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Respiratory Physiology and Anesthesia



A significant part of modern anesthesiology practice is essentially the applied physiology of respiration. So, the action of the most common anesthetics - inhalation - depends on their absorption and elimination in the lungs. The main side effects of inhaled and non-inhaled anesthetics are associated with breathing. Muscle relaxation, the patient’s unusual position on the operating table and some special benefits (for example, one-lung ventilation and cardiopulmonary bypass) all have a profound effect on breathing.
This chapter discusses the basic principles of the physiology of respiration necessary for understanding and performing various anesthetic procedures; information on the effect of general anesthesia on respiration is also presented in a systematic way. The mechanism of action of individual anesthetics on respiration is discussed in other sections of the manual.
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Respiratory Physiology and Anesthesia

  1. PHYSIOLOGY OF RESPIRATION
    The vital activity of a living organism is associated with its absorption of O2 and the release of CO2. Therefore, the concept of “respiration” includes all processes associated with the delivery of O2 from the external environment into the cell and the release of CO2 from the cell into the environment. A person is distinguished by respiration: 1) internal (cellular, tissue); 2) the transport of gases by blood or other body fluids; 3) external (pulmonary). Actually howl
  2. CLINICAL PHYSIOLOGY AND PATHOPHYSIOLOGY OF RESPIRATORY BODIES
    The physiology and pathophysiology of the respiratory system can only be considered in the context of the life of the whole anatomical and physiological complex, which provides the process of external respiration, which includes extrapulmonary and pulmonary structures. Extrapulmonary structures include: 1. CNS regulatory structures (certain zones of the cerebral cortex, reticular formation, oblong
  3. PATHOLOGICAL PHYSIOLOGY OF EXTERNAL RESPIRATION
    The respiratory organs together with the circulatory apparatus provide the body with oxygen. Breathing in the broadest sense is a complex biological process, at the entrance of which the body consumes oxygen and releases carbon dioxide into the environment. In the process of biological oxidation, organophosphorus compounds rich in energy are formed, which are necessary for functioning and renewal.
  4. LIVER PHYSIOLOGY AND ANESTHESIA
    The liver is the largest organ of the body: its weight in an adult is 1500-1600 g. The liver performs many complex and interrelated functions. Due to the large functional reserve, clinically significant liver dysfunction rarely occurs after anesthesia and surgery - mainly with concomitant liver diseases, as well as with idiosyncrasy to halogen-containing inhalation
  5. The effect of anesthesia on breathing
    An increase in the work of breathing with general anesthesia is most often explained by a decrease in the extensibility of the lungs and chest and, more rarely, an increase in airway resistance. The problems associated with increasing the work of breathing are solved by
  6. Fundamentals of physiology and pathophysiology of the respiratory system
    Air containing oxygen fills the pulmonary alveoli, and through the alveolar-capillary membrane, oxygen enters the blood of the pulmonary capillaries. From the pulmonary capillaries, carbon dioxide enters the alveoli. With the help of lung ventilation, a constant exchange of ambient air with the alveoli is ensured. Ventilation, i.e., inhalation and exhalation, occurs due to contraction of the respiratory muscles,
  7. Brief information on the clinical physiology of the respiratory system.
    The main function of the respiratory system is the blood gas exchange: the supply of oxygen and the removal of carbon dioxide. The normal composition of arterial blood gases: PaO 2: 90 - 100 mm Hg PaCO 2: 35 - 40 mm Hg To ensure this function, the alveolar apparatus of the lungs, combined into acini (a group of alveolar sacs + terminal airway tube - bronchiole) is used. The acini are the bottom
  8. The effect of general anesthesia on breathing patterns
    The effect of anesthesia on breathing is complex and depends on both the change in body position and the type of anesthetic. When a patient takes a prone position from a standing or sitting position, the role of intercostal muscles in the act of breathing decreases and abdominal breathing begins to prevail. When moving from a vertical position to a horizontal, the diaphragm shifts 4 cm more cranially, which makes it
  9. 5. INFLUENCE OF ANESTHESIA ON THE RESPIRATORY MECHANIC
    The effect of anesthesia on pulmonary volumes and extensibility In addition to reducing FOB due to movement from vertical to horizontal, induction of anesthesia leads to an additional decrease in FOE of 15-20% (400ml on average). Due to the loss of muscle tone, the diaphragm at the end of exhalation is displaced by the abdominal cavity much more cranially than under normal conditions (Fig. 22-13). More
  10. 4. INFLUENCE OF ANESTHESIA ON RESPIRATION REGULATION
    Most general anesthetics potentiate hypoventilation. This effect of anesthetics has two components: central - inhibition of central chemoreceptors; PI peripheral - inhibition of the activity of external intercostal muscles. The severity of hypoventilation is usually proportional to the depth of anesthesia. With increasing depth of anesthesia, the curve of minute ventilation versus PaCO2 becomes more gentle,
  11. Anesthesia for concomitant respiratory diseases
    Even in people without diseases of the respiratory system, anesthesia has a number of negative effects: irritation of the mucous membrane with anesthetics, damage to the respiratory epithelium, respiratory depression by the drugs used, the possibility of provoking bronchospasm and infection by intubation or aspiration of the gastric contents. Functional residual capacity (FOE) is reduced, especially in
  12. Kidney physiology and anesthesia
    The kidneys regulate the volume and composition of body fluids, provide the removal of toxins. In addition, they produce renin and erythropoietin, and the inactive form of vitamin D turns into the active. Surgery and anesthesia can have a significant effect on renal function. Hyperhydration, hypovolemia, and postoperative renal failure are common
  13. Intravenous anesthesia with preserved spontaneous respiration
    (no more than 1 hour, patients I – II ASA) Diagnosis (diagnosis and monitoring) when establishing a diagnosis (before surgery) - mandatory: It is determined by the patient’s membership in group 1, 2 or 3, depending on the nature of the surgery and its duration - additional (by showing). It is determined by the patient's belonging to group 1, 2 or 3, depending on the nature
  14. Spontaneous inhalation anesthesia
    (no more than 1 hour, patients I-II ASA) Diagnosis (diagnosis and monitoring) when establishing a diagnosis (before surgery) - mandatory: It is determined by the patient's membership in group 1, 2 or 3, depending on the nature of the surgery and its duration - additional (by showing). It is determined by the patient's belonging to group 1, 2 or 3, depending on the nature
  15. Section IV Anesthesiology manual Physiology of blood circulation and anesthesia
    An anesthesiologist must have fundamental knowledge of the physiology of blood circulation, which is necessary both for understanding the scientific foundations of the specialty and for practical work. This chapter discusses the physiology of the heart and the pulmonary circulation, as well as the pathophysiology of heart failure. The pulmonary (pulmonary) circle of blood circulation is discussed in chapter 22, blood physiology and metabolism
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