The Fink effect, also known as "diffusion
anoxia",
[ "diffusion hypoxia",
or the "second gas effect",
is a factor that influences the pO2 (partial pressure of oxygen) within the ]pulmonary alveoli
A pulmonary alveolus (plural: alveoli, from Latin ''alveolus'', "little cavity"), also known as an air sac or air space, is one of millions of hollow, distensible cup-shaped cavities in the lungs where oxygen is exchanged for carbon dioxide. A ...
. When water-soluble
In chemistry, solubility is the ability of a substance, the solute, to form a solution with another substance, the solvent. Insolubility is the opposite property, the inability of the solute to form such a solution.
The extent of the solubi ...
gases such as anesthetic agent
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), am ...
N2O (nitrous oxide
Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, or nos, is a chemical compound, an oxide of nitrogen with the formula . At room temperature, it is a colourless non-flammable gas, and has ...
) are breathed in large quantities they can be dissolved in body
Body may refer to:
In science
* Physical body, an object in physics that represents a large amount, has mass or takes up space
* Body (biology), the physical material of an organism
* Body plan, the physical features shared by a group of anima ...
fluids
In physics, a fluid is a liquid, gas, or other material that continuously deforms (''flows'') under an applied shear stress, or external force. They have zero shear modulus, or, in simpler terms, are substances which cannot resist any she ...
rapidly. This leads to a temporary increase in both the concentration
In chemistry, concentration is the abundance of a constituent divided by the total volume of a mixture. Several types of mathematical description can be distinguished: '' mass concentration'', ''molar concentration'', '' number concentration'', ...
s and partial pressure
Pressure (symbol: ''p'' or ''P'') is the force applied perpendicular to the surface of an object per unit area over which that force is distributed. Gauge pressure (also spelled ''gage'' pressure)The preferred spelling varies by country and e ...
s of oxygen
Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements as ...
and carbon dioxide
Carbon dioxide ( chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is trans ...
in the alveoli.
The effect is named for Bernard Raymond Fink
Bernard Raymond Fink (25 May 1914 – 30 October 2000) was a British physician.
Fink was born in London, brought up in Antwerp, Belgium, and emigrated to the United States in 1950. He was bestowed ASA Excellence in Research Award in 1987. He was ...
(1914–2000), whose 1955 paper first explained it.[
]
When a patient is recovering from N2O anaesthesia
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), a ...
, large quantities of this gas cross from the blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
into the alveoli (down its concentration gradient
In vector calculus, the gradient of a scalar-valued differentiable function of several variables is the vector field (or vector-valued function) \nabla f whose value at a point p is the "direction and rate of fastest increase". If the gr ...
) and so for a short period of time, the O2 and CO2 in the alveoli are diluted by this gas. A sufficiently large decrease in the partial pressure of oxygen leads to hypoxia, especially if the patient hypoventilates (which allows more time for evolving nitrous to dilute alveolar oxygen each breath.)
Nonetheless, this effect only lasts a couple of minutes and hypoxia can be avoided by increasing the fractional inspired oxygen concentration when recovering from N2O administration.
It is for this reason that Entonox
Nitrous oxide, is an inhaled gas used as a pain medication and together with other medications for anesthesia. Common uses include during childbirth, following trauma, and as part of end-of-life care. Onset of effect is typically within half a m ...
, a 50:50 gaseous mixture of nitrous oxide
Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, or nos, is a chemical compound, an oxide of nitrogen with the formula . At room temperature, it is a colourless non-flammable gas, and has ...
and oxygen
Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements as ...
, is suitable for use by para-medical staff such as ambulance officers: it provides sufficient nitrous oxide for pain relief with sufficient oxygen to avoid hypoxia.[
]
See also
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*
*
References
{{DEFAULTSORT:Fink Effect
Anesthesia
Diffusion