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Anesth Analg 2008; 106:1491-1494
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e318168b4cd
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TECHNOLOGY, COMPUTING, AND SIMULATION

The Impact of Different Step Changes of Inspiratory Fraction of Oxygen on Functional Residual Capacity Measurements Using the Oxygen Washout Technique in Ventilated Patients

Hermann Heinze, MD, Beate Sedemund-Adib, MD, Matthias Heringlake, MD, Ulrich W. Gosch, MD, Hartmut Gehring, MD, and Wolfgang Eichler, MD

From the Department of Anaesthesiology, University of Luebeck, Luebeck, Germany.

Address correspondence and reprint requests to Dr. Hermann Heinze, Department of Anaesthesiology, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany. Address e-mail to Hermannheinze{at}ngi.de.

BACKGROUND: Functional residual capacity (FRC) measurements may help to guide respiratory therapy. Using the oxygen washout technique, FRC can be assessed at bedside during spontaneous breathing. High repeatability, crucial for monitoring, has not been shown in ventilated patients. A large step change of inspiratory fraction of oxygen (Fio2) ({Delta}Fio2) may impede the clinical use in patients ventilated with high Fio2. We investigated the repeatability of FRC measurements and the impact of different {Delta}Fio2 on this repeatability.

METHODS: The LUFU system (Draeger Medical, Luebeck, Germany) estimates FRC by oxygen washout, a variant of multiple-breath-nitrogen-washout during a fast {Delta}Fio2. In 20 postoperative cardiac surgery patients, FRC was measured in duplicate using {Delta}Fio2 of 0.1, 0.2, and 0.6.

RESULTS: There were no differences between repeated measurements of FRC, neither using a {Delta}Fio2 of 0.1, 0.2 nor 0.6({Delta}0.1: 2.62 L ± 0.58, 2.62 L ± 0.59, P = 0.995; {Delta}0.2: 2.70 L ± 0.59, 2.66 L ± 0.56, P = 0.258; {Delta}0.6: 2.61 L ± 0.58, 2.59 L ± 0.58, P = 0,639). Coefficients of variation were 6.6%, 5.6%, and 6.6%, respectively.

CONCLUSIONS: FRC can be measured in ventilated patients using the oxygen washout technique with a clinically acceptable repeatability. Repeatability is not significantly influenced whether using a {Delta}Fio2 of 0.1, 0.2, or 0.6.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.