Document Detail

Different Tracheotomy Tube Diameters Influence Diaphragmatic Effort and Indices of Weanability in Difficult to Wean Patients.
MedLine Citation:
PMID:  22612986     Owner:  NLM     Status:  Publisher    
PURPOSE: Determine the effects of different tracheotomy tube (TT) sizes on diaphragm effort and weanability indices Methods: 10 tracheotomized and difficult to wean patients were randomized to two T-piece trials, with different TT diameters (8mm ID and 6.5mm ID). Diaphragm pressure time product per min. (PTPdi/min), lung compliance and resistances (C,L and R,L), breathing pattern, Tension-Time Index of the diaphragm (TTdi) and the ratio between breathing frequency and tidal volume (f/VT) were recorded. In an in vitro model the flow-pressure relationship was measured using the two TTs and two endotracheal tubes(ET) of the same diameter. MAIN RESULTS: The use of a smaller diameter resulted in an increased of PTPdi (337.63±194.35 cmH2Oxs/min vs 263.28±156.23 for 6.5 and 8 mm, respectively p<0.004) and R,L (16.74±8.10 cmH2Oxs/min vs 11.72±7.88,respectively p<0.008). Both weanability indices were also significantly higher using the smaller tube (f/VT: 93.32±20.91 vs 77.06±19.26 for 6.5 mm and 8 mm, respectively p<0.02; TTdi: 0.09±0.052 vs 0.08±0.04,respectively p<0.02). In vitro measurements confirmed that the resistances were higher with the smaller diameter and similar between the TT and the ET of the same diameters. CONCLUSIONS: in tracheotomized difficult to wean patients the decrease of the TT size was associated with an increased of PTPdi, f/VT and TTdi, that were otherwise normal, using an higher diameter. The in vitro study showed that the resistances increased similarly for TT and ET decreasing the diameter and increasing the flows.
Ilaria Valentini; Eva Tonveronachi; Cesare Gregoretti; Chiara Mega; Luca Fasano; Lara Pisani; Stefano Nava
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-14
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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