Abstract
Timing and drive components of respiration were studied in 18 young children following induction of anaesthesia with ketamine and were compared with results from ten children following induction of anaesthesia with halothane. During one minute of quiet breathing, signals from a pneumotachograph attached to the anaesthetic mask were analysed for tidal volume (Vt), respiratory frequency (f), minute volume (Ve), inspiratory and expiratory times (Ti, Te) and flow patterns. Following induction of anaesthesia with ketamine, children breathed more slowly and deeply than children receiving halothane, but there was no significant difference in Ve or in Vt/Ti, suggesting that respiratory drive was similar in the two groups of children. In the children receiving ketamine, Ti was more than twice as long, and thus the ratio Ti/Te was significantly increased, in comparison with the group receiving halothane. In addition to the prolonged Ti in the children induced with ketamine. there was a more rapid increase in volume in early inspiration than in late inspiration, which is an apneustic breathing pattern. There was a slower decrease in volume in early expiration, with occasional early expiratory breath holding lasting up to three seconds, in the ketamine-induced children. The unique breathing pattern demonstrated with ketamine, consisting of large Vt, increased Ti/Te ratio, apneustic inspiratory pattern, and expiratory braking, contributed to an increased mean lung volume above functional residual capacity, of 2.40 ml · kg1 body weight, in comparison to 1.27 ml · kg1 in the children receiving halothane.
Résumé
Les facteurs temps et force motrice de la respiration ont été étudiés chez 18 jeunes enfants après ľinduction de ľanesthésie avec la kétamine et furent comparés avec les résultats obtenus chez 10 enfants après induction de ľanesthésie avel ľhalothane. Après une minute de respiration calme, les signaux obtenus dans un pneumotachographe attaché au masque anesthésique furent analysés pour le volume courant (Vt), fréquence respiratoire (f), volume minute (Ve), les temps inspiratoire et expiratoire (Ti, Te) et les tendances des flots. Après ľinduction de ľanesthésie avec la kétamine les enfants ont respiré plus lentement et plus profondément que les enfants ayant reçu ľhalothane mais il n’y avait pas de différence significative dans le Ve ou le Vt/Ti suggérant que la force motrice respiratoire était similaire dans les deux groupes ďenfants. Chez les enfants ayant reçu la kétamine la Ti était deux fois plus longue et ainsi le rapport Ti/Te était signifîcativement augmenté en comparaison avec le groupe de patient ayant reçu ľhalothane. En plus de la prolongation du Ti chez les enfants induits à la kétamine, on nota une plus grande augmentation du volume au début de ľinspiration qu’à la fin de ľinspiration ce qui dénote une respiration apneustique. On nota une plus lente diminution du volume au début de ľexpiration avec occasionnellement tôt dans ľexpiration un arrêt respiratoire pouvant durer trois secondes chez les patients induits à la kétamine. Ce schéma unique de ľinspiration après kétamine consistait en une Vt large, une augmentation de Ti/Te, une inspiration apneustique et un frein expiratoire contribué en une augmentation du volume pulmonaire moyen supérieur à la capacité résiduelle fonctionnelle 2.40 ml · kg-1 du poids corporel en comparaison à 1 .27 ml · kg-1 chez les enfants ayant reçu de ľhalothane.
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Shulman, D., Bar-Yishay, E. & Godfrey, S. Drive and timing components of respiration in young children following induction of anaesthesia with halo-thane or ketamine. Can J Anaesth 35, 368–374 (1988). https://doi.org/10.1007/BF03010858
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DOI: https://doi.org/10.1007/BF03010858