• Br J Anaesth · Dec 1987

    Flow requirements and rebreathing during mechanically controlled ventilation in a T-piece (Mapleson E) system.

    • D J Hatch, A P Yates, and S G Lindahl.
    • Department of Anaesthesia, Hospital for Sick Children, London.
    • Br J Anaesth. 1987 Dec 1;59(12):1533-40.

    AbstractThe influence of fresh gas flow (FGF) setting on rebreathing was investigated in 15 infants and children (weight 3.5-21.8 kg) during balanced anaesthesia with mechanically controlled ventilation using a T-piece (Mapleson E) system and a Nuffield ventilator 200. Tidal volume (VT), minute volume (VE), maximal inspired (PICO2) and end-tidal (PE'CO2) carbon dioxide tensions and airway pressure were measured. VE, set to produce a PE'CO2 of about 4.5 kPa and measured at a high FGF (minimal rebreathing), was unchanged throughout the study and the regression equation for VE and weight was: VE (ml min-1) = 146 x kg + 482, r = 0.92. Measurements were then repeated at FGF:VE ratios reduced to 1.5 and 1.0. To achieve minimal rebreathing (PICO2 less than 0.5 kPa), FGF:VE ratios greater than 1.8 (range 1.8-4.9) had to be used. At FGF:VE ratios of 1.5, some alveolar rebreathing occurred, indicated by increased inspired (P less than 0.001) and end-tidal (P less than 0.001) carbon dioxide tensions. At FGF:VE ratios equal to 1.0, alveolar rebreathing was more pronounced and hypercapnoea occurred with a PE'CO2 (mean +/- 1 SD) of 5.89 +/- 0.53 kPa. At this FGF setting, change in I:E ratio from 1:2 to 1:1 did not influence the level of alveolar rebreathing. A minimal FGF (ml min-1) setting of 1.5 x VE (that is, 1.5 (146 x kg + 482), approximated to the expression (200 x kg + 1000) is recommended for controlled ventilation to avoid hypercapnoea when using the T-piece system in children weighing less than 20 kg.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…