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Title: Effects of N2 O elimination on the elimination of second gases in a two-step mathematical model of heterogeneous gas exchange.
Austin Authors: Korman, Ben;Dash, Ranjan K;Peyton, Philip J 
Affiliation: School of Medicine, University of Western Australia, Perth, Western Australia, Australia.;Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Western Australia, Australia.
Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.;Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Perioperative and Pain Medicine
Issue Date: Nov-2023
Publication information: Physiological Reports 2023-11; 11(21)
Abstract: We have investigated the elimination of inert gases in the lung during the elimination of nitrous oxide (N2 O) using a two-step mathematical model that allows the contribution from net gas volume expansion, which occurs in Step 2, to be separated from other factors. When a second inert gas is used in addition to N2 O, the effect on that gas appears as an extra volume of the gas eliminated in association with the dilution produced by N2 O washout in Step 2. We first considered the effect of elimination in a single gas-exchanging unit under steady-state conditions and then extended our analysis to a lung having a log-normal distribution of ventilation and perfusion. A further increase in inert gas elimination was demonstrated with gases of low solubility in the presence of the increased ventilation-perfusion mismatch that is known to occur during anesthesia. These effects are transient because N2 O elimination depletes the input of that gas from mixed venous blood to the lung, thereby rapidly reducing the magnitude of the diluting action.
DOI: 10.14814/phy2.15822
ORCID: 0000-0002-8946-528X
Journal: Physiological Reports
Start page: e15822
PubMed URL: 37923389
ISSN: 2051-817X
Type: Journal Article
Subjects: anesthetic uptake and elimination
mathematical modeling
second gas effect
ventilation-perfusion mismatch
volume contraction and expansion
Appears in Collections:Journal articles

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