Scientific Foundations of

Anesthesia Practice II

Presented By
Dr. Sey-Sawo
08th February, 2024
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 Dalton’s Law of Partial Pressure
• The total pressure in a
mixture of gases is equal
to the sum of the
pressures of the individual
gases.
• Each gas exerts a partial
pressure.

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 Dalton’s Law
• 100 kPa = 760 mm Hg = 1 atmosphere
• Partial pressure of O2 in mm Hg = 0.21 x 760
mm Hg = 160 mm Hg.
• Partial pressure of N2 in mm Hg = 0.79 x 760
mm Hg = 600 mm Hg.
• Room air at sea level = 160 mm Hg (O2) + 600
mm Hg (N2) = 760 mm Hg

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 Dalton’s Law Problem
• What is the partial pressure of O2 in the
mountains where the atmospheric pressure
is 550 mm Hg?

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 Dalton’s Law Problem
• 0.21 x 550 mm Hg = 115.5 mm Hg
• What is the partial pressure of carbon dioxide
if the end-tidal concentration is 5% at
standard temperature and pressure?

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 Dalton’s Law Problem
• 0.05 x 760 mm Hg = 38 mm Hg
• What is the partial pressure of sevoflurane if
the end tidal concentration is 2% at standard
temperature and pressure?

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 Dalton’s Law Problem
• 0.02 x 760 mm Hg = 15.2 mm Hg

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 Dalton’s Law
• If we put isoflurane into a beaker filled with
100% oxygen, what is the percent of O2 and
percent of the anesthetic agent in the beaker
above the liquid once equilibrium is achieved?
• Vapor pressure of isoflurane = 239 mm Hg
• Partial pressure of O2 = 760 – 239 = 521 mm Hg
• % O2 = 521/760 = 68.6%

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 • % Isoflurane = 239/760 =31.4%
Dalton’s Law Problem
• If a patient is administered 40% oxygen, what
would the partial pressure of oxygen (PaO2) in
the blood be at sea level?
• 0.40 x 760 mm Hg = 304 mm Hg
• Actual PaO2 ≠ 304 mm Hg

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• Actual PaO2 = 200 mm Hg
Dalton’s Law
• Other factors that exert partial pressure in
inspired air prevent this direct relationship
between inspired gas and arterial gas implied
in Dalton’s law.

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• The inspired gases (like oxygen) are diluted by
water vapor, carbon dioxide, as well as by
expired gases in the respiratory tree.
Estimation of PaO2:
Arterial
• A simple method for estimating the partial
pressure of arterial oxygen (PaO2) in a healthy
individual based on the fraction of inspired

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 oxygen (FiO2) is to multiply the FiO2 as a
percent by 5:
40 % x 5 = 200 mm Hg PaO2
Estimation of PAO2:
Alveolar
• To estimate the partial pressure of oxygen
(PAO2) in the alveoli of a healthy individual
based on the inspired concentration of

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 oxygen (FiO2), multiply the FiO2 as a
percentage by 6:
40% x 6 = 240 mm Hg PAO2
PAO2-PaO2 Gradient
• The difference between the
partial pressure of alveolar
oxygen (PAO2) and arterial
oxygen (PaO2) is the
PAO2PaO2 gradient.

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• The gradient for 40% oxygen as calculated is 40 mm Hg.
Estimated gradient = FiO2.

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 V/Q (Ventilation/Perfusion) Mismatch

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• If the measured PAO2PaO2
gradient is substantially
greater than predicted, there is
a ventilation/perfusion (V/Q)
mismatch.

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 Henry’s Law
• Permits calculation of dissolved
O2 and CO2 in the blood.
• States that the amount of a gas
that dissolves in a liquid is
proportional to the partial
pressure of the gas in the
gaseous phase.

