Document Detail

Combination of tracheal gas insufflation and airway pressure release ventilation.
MedLine Citation:
PMID:  9149596     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: We hypothesized that the continuous gas flow administration delivered through an insufflation catheter positioned above the carina during airway pressure release ventilation (APRV) would facilitate carbon dioxide (CO2) elimination, resulting in normocarbia with a substantially reduced peak airway pressure (Paw). To test this hypothesis, we compared intermittent positive pressure ventilation (IPPV), tracheal gas insufflation (TGI), APRV, and combined TGI and APRV (TGI + APRV). DESIGN: Animal study with random application of four ventilatory modes in a canine restrictive-thorax model with and without pulmonary edema. SETTING: Research laboratory at Kumamoto (Japan) University School of Medicine. SUBJECTS: Six mongrel dogs. INTERVENTIONS: Application of four ventilatory modes (IPPV, TGI, APRV, and TGI + APRV). MEASUREMENTS AND RESULTS: TGI + APRV facilitated CO2 elimination. The peak Paw was significantly lower during TGI + APRV than during IPPV (nonpulmonary edema model; 15 +/- 4 vs 28 +/- 9 cm H2O; p < 0.05; pulmonary edema model: 20 +/- 4 vs 34 +/- 10 cm H2O; p < 0.05). Normocarbia was observed in both models. Neither TGI nor APRV alone maintained normocarbia. CONCLUSION: The combined use of TGI and APRV is a more effective method of maintaining normocarbia with reduced peak Paw than either IPPV or APRV alone.
K Okamoto; H Kishi; H Choi; T Sato
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  111     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-03     Completed Date:  1997-06-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1366-74     Citation Subset:  AIM; IM    
Department of Anesthesiology, Kumamoto University School of Medicine, Japan.
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MeSH Terms
Blood Pressure
Carbon Dioxide / blood,  metabolism
Cardiac Output
Central Venous Pressure
Heart Rate
Hypercapnia / etiology
Intermittent Positive-Pressure Ventilation
Lung Compliance
Oxygen / blood
Positive-Pressure Respiration
Pulmonary Edema / therapy
Pulmonary Ventilation
Pulmonary Wedge Pressure
Random Allocation
Respiration, Artificial / methods*
Ventilation-Perfusion Ratio
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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