Deadspace during anaesthesia

Abstract

Deadspace is defined in terms of the efficiency of the lung in eliminating carbon dioxide. The airway deadspace is the volume of the airway in which gas moves chiefly by convection. The alveolar deadspace is caused by ventilation/perfusion inequalities at the alveolar level. The commonest causes of increased alveolar deadspace are airways disease--smoking, bronchitis, emphysema, and asthma. Other causes include pulmonary embolism, pulmonary hypotension, and ARDS. In addition, right-to-left shunting (cyanotic heart disease, atelectasis) causes an apparent or virtual deadspace, which, although not representing non-perfusion of any compartment, nevertheless reduces the efficiency of ventilation.