Although the artificial airway establishes an essentially airtight connection between the ventilatory device (or atmosphere) and the lung, it also has a number of side-effects including the following:

1. increasing resistance to gas flow (with some exceptions);

2. increasing respiratory dead-space (again, with some exceptions);

3. interference with conditioning of the inspired gas;

4. possible effects on functional residual capacity (FRC);

5. prevention of autoinhalation of endogenously produced nasal nitric oxide (NO) with possible negative effects on ventilation-perfusion matching;

6. damage to and infection of the airway wall with subsequent stenosis.

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