| Effect of closed endotracheal tube suction method, catheter size, and post-suction recruitment during high-frequency jet ventilation in an animal model. | |
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MedLine Citation:
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PMID: 22290736 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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RATIONALE: High-frequency jet ventilation (HFJV) is often used to treat infants with pathologies associated with gas trapping and abnormal lung mechanics, who are sensitive to the adverse effects of suction. OBJECTIVE: This study aimed to investigate the effect of closed suction (CS), catheter size, and the use of active post-suction sighs on tracheal pressure (P(trach) ), and global and regional end-expiratory lung volume (EELV) during HFJV. METHODS: Six anaesthetized and muscle-relaxed adult rabbits were stabilized on HFJV. CS was performed using all permutations of three CS methods (Continual negative pressure, negative pressure applied during Withdrawal, and HFJV in Standby) and 6 French gauge (6FG) and 8 French gauge (8FG) catheter, randomly assigned. The sequence was repeated using post-suction sighs. P(trach) , absolute (respiratory inductive plethysmography) and regional (electrical impedance tomography; expressed as percentage of vital capacity for the defined region of interest, %Z(VCroi) ) EELV were measured before, during and 60 sec post-suction. RESULTS: CS methods exerted no difference on ΔP(trach) , ΔEELV(RIP) , or Δ%Z(VCroi) . 8FG catheter resulted in a mean (95%CI) 20.0 (17.9,22.2) cm H(2) O greater loss of P(trach) during suction compared to 6FG (Bonferroni post-test). Mean (±SD) ΔEELV(RIP) was -6(±3) and -2(±1) ml/kg with the 8 and 6FG catheters (P < 0.0001; Bonferroni post-test). ΔEELV was 31.7 (21.1,42.4) %Z(VCroi) and 24.8 (10.9,38.7) %Z(VCroi) greater in the ventral and dorsal hemithoraces using the 8FG. Only after 8FG CS was post-suction recruitment required to restore EELV. CONCLUSIONS: In this animal model receiving HFJV, ΔP(trach) , ΔEELV, and need for post-suction recruitment during CS were most influenced by catheter size. Volume changes within the lung were uniform. Pediatr Pulmonol. © 2012 Wiley Periodicals, Inc. |
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Authors:
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J Michele Hepponstall