Document Detail

Bacterial colonization of the respiratory tract following tracheal intubation-effect of gravity: an experimental study.
MedLine Citation:
PMID:  12626976     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To explore the role of the horizontal orientation of endotracheal tube and neck on bacterial colonization of the respiratory tract in anesthetized sheep on mechanical ventilation, without use of antibiotics. DESIGN: Prospective animal study. SETTING: National Institutes of Health research laboratory. SUBJECTS: Anesthetized, paralyzed, and ventilated sheep. INTERVENTIONS: Sheep were randomized into five groups and managed as follows: Group IS contained sheep that were not intubated and were immediately killed. Group HU4 contained six sheep that were mechanically ventilated for 4 hrs, with head and endotracheal tube elevated 30 degrees from horizontal. Group HU72 contained seven sheep that were prone, mechanically ventilated for 72 hrs, and managed the same as group HU4. Groups G and Gf each contained seven sheep that were prone on a lateral body rotation device, mechanically ventilated for 72 hrs, with neck and endotracheal tube horizontal. Group Gf received nasogastric enteral feeding. MEASUREMENTS AND MAIN RESULTS: At the end of the study, sheep were examined postmortem, and a total of 11 tissue samples were taken from the trachea, the five lobar bronchi, and the five lobar parenchyma, for qualitative and quantitative culture. Group HU72 had significant decrease in Pao2/Fio2 and heavy bacterial colonization in all sheep. Groups G and Gf retained excellent lung function; lung bacterial colonization was no different from the IS group. CONCLUSIONS: The horizontal orientation of the endotracheal tube and neck, through lateral body rotation, showed no altered airway colonization and maintained excellent gas exchange and lung function in our animal model.
M Panigada; L Berra; G Greco; M Stylianou; T Kolobow
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-10     Completed Date:  2003-04-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  729-37     Citation Subset:  AIM; IM    
Pulmonary and Cardiac Assist Devices, Office of Biostatistics Research, NHLBI, National Institutes of Health, Bethesda, MD 20892, USA.
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MeSH Terms
Bacteria / growth & development*
Bacterial Translocation
Blood Gas Analysis
Bronchi / microbiology*
Colony Count, Microbial
Disease Models, Animal*
Enteral Nutrition / adverse effects*,  methods
Head / physiology*
Intubation, Intratracheal / adverse effects*,  methods
Lung / microbiology*
Neck / physiology*
Pneumonia, Bacterial / blood,  etiology*
Posture / physiology*
Prospective Studies
Pulmonary Gas Exchange
Random Allocation
Respiration, Artificial / adverse effects*,  methods
Risk Factors
Time Factors
Trachea / microbiology*
Comment In:
Crit Care Med. 2003 Mar;31(3):973-4   [PMID:  12627016 ]

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