 12 mmHg, with small fluctuations during a 24-hour study. This profound respiratory alkalosis was only partly compensated in the arterial blood (pH: 7.54 and 7.50), suggesting a new state of acid-base equilibrium. The cerebrospinal fluid lactate was significantly increased to about 4 mmol/l, but the patients revealed no signs of impaired cerebral function. A reduction of the degree of hypocapnia by the use of a mechanical dead space is recommended. |
| Databáze: | OpenAIRE |
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