Validation of an original mathematical model of CO(2) elimination and dead space ventilation

Anesthesia and Analgesia
J G Hardman, A R Aitkenhead

Abstract

We present an original, mathematical model of ventilation and gas-exchange. Our aim was to validate it using data from previous clinical investigations, allowing our use of it in future investigations. The first previous investigation used a low-dead space, double-lumen, tracheal tube (DLT). We matched the model's PaCO(2) and airway pressures (P(AW)) to the patient mean during use of the DLT and a single-lumen tube (SLT). The model's resulting PaCO(2), PECO(2) and P(AW) were compared with the patients' as tidal volume (VT) changed with constant minute volume. The second investigation examined dead space during anesthesia. The model's VT, respiratory rate, CO(2) production, temperature, and alveolar and anatomical dead spaces were matched to each mechanically ventilated subject. Bias and precision in predictions of PaCO(2) and PECO(2) were calculated. The model's bias in prediction of dead space reduction by the DLT was 6.9%. Bias in prediction of P(AW) was 0.1% (peak) and -5.13% (mean), of PaCO(2) was 1.2% (DLT) and 1.5% (SLT) and of PECO(2) was 1.7% (DLT) and 1.3% (SLT). Prediction of PaCO(2) and PECO(2) in the second investigation (as 95% confidence interval of bias): PaCO(2) -2.6% to 0.8% and PECO(2) -4.9% to 1.2%. This vali...Continue Reading

References

Mar 1, 1979·Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology·J W Severinghaus
Jul 1, 1990·British Journal of Anaesthesia·J Milic-EmiliJ H Bates
Dec 1, 1989·Journal of Applied Physiology·E D'AngeloJ Milic-Emili
Nov 1, 1993·Anaesthesia·S N Costigan, S L Snowdon
Jun 12, 1999·British Journal of Anaesthesia·C S LiebenbergP E Cleaton-Jones
Mar 7, 2000·Anesthesia and Analgesia·J G HardmanA R Aitkenhead
Mar 11, 2000·Anaesthesia·N R Bennett, C Stack
Apr 26, 2002·The New England Journal of Medicine·Thomas J NucktonMichael A Matthay
Sep 1, 1948·The American Journal of Physiology·W S FOWLER

Citations

Jan 17, 2013·IEEE Transactions on Bio-medical Engineering·Anup DasDeclan G Bates
Nov 25, 2003·Anesthesia and Analgesia·J G Hardman, A R Aitkenhead
Oct 6, 2006·Current Opinion in Anaesthesiology·Guillermo GutierrezH David Reines
Feb 10, 2017·BMC Pulmonary Medicine·Anup DasDeclan G Bates

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