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 Henry’s Law
• Oxygen, which has a partial
pressure of 100 mm Hg in the
alveoli of room air (0.21 x 6 =
120), diffuses from the alveoli
to the pulmonary capillary, in
which the partial pressure of
oxygen is 40 mm Hg.
• Carbon dioxide (CO2), which
has a partial pressure of 45

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 Henry’s Law
mm Hg in the pulmonary capillary, diffuses from the
capillary to the alveoli, in which the partial pressure of CO2
is nearly zero.
• The amount of O2 that dissolves in blood is
0.003 mL/100mL blood/mm Hg partial
pressure.

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 Henry’s Law
• To calculate the amount of oxygen
dissolved in blood, multiply the partial
pressure of O2 by 0.003.

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 Henry’s Law Problem
• How much O2 is dissolved in arterial blood
when the PaO2 is 300 mm Hg?
• 300 mm Hg x 0.003 = 0.9 mL O2/100 mL blood
dissolved.

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 Henry’s Law Problem
• How much does dissolved O2 increase in the
blood when the PaO2 increases from 100
mmHg to 500 mmHg?
• PaO2 100 mm Hg = 100 x 0.003 = 0.3 mL
O2/100 mL blood
• PaO2 500 mm Hg = 500 x 0.003 = 1.5 mL
O2/100 mL blood

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• ↑ O2 = 1.2 mL O2/ 100 mL (1.5 – 0.3)
Henry’s Law
• The amount of CO2 that dissolves in blood is
0.067 mL/100mL blood/mm Hg partial
pressure.
• To calculate the amount of carbon dioxide
that is dissolved in blood, multiply the partial
pressure of CO2 by 0.067.

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 Henry’s Law Problem
• How much CO2 is dissolved in arterial blood
when the PaCO2 is 50 mm Hg?
• 50 mm Hg x 0.067 = 3.35 mL CO2/100 mL
blood

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 Transport Processes for Gases
• Diffusion: the process by
which gases move from
an area of high
concentration to an area
of low concentration.

Diffusion

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 Fick’s Law of Diffusion
• Fick’s law of diffusion applies to
gases:

Diffusion rate =

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 Fick’s Law of Diffusion

• Diffusion rate of a gas is

directly proportional to:
• partial pressure gradient
(P1-P2)

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 Fick’s Law of Diffusion
• membrane area
• solubility coefficient of gas in membrane
• Diffusion rate of a gas is
inversely proportional
to:
• membrane thickness

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 Fick’s Law of Diffusion
• square root of the molecular weight of gas

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 Diffusion Properties of Gases
• Gases diffuse from area of high pressure to low
pressure.
• Lighter gases diffuse more rapidly than heavy ones.
• Heat increases molecular movement of gases and
thus diffusion.
• Main determinants of diffusion of any gas with all
other factors equal, is the concentration gradient.

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 Diffusion Properties of Gases
• Nitrous oxide (N2O) diffuses 36 times more
readily than nitrogen (N2) and should be
avoided when there are air-containing
cavities in the body:
• Air embolism
• Pneumothorax

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 Diffusion Properties of Gases
• Pneumocephalus
• Carbon dioxide (CO2) and nitrous oxide (N2O)
both diffuse ~ 20 times more readily than
oxygen (O2).

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 Ficks’s Law of Diffusion
• Explains:
• The concentration effect
• The second gas effect
• Diffusion hypoxia
• Why nitrous oxide leads to increases in volume
(or pressure) in gas spaces.

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 Graham’s Law
• The rate of effusion
(diffusion through a pore)
for a gas is inversely
proportional to the
square root of the
molecular weight.
• The heavier the molecule,
the slower the diffusion.

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 Humidification
• Absolute humidity is the mass of water vapor
in a given volume of air.
• Relative humidity (%) is the ratio of the
absolute humidity to the saturated vapor
pressure expressed as percent.
• Relative humidity increases as temperature
falls because saturated vapor pressure falls.

