Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation.
Standard
Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation. / Reissmann, Hajo; Böhm, Stephan H; Suárez-Sipmann, Fernando; Tusman, Gerardo; Buschmann, Claas; Maisch, Stefan; Pesch, Tanja; Thamm, Oliver; Plümers, Christoph; Jochen, Schulte Am Esch; Hedenstierna, Göran.
in: INTENS CARE MED, Jahrgang 31, Nr. 3, 3, 2005, S. 431-440.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation.
AU - Reissmann, Hajo
AU - Böhm, Stephan H
AU - Suárez-Sipmann, Fernando
AU - Tusman, Gerardo
AU - Buschmann, Claas
AU - Maisch, Stefan
AU - Pesch, Tanja
AU - Thamm, Oliver
AU - Plümers, Christoph
AU - Jochen, Schulte Am Esch
AU - Hedenstierna, Göran
PY - 2005
Y1 - 2005
N2 - OBJECTIVE: Endotracheal suctioning can cause alveolar collapse and impede ventilation. One reason is the gas flow through a single-lumen endotracheal tube (ETT) provoking a gradient between airway opening and tracheal (P(tr)) pressures. Separately extending the patient tubing limbs of a suitable ventilator into the trachea via a double-lumen ETT should maintain P(tr). Can this technique reduce the side effects? DESIGN AND SETTING: Bench and animal studies in a university hospital laboratory. INTERVENTIONS: A lung model was ventilated via single and double-lumen ETTs. Closed-system suctioning was applied with catheters introduced into the single-lumen ETT or the expiratory lumen of the double-lumen ETT via swivel adapter. Seven anesthetized pigs (lungs lavaged) underwent three runs of ventilation and suctioning through (a, b) an 8.0-mm ID single-lumen ETT, (c) a double-lumen ETT (41Ch outer diameter, OD). In (a) the single-lumen ETT was disconnected for suctioning, in (b) and (c) ventilator mode was set to continuous positive airway pressure mode, and the ETTs remained connected. MEASUREMENTS AND RESULTS: Bench: Suction through single-lumen ETTs impaired ventilation and led to strongly negative P(tr) (common: -10 to -20 mbar); the double-lumen ETT technique maintained ventilation and pressures. Animals: Lung gas content (computed tomography, n=4) and arterial oxygen partial pressure, initially 1462+/-65 ml/532+/-76 mmHg, were significantly reduced by suctioning through single-lumen ETT: to 302+/-79 ml/62+/-6 mmHg with disconnection and to 851+/-211 ml/158+/-107 mmHg with closed suction. With double-lumen ETT they remained at 1377+/-95 ml/521+/-56 mmHg. CONCLUSIONS: The double-lumen ETT technique minimizes side effects of suctioning by maintaining P(tr).
AB - OBJECTIVE: Endotracheal suctioning can cause alveolar collapse and impede ventilation. One reason is the gas flow through a single-lumen endotracheal tube (ETT) provoking a gradient between airway opening and tracheal (P(tr)) pressures. Separately extending the patient tubing limbs of a suitable ventilator into the trachea via a double-lumen ETT should maintain P(tr). Can this technique reduce the side effects? DESIGN AND SETTING: Bench and animal studies in a university hospital laboratory. INTERVENTIONS: A lung model was ventilated via single and double-lumen ETTs. Closed-system suctioning was applied with catheters introduced into the single-lumen ETT or the expiratory lumen of the double-lumen ETT via swivel adapter. Seven anesthetized pigs (lungs lavaged) underwent three runs of ventilation and suctioning through (a, b) an 8.0-mm ID single-lumen ETT, (c) a double-lumen ETT (41Ch outer diameter, OD). In (a) the single-lumen ETT was disconnected for suctioning, in (b) and (c) ventilator mode was set to continuous positive airway pressure mode, and the ETTs remained connected. MEASUREMENTS AND RESULTS: Bench: Suction through single-lumen ETTs impaired ventilation and led to strongly negative P(tr) (common: -10 to -20 mbar); the double-lumen ETT technique maintained ventilation and pressures. Animals: Lung gas content (computed tomography, n=4) and arterial oxygen partial pressure, initially 1462+/-65 ml/532+/-76 mmHg, were significantly reduced by suctioning through single-lumen ETT: to 302+/-79 ml/62+/-6 mmHg with disconnection and to 851+/-211 ml/158+/-107 mmHg with closed suction. With double-lumen ETT they remained at 1377+/-95 ml/521+/-56 mmHg. CONCLUSIONS: The double-lumen ETT technique minimizes side effects of suctioning by maintaining P(tr).
M3 - SCORING: Zeitschriftenaufsatz
VL - 31
SP - 431
EP - 440
JO - INTENS CARE MED
JF - INTENS CARE MED
SN - 0342-4642
IS - 3
M1 - 3
ER -