{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T08:43:34Z","timestamp":1769157814358,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T00:00:00Z","timestamp":1450656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Isocapnic hyperventilation (<jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content>) has the potential to increase the elimination rate of anaesthetic gases and has been shown to shorten time to wake\u2010up and post\u2010operative recovery time after inhalation anaesthesia. In this bench test, we describe a technique to achieve isocapnia during hyperventilation (HV) by adding carbon dioxide (<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>) directly to the breathing circuit of a standard anaesthesia apparatus with standard monitoring equipment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Into a mechanical lung model, carbon dioxide was added to simulate a <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> production (<jats:sc><jats:italic>V<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub>) of 175, 200 and 225 ml\/min. Dead space (<jats:styled-content style=\"fixed-case\"><jats:italic>V<\/jats:italic><jats:sub>D<\/jats:sub><\/jats:styled-content>) volume could be set at 44, 92 and 134 ml. From baseline ventilation (<jats:styled-content style=\"fixed-case\">BLV<\/jats:styled-content>), HV was achieved by doubling the minute ventilation and fresh gas flow for each level of <jats:sc><jats:italic>V<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub>, and dead space. During HV, <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> was delivered (<jats:sc><jats:italic>D<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub>) by a precision flow meter via a mixing box to the inspiratory limb of the anaesthesia circuit to achieve isocapnia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During HV, the alveolar ventilation increased by 113 \u00b1 6%. Tidal volume increased by 20 \u00b1 0.1% during <jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content> irrespective of <jats:styled-content style=\"fixed-case\"><jats:italic>V<\/jats:italic><jats:sub>D<\/jats:sub><\/jats:styled-content> and <jats:sc><jats:italic>V<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub> level. <jats:sc><jats:italic>D<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub> varied between 147 \u00b1 8 and 325 \u00b1 13 ml\/min. Low <jats:sc><jats:italic>V<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub> and large <jats:styled-content style=\"fixed-case\"><jats:italic>V<\/jats:italic><jats:sub>D<\/jats:sub><\/jats:styled-content> demanded a greater <jats:sc><jats:italic>D<\/jats:italic>co<\/jats:sc><jats:sub>2<\/jats:sub> administration to achieve isocapnia. The <jats:styled-content style=\"fixed-case\">FICO<\/jats:styled-content><jats:sub>2<\/jats:sub> level during <jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content> varied between 2.3% and 3.3%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is possible to maintain isocapnia during HV by delivering carbon dioxide through a standard anaesthesia circuit equipped with modern monitoring capacities. From alveolar ventilation, <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> production and dead space, the amount of carbon dioxide that is needed to achieve IHV can be estimated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12674","type":"journal-article","created":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T09:44:37Z","timestamp":1450691077000},"page":"597-606","source":"Crossref","is-referenced-by-count":6,"title":["A simple method for isocapnic hyperventilation evaluated in a lung model"],"prefix":"10.1111","volume":"60","author":[{"given":"K.","family":"Hall\u00e9n","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care medicine Institution of Clinical Sciences The Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Stenqvist","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care medicine Institution of Clinical Sciences The Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.\u2010E.","family":"Ricksten","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care medicine Institution of Clinical Sciences The Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Lindgren","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care medicine Institution of Clinical Sciences The Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,12,21]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"20","article-title":"The stimulating effect of carbon dioxid inhalations in dementia praecox catatonia","volume":"31","author":"Leake CD","year":"1929","journal-title":"Cal West Med"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/38.7.500"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/45.2.159"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1989.tb11294.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200111000-00027"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg269"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000255199.43961.87"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000255074.96657.39"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000265849.33203.60"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181602dd4"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-009-9171-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02486.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181e2475c"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12093"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1982.tb01774.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes102"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051231"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1955.7.4.451"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1960.tb13317.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/36.1.5"},{"key":"e_1_2_6_22_1","first-page":"233","volume-title":"Carbon Dioxide. 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