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 Humidification
• Inspired gas is quickly humidified to 100%
when breathing through the nose.
• Air is saturated 100% by the time it reaches
the trachea.
• The partial pressure of saturated water vapor
at 37oC is 47 mm Hg.

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 Law of Laplace
• The tangential tension on the wall of a hollow
structure is proportional to the internal
pressure and to the radius.
• Tension may be defined as the internal force
generated by a structure.

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• The greater the radius in a chamber or a
vessel, the greater the tension in the walls of
the chamber or vessel.

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 Law of
Laplace:
Cylinders
• For tissues that are
cylindrically shaped, T = Pr
• T = wall tension
• P = pressure of liquid
within cylinder

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 Law of
Laplace:
• r = radius
Cylinders
• As a structure expands
(i.e. increases its radius),
the tension of the wall of
the structure increases.

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 Law of
Laplace:
Cylinders
• Examples of cylindrical
structures in the body
are blood vessels, bowel,
aneurysms and the left
ventricle.

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 Law of
Laplace:
Cylinders
• For blood vessels, the
tension in the wall is
proportional to the
radius. The larger the
radius, the higher the

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 Law of
Laplace:
tension and the more likely the
vessel will rupture.
Cylinders
• An aortic aneurysm is
much more likely to
rupture than a normal

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 Law of
Laplace:
segment of aorta because the
radius is larger.
Cylinders
• A capillary will withstand
a pressure of 100 mm
Hg far better than a
vein because of its tiny

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 Law of
Laplace:
radius, so the tension on the
wall is extraordinarily smaller.
Cylinders
• The greater the filling of the
left ventricle, the greater the
tension in the ventricular
wall.

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 Law of
Laplace:
Spheres
• Alveoli of the lungs are
spherically shaped.
• The law of Laplace has two
applications to alveoli:
• normal alveoli;

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 Law of
Laplace:
• alveoli deficient in surfactant.

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 Physics of Soap Bubbles
• Tension is independent
of radius for all spheres
where there are two
liquid-air interfaces
(soap bubbles).

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 Physics of Soap Bubbles
• Because tension in the wall is independent of size
(radius), the pressure inside the bubble will change
with size.
• The smaller the radius of the bubble, the greater
the pressure inside the bubble.

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 Physics of Soap Bubbles
• Explains why small soap bubbles have greater
pressure than large
ones.
• If two soap bubbles are
connected by an open

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 Physics of Soap Bubbles
straw, the smaller bubble will collapse and empty into the
larger one.
↑ P1 = 2T1 /↓r1
↓ P2 = 2T2 /↑r2
P1 >P2 because T1 = T2

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 Physics of Surfactant-Deficient Alveoli
• For alveoli devoid of normal
surfactant, wall tension is
constant and independent of
radius (like a soap bubble):
↑ P1 = 2T1/↓r1
↓ P2 = 2T2/↑r2
P1 > P2 because T1=T2

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 Physics of Surfactant-Deficient Alveoli
• As a consequence, alveoli
with smaller radii have a
higher pressure and will
empty into alveoli with lower
pressure.
• Explains alveolar collapse
(atelectasis) seen in ARDS and
prematurity.

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 Normal Alveoli
• For alveoli with surfactant, tension increases
with an increase in radius.
• Because alveolar wall tension increases in
proportion to increases in radius, the
pressure with the alveolus does not change.

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 Normal Alveoli
• Explains why small alveoli
do not empty into large
alveoli in the normal
lung:
P1 = 2T1 ↓/↓r1
P2 = 2T2 ↑ /↑r2

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P1 = P2 because tension changes

Poiseueille’s Law
• Flow = V = πr4∆P
t 8ηL π = 3.14
R = radius ∆P = P1 –
P2 η = viscosity
L= length of
tube

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 Poiseueille’s Law:
Radius
• Flow is directly proportional to the 4th
power of the radius (r):
• Doubling the radius increases flow 16 times
• (2r)4 = 2 ∙ 2 ∙ 2 ∙ 2 r4 = 16r4
• Tripling the radius increases flow 81 times
• (3r)4 = 3 ∙ 3 ∙ 3 ∙ 3 r4 = 81r4

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 Poiseueille’s Law
• Describes streamline
(laminar) flow.
• Flow is defined as the
quantity of a fluid (gas or
liquid) passing a point in
unit time.

