ADVERSE EFFECTS OF LOW CARBON DIOXIDE TENSIONS DURING MECHANICAL OVER-VENTILATION OF PATIENTS WITH COMBINED HEAD AND CHEST INJURIES

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Abstract
SUMMARYTwo patients are described who had suffered injuries both to the chest and the head. Both patients had evidence of impairment of ventilation-perfusion relationships, and were ventilated mechanically. The large minute volumes which were used to inflate the lungs and to restore normal arterial oxygen tensions severely reduced the arterial carbon dioxide tension, and produced an arterial alkalaemia. The insertion of a dead-space into the ventilation circuit increased the arterial carbon dioxide tension; the arterial oxygen tension was not further impaired, and the levels of consciousness of both patients improved. A suitable deadspace allows normal carbon dioxide tension to be maintained when increased ventilation volumes are required for adequate mechanical ventilation.

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