Document Detail

Constant-flow insufflation prevents arterial oxygen desaturation during endotracheal suctioning.
MedLine Citation:
PMID:  1859066     Owner:  NLM     Status:  MEDLINE    
In mechanically ventilated patients, disconnection from the ventilator and endotracheal suctioning can induce major arterial oxygen desaturation resulting from apnea, changes in inspired oxygen fraction, and decrease in lung volume. The aim of this study was to test the efficacy of a simple method of delivering oxygen and maintaining lung volume during this process. Our study was conducted in two parts. In the first part, constant-flow insufflation of oxygen (CFI) was used in seven patients ventilated for acute respiratory failure (PaO2/FlO2 = 347 +/- 33 mm Hg) as a means of maintaining arterial oxygenation during apnea and disconnection from the ventilator. CFI was administered via a modified endotracheal tube in which small capillaries allowed delivery of a high-velocity jet flow near the tracheal end of the tube during disconnection from the ventilator. In comparison to apnea alone, CFI prevented a fall in arterial oxygen tension (16 +/- 7 mm Hg during CFI versus 117 +/- 27 during apnea, after 90 s of disconnection in the two situations, p less than 0.001), whereas it did not reduce the development of hypercapnia. The efficacy of CFI resulted both from the injection of oxygen into the trachea and from the maintenance of positive alveolar pressure induced by air entrainment (mean 10.4 +/- 1.1 cm H2O), preventing a fall in lung volume usually occurring after disconnection (+338 +/- 88 ml during CFI versus -344 +/- 64 ml during apnea, p less than 0.01). In the second part of the study CFI was used to prevent arterial oxygen desaturation induced by endotracheal suctioning.(ABSTRACT TRUNCATED AT 250 WORDS)
L Brochard; G Mion; D Isabey; C Bertrand; A A Messadi; J Mancebo; G Boussignac; N Vasile; F Lemaire; A Harf
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  144     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-08-29     Completed Date:  1991-08-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  395-400     Citation Subset:  AIM; IM    
Départment de Physiologie, Université Paris XII, Creteil, France.
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MeSH Terms
Intubation, Intratracheal*
Lung Volume Measurements
Oxygen / administration & dosage*,  blood,  therapeutic use
Respiratory Insufficiency / therapy
Ventilators, Mechanical*
Reg. No./Substance:

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