Newly Published
Review Article  |   April 2019
Respiratory Physiology for the Anesthesiologist
Author Notes
  • From the Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts (L.B.), and the Department of Emergency, Anesthesia and Critical Care, Foundation IRCCS Ospedale Maggiore Policlinico, and Department of Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy (A.P.).
  • Submitted for publication March 12, 2018. Accepted for publication January 16, 2019.
    Submitted for publication March 12, 2018. Accepted for publication January 16, 2019.×
  • Correspondence: Address correspondence to Dr. Bigatello: Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington Street, Boston, Massachusetts 02115. lbigatello@gmail.com. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Review Article / Respiratory System
Review Article   |   April 2019
Respiratory Physiology for the Anesthesiologist
Anesthesiology Newly Published on April 12, 2019. doi:10.1097/ALN.0000000000002666
Anesthesiology Newly Published on April 12, 2019. doi:10.1097/ALN.0000000000002666
Abstract

Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic support, and return to the preoperative state. The current work provides a review of classic physiology and emphasizes features important to the anesthesiologist. The material is divided in two main sections, gas exchange and respiratory mechanics; each section presents the physiology as the basis of abnormal states. We review the path of oxygen from air to the artery and of carbon dioxide the opposite way, and we have the causes of hypoxemia and of hypercarbia based on these very footpaths. We present the actions of pressure, flow, and volume as the normal determinants of ventilation, and we review the resulting abnormalities in terms of changes of resistance and compliance.