• E Samain, E Farah, D Delefosse, and J Marty.
• Service d'Anesthésie-Réanimation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, UFR Xavier Bichat, Université Paris VII, 100 Bvd Général Leclerc, 92118 Clichy Cedex, France.
• Anaesthesia. 2000 Sep 1; 55 (9): 841-6.

AbstractWe hypothetised that the rate of pre-oxygenation could be altered by the increase in lung volume and airflow obstruction observed in emphysema. End-tidal oxygen concentration was monitored, using a paramagnetic oxygen analyser, during 10-min pre-oxygenation (tidal breathing of 100% oxygen) in 10 normal patients and in 10 patients with severe diffuse emphysema documented by computerised tomography. Emphysema was characterised by an important increase in functional residual capacity of the lungs [190 (23)% of predicted values] and a decrease in expiratory flow. The increase in end-tidal oxygen concentration was slower in the emphysema group than in the control group (p = 0.0024). After 3 and 5 min of pre-oxygenation, the end-tidal fractional oxygen concentration was significantly lower in the emphysema group than the control group [mean (SD); value at 3 min: emphysema: 0.83 (0.06) vs. control: 0.91 (0.02), p = 0.0005]. Individual values of end-tidal oxygen concentration measured after 3, 5 and 10 min of pre-oxygenation were negatively correlated with functional residual capacity in the emphysema group, whereas no such correlation was found in the control group. These results suggest that pre-oxygenation should be monitored in patients with diffuse emphysema to ensure that adequate pre-oxygenation is achieved.

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