Targeted Versus Continuous Delivery of Volatile Anesthetics During Cholinergic Bronchoconstriction

Jarred R Mondoñedo; John S McNeil; Jacob Herrmann; Brett A Simon; David W Kaczka

doi:10.1115/1.4040001

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Targeted Versus Continuous Delivery of Volatile Anesthetics During Cholinergic Bronchoconstriction

Journal article

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Targeted Versus Continuous Delivery of Volatile Anesthetics During Cholinergic Bronchoconstriction

Jarred R Mondoñedo, John S McNeil, Jacob Herrmann, Brett A Simon and David W Kaczka

Journal of Engineering and Science in Medical Diagnostics and Therapy, Vol.1(3), 031003

08/01/2018

DOI: 10.1115/1.4040001

PMCID: PMC6516463

PMID: 31106293

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Abstract

Volatile anesthetics have been shown to reduce lung resistance through dilation of constricted airways. In this study, we hypothesized that diffusion of inhaled anesthetics from airway lumen to smooth muscle would yield significant bronchodilation in vivo, and systemic recirculation would not be necessary to reduce lung resistance (RL) and elastance (EL) during sustained bronchoconstriction. To test this hypothesis, we designed a delivery system for precise timing of inhaled volatile anesthetics during the course of a positive pressure breath. We compared changes in RL, EL, and anatomic dead space (VD) in canines (N = 5) during pharmacologically induced bronchoconstriction with intravenous methacholine, and following treatments with: (1) targeted anesthetic delivery to VD and (2) continuous anesthetic delivery throughout inspiration. Both sevoflurane and isoflurane were used during each delivery regimen. Compared to continuous delivery, targeted delivery resulted in significantly lower doses of delivered anesthetic and decreased end-expiratory concentrations. However, we did not detect significant reductions in RL or EL for either anesthetic delivery regimen. This lack of response may have resulted from an insufficient dose of the anesthetic to cause bronchodilation, or from the preferential distribution of air flow with inhaled anesthetic delivery to less constricted, unobstructed regions of the lung, thereby enhancing airway heterogeneity and increasing apparent RL and EL.

Details

Title: Subtitle: Targeted Versus Continuous Delivery of Volatile Anesthetics During Cholinergic Bronchoconstriction
Creators: Jarred R Mondoñedo - Department of Biomedical Engineering, School of Medicine, Boston University, Boston, MA 02215
John S McNeil - Department of Anesthesiology, University of Virginia, Charlottesville, VA 22903
Jacob Herrmann - Department of Anesthesiology; Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242
Brett A Simon - Department of Anesthesiology and Critical Care Medicine; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065
David W Kaczka - Department of Anesthesiology, Biomedical Engineering, and Radiology; Department of Biomedical Engineering; Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 e-mail
Resource Type: Journal article
Publication Details: Journal of Engineering and Science in Medical Diagnostics and Therapy, Vol.1(3), 031003
DOI: 10.1115/1.4040001
PMID: 31106293
PMCID: PMC6516463
NLM abbreviation: J Eng Sci Med Diagn Ther
ISSN: 2572-7958
eISSN: 2572-7966
Grant note: DOI: 10.13039/100000050, name: \National Heart, Lung, and Blood Institute\, award: 89227; DOI: 10.13039/100000050, name: \National Heart, Lung, and Blood Institute\, award: 108724; DOI: 10.13039/100000070, name: National Institute of Biomedical Imaging and Bioengineering, award: 6359
Language: English
Date published: 08/01/2018
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Anesthesia
Record Identifier: 9984007165002771

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