Document Detail

Aspiration of airway dead space. A new method to enhance CO2 elimination.
MedLine Citation:
PMID:  10051243     Owner:  NLM     Status:  MEDLINE    
Alveolar ventilation and CO2 elimination during mechanical ventilation can be enhanced by reducing dead-space ventilation. Aspiration of gas from the dead space (ASPIDS) is a new principle, according to which gas rich in CO2 during late expiration is aspirated through a channel ending at the distal end of the tracheal tube. Simultaneously, fresh gas injected into the inspiratory line fills the airway down to the same site. We hypothesized that ASPIDS would allow a reduction of tidal volume (VT) and airway pressure (Paw). To test our hypothesis we studied six anaesthetized and mechanically ventilated pigs (24 +/- 4 kg). The intention was to decrease VT while keeping PaCO2 constant by using ASPIDS. VT was reduced by decreasing the minute ventilation (V E) in two steps, of 1.8 L/min (VE - 1.8) and 2.2 L/min (VE - 2.2), respectively, and by increasing respiratory rate (RR) from 20 to 46 breaths/min. At ASPIDS, peak Paw was reduced by 35% at VE - 1.8 and at VE - 2.2 (p < 0.001), and by 20% at an RR of 46 (p < 0.01). PaCO2 was maintained or reduced at ASPIDS. No intrinsic positive end-expiratory pressure developed. Arterial blood pressure and heart rate were unaffected. The results show that ASPIDS allows a reduction in VT and Paw while PaCO2 is kept constant. ASPIDS does not lead to problems associated with jet streams of gas or with gas humidification, and can be developed as a safe technique.
E De Robertis; S E Sigurdsson; B Drefeldt; B Jonson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  159     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-04-01     Completed Date:  1999-04-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  728-32     Citation Subset:  AIM; IM    
Departments of Clinical Physiology and Anaesthesia and Intensive Care, University Hospital of Lund, Sweden.
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MeSH Terms
Airway Resistance
Carbon Dioxide / physiology*
Positive-Pressure Respiration, Intrinsic
Pulmonary Alveoli / physiology*
Pulmonary Ventilation
Respiration, Artificial / instrumentation,  methods*
Respiratory Dead Space*
Tidal Volume
Reg. No./Substance:
124-38-9/Carbon Dioxide

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