Authors: Hajo Reissmann Stephan H Böhm Fernando SuárezSipmann Gerardo Tusman Claas Buschmann Stefan Maisch Tanja Pesch Oliver Thamm Christoph Plümers Jochen Schulte am Esch Göran Hedenstierna
Publish Date: 2005/02/03
Volume: 31, Issue: 3, Pages: 431-440
Abstract
Endotracheal suctioning can cause alveolar collapse and impede ventilation One reason is the gas flow through a singlelumen endotracheal tube ETT provoking a gradient between airway opening and tracheal Ptr pressures Separately extending the patient tubing limbs of a suitable ventilator into the trachea via a doublelumen ETT should maintain Ptr Can this technique reduce the side effectsA lung model was ventilated via single and doublelumen ETTs Closedsystem suctioning was applied with catheters introduced into the singlelumen ETT or the expiratory lumen of the doublelumen ETT via swivel adapter Seven anesthetized pigs lungs lavaged underwent three runs of ventilation and suctioning through a b an 80mm ID singlelumen ETT c a doublelumen ETT 41Ch outer diameter OD In a the singlelumen ETT was disconnected for suctioning in b and c ventilator mode was set to continuous positive airway pressure mode and the ETTs remained connectedBench Suction through singlelumen ETTs impaired ventilation and led to strongly negative Ptr common −10 to −20 mbar the doublelumen 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 singlelumen ETT to 302±79 ml/62±6 mmHg with disconnection and to 851±211 ml/158±107 mmHg with closed suction With doublelumen ETT they remained at 1377±95 ml/521±56 mmHg
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