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 Poiseueille’s Law:
Radius
• Halving the radius
decreases flow to 1/16th
the original value.
• Changing the radius has
the most dramatic
effect on flow.
Poiseueille’s Law:

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 Pressure
• Flow is directly proportional
to hydrostatic pressure
(change in pressure):

INFLOW P - OUTFLOW P

Viscosity

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 Poiseueille’s Law:
• Flow is inversely proportional to fluid
viscosity (η). Viscosity describes a fluid’s
internal resistance to flow:
• If viscosity increases, flow decreases. • If viscosity
decreases, flow increases.
• Viscosity is the property of a fluid that
determines flow for LAMINAR flow.

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 Poiseuille’s Law:
Length
• Flow is indirectly
proportional to the
length of the tube (L).

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 Poiseueille’s Law:
Clinical Application
• RADIUS: Flow through a
large bore needle is
faster than a small one.
• Remember lower the
needle gauge the larger
the radius: 14G versus
20 G.

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 Poiseueille’s Law:
Clinical Application
• PRESSURE: Raising the IV
pole increases the
hydrostatic pressure in the
fluid delivered to the
patient due to gravity and
increases flow.

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 Poiseueille’s Law:
Clinical Application
• VISCOSITY: Polycythemic
patients have higher blood
viscosity, so flow through
blood vessels is reduced.
• Anemic patients have
decreased blood viscosity so
greater flows to tissues will
result.

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 Poiseueille’s Law:
Clinical Application
• Selecting a needle with a
shorter length can increase
flow through an IV line.

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 Poiseueille’s Law:
Clinical Application
• What can be done to
administer packed red
blood cells (PRBCs)
rapidly?

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 Poiseueille’s Law:
Clinical Application
• Radius: Administer the PRBCs through a
large bore IV catheter.
• Pressure: Increase height of IV pole; use a
pressure bag; administer with infusion
pump.

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 Poiseueille’s Law:
• Viscosity: Dilute the PRBCs (Hct = 70-80%)
with saline.
• Length: Use shorter IV catheters.

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 Bernouilli’s Principle
• If the pressure of a tube is
measured, it is found that
the pressure at the
narrowest point is lower
than elsewhere.

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 Bernouilli’s Principle
• The fall of pressure at the constriction of a tube is the basis
for the Bernoulli’s principle.
• When fluid flows
through a constricted
region of a tube, the
velocity of flow
increases, and the lateral

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 Bernouilli’s Principle
pressure exerted by the fluid on the walls of the
tube decreases.
• Fluid has both potential and kinetic energy.
Potential energy is associated with its pressure and
kinetic energy is associated with its flow.

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 Bernouilli’s Principle
• At the constricted point, there is a considerable
increase in fluid velocity and a great gain in kinetic
energy.
• This gain can only occur if there is a fall in potential
energy, because total energy must remain constant.

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 Venturi Tube
• The Venturi tube is a
device that contains a
constriction which
exploits Bernouilli’s
principle.

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 Venturi Tubes
• Used for flow measurement,
oxygen masks, jet ventilators
and injectors, nebulizers.
• Venturi devices entrain air or
liquid based on the pressure
changes elaborated by
Bernouilli.

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 Venturi Mask
• An air entrainment mask
that can deliver a precise
oxygen concentration.
• Used multiple jets to
adjust the amount of train
air and vary the FiO2.

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 Nebulizer
• Entrainment of fluid due to
change in pressure in
Venturi device allows
nebulization of medications
or water.

Questions?

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