![]() Īnother important part of lung physiology is compliance which simply means the opposite of stiffness. CO 2 diffuses more readily than O 2 because of its high plasma solubility. The barrier to this process includes a cytoplasmic extension of type 1 cells, the basement membrane, and the capillary endothelial layer. This difference results in the diffusion of O 2 from the alveolus to the capillaries. Monitoring dead space helps anesthesiologists monitor the status of the lung and find appropriate ventilatory settings during thoracic surgeries.Gas exchange between the alveolus and the blood capillary depends on the passive diffusion of PO 2 in the alveolus (around 100 mmHg), and the blood entering the capillary (around 40 mm). Therefore, continuous assessment of dead space is helpful in guiding ventilation and avoiding overdistension while maintaining the elimination of CO(2) during thoracic surgery sufficiently high. ![]() However, such a ventilatory strategy impairs ventilation and induces hypercapnia due to increases in dead space. It has been shown to reduce the incidence of postoperative pulmonary complications after thoracic surgeries. To date, lung protective ventilation is based on the use of low tidal volumes and airway pressures to decrease overdistension. This type of injury threatens the fragile lungs especially during one-lung ventilation and can clinically be recognized as an increase in airway and alveolar dead space above normal values. Another interesting use of such monitoring is to detect ventilator-induced lung injury due to tidal overdistension. ![]() Monitoring dead space during thoracic surgery assesses the ventilatory deficiencies related to increases in instrumental, airway and/or alveolar dead space, when ventilating patients with positive pressure and double-lumen tubes. ![]() The concept of dead space has gained renewed interest among anesthesiologists ever since breath-by-breath measurement by volumetric capnography became available. Describe the importance of monitoring dead space during thoracic surgery, specifically during one-lung ventilation. ![]()
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