Fink effect

Short description: Changes of oxygen partial pressure in the pulmonary alveoli caused by a soluble anesthetic gas

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The Fink effect, also known as "diffusion anoxia",[1] "diffusion hypoxia",[2] or the "second gas effect",[3] is a factor that influences the pO2 (partial pressure of oxygen) within the pulmonary alveoli. When water-soluble gases such as anesthetic agent N2O (nitrous oxide) are breathed in large quantities they can be dissolved in body fluids rapidly. This leads to a temporary increase[clarification needed] in both the concentrations and partial pressures of oxygen and carbon dioxide in the alveoli.

The effect is named for Bernard Raymond Fink (1914–2000), whose 1955 paper first explained it.[1][4] When a patient is recovering from N2O anaesthesia, large quantities of this gas cross from the blood into the alveoli (down its concentration gradient) 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).[5] 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.[6] It is for this reason that Entonox, a 50:50 gaseous mixture of nitrous oxide and oxygen, 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.[7][8]

## See also

* Concentration effect
* Inhalational anesthetic
* Second gas effect

## References

1. ↑ 1.0 1.1 J. Roger Maltby (2002). Notable Names in Anaesthesia. Royal Society of Medicine Press. p. 63. ISBN 978-1-85315-512-3. https://books.google.com/books?id=Yc4_uLDkzgAC&q=Fink-effect nitrous&pg=PA63.
2. ↑ S. Ahanatha Pillai (2007). Understanding Anaesthesiology. Jaypee Brothers Publishers. p. 101. ISBN 978-81-8448-169-3. https://books.google.com/books?id=rCvEJibQstcC&q=Fink-effect hypoxia&pg=PA101.
3. ↑ Steven M. Yentis; Nicholas P. Hirsch; Gary B. Smith (2009). Anaesthesia and Intensive Care A–Z: An Encyclopedia of Principles and Practice. Elsevier Health Sciences. ISBN 978-0-443-06785-3. https://books.google.com/books?id=kxxDYTV7DqUC&q="third gas effect" fink&pg=PT534.
4. ↑ Bernard R. Fink (1955). "Diffusion Anoxia". Anesthesiology 16 (4): 511–519. doi:10.1097/00000542-195507000-00007. PMID 13238868.
5. ↑ S. EINARSSON (1993). "Nitrous Oxide Elimination and Diffusion Hypoxia During Normo- and Hypoventilation". British Journal of Anaesthesia 71 (2): 189–93. doi:10.1093/bja/71.2.189. PMID 8123390.
6. ↑ Andrew B. Lumb; John F. Nunn (2005). Nunn's Applied Respiratory Physiology (6th ed.). Elsevier/Butterworth Heinemann. p. 169. ISBN 978-0-7506-8791-1. https://books.google.com/books?id=29hqAAAAMAAJ&q=Fink-effect++intitle:Respiratory+intitle:Physiology+inauthor:Nunn.
7. ↑ "Entonox". 26 January 2009. http://www.frca.co.uk/article.aspx?articleid=100364.
8. ↑ Joanne D. Fisher; Simon N. Brown; Matthew W. Cooke (October 2006). UK Ambulance Service Clinical Practice Guidelines (2006). Joint Royal Colleges Ambulance Liaison Committee. ISBN 1-84690-060-3. http://www2.warwick.ac.uk/fac/med/research/hsri/emergencycare/prehospitalcare/jrcalcstakeholderwebsite/guidelines/clinical_guidelines_2006.pdf. Retrieved 27 February 2018.

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Anesthesia and anesthesiology

Types|

* General
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Techniques|

* Airway management
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Scientific principles|

* Blood–gas partition coefficient
* Concentration effect
* Fink effect
* Minimum alveolar concentration
* Second gas effect

Measurements|

* ASA physical status classification system
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* Anaesthetic machine
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Complications|

* Emergence delirium
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Subspecialties|

* Cardiothoracic
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* Anesthesiologist
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History|

* ACE mixture
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Organizations|

* American Association of Nurse Anesthetists
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