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CRITICAL CARE AND TRAUMA

Investigating Hypoxemia during Apnea: Validation of a Set of Physiological Models

University Department of Anesthesia, University Hospital, Queen’s Medical Centre, Nottingham, United Kingdom

Address correspondence and reprint requests to Dr. J. G. Hardman, Department of Anaesthesiology, Royal Brisbane Hospital, Herston, Brisbane, QLD 4029, Australia.

The aim of our study was to validate the Nottingham Physiology Simulator (NPS) for examining pulmonary denitrogenation and apnea by reproducing the methodology and results of previous clinical studies. Only four studies provided sufficient detail in their description of their methodology to allow accurate reproduction by using the NPS or provided a sufficiently detailed description of their subjects to allow accurate modelling. The results of the NPS recreation of the studies were within 13% of the values found clinically in all cases and were within 2% in the majority of cases. The four studies included healthy and morbidly obese patients, conscious and anesthetized patients, and included examination of the effect of denitrogenation and apnea on plasma pH and on lung and arterial oxygen and carbon dioxide tensions at various lung volumes.

Implications: We used mathematical, physiological models to recreate the methods and subjects of four clinical studies investigating oxygenation and low oxygen levels during cessation of breathing. Our aim was to validate the models, allowing theoretical investigations into this area. The blindly recreated results closely matched the clinical studies, validating the models.

This article has been cited by other articles:

				R. A. McCahon, M. O. Columb, R. P. Mahajan, and J. G. Hardman Validation and application of a high-fidelity, computational model of acute respiratory distress syndrome to the examination of the indices of oxygenation at constant lung-state Br. J. Anaesth., September 1, 2008; 101(3): 358 - 365. [Abstract] [Full Text] [PDF]

				J. G. Hardman and J. S. Wills The development of hypoxaemia during apnoea in children: a computational modelling investigation Br. J. Anaesth., October 1, 2006; 97(4): 564 - 570. [Abstract] [Full Text] [PDF]

				I. K. Moppett, C. B. Gornall, and J. G. Hardman The dependence of measured alveolar deadspace on anatomical deadspace volume Br. J. Anaesth., September 1, 2005; 95(3): 400 - 405. [Abstract] [Full Text] [PDF]

				J. G. Hardman and A. R. Aitkenhead Validation of an Original Mathematical Model of CO2 Elimination and Dead Space Ventilation Anesth. Analg., December 1, 2003; 97(6): 1840 - 1845. [Abstract] [Full Text] [PDF]

				J. G. Hardman and A. R. Aitkenhead Estimating Alveolar Dead Space from the Arterial to End-Tidal CO2 Gradient: A Modeling Analysis Anesth. Analg., December 1, 2003; 97(6): 1846 - 1851. [Abstract] [Full Text] [PDF]

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