Pulmonary tissue volume measured by acetylene rebreathing under artificial ventilation.

Abstract

In order to evaluate the pulmonary congestive state of patients being mechanically ventilated, an acetylene rebreathing method was employed. Measurement of pulmonary tissue volume by the acetylene (C2H2) rebreathing method was performed in 15 patients under artificial ventilation including four congestive heart failure cases, one renal failure case, and 12 healthy controls. The subjects rebreathed mixed gas containing 0.65% C2H2, 10% argon (Ar), and 60% oxygen (O2) from end-tidal level, and inspiratory and expiratory gas concentrations were measured by a mass spectrometer. Correction for system volume reduction during rebreathing due to gas exchange and C2H2 concentration fluctuation was performed, pulmonary tissue volume was calculated from the C2H2 and Ar concentration difference at the time zero intercept. Time zero was assumed to be the time at which C2H2 and Ar concentration started to differ. Pulmonary tissue volume per functional residual capacity and pulmonary tissue volume per pulmonary capillary blood flow for cases with congestive heart failure and renal failure cases were significantly higher than those for non-pulmonary congestion cases and normal controls. The measurement of pulmonary tissue volume by C2H2 rebreathing can be applied to the patients under artificial ventilation in order to quantitatively evaluate pulmonary congestion or edema.