The venous admixture was measured before, during, and after deflation of one lung during anaesthesia for thoracotomy in 10 subjects ventilated with 50% oxygen. The mean oxygen saturation fell from 99% before deflation of the lung to 89% after 30 minutes’ atelectasis. The pH and carbon dioxide tension did not change significantly. The shunt was 38% of cardiac output five minutes after and 41% 30 minutes after deflation. The reciprocal of the arterial venous oxygen content difference correlated positively with the shunt, suggesting that increased venous admixture is accompanied by increased cardiac output.
This paper reviews the clinical situation in anaesthesia before the introduction of halothane into clinical practice in 1956, emphasising the limitations of agents available at the time. The background to the development of halogenated hydrocarbon compounds as anaesthesia agents is presented, including the involvement of Imperial Chemical Industries in England. The Nuffield Department of Anaesthetics was involved in the clinical trials and the designing and execution of these. The results of their work and the problems encountered are presented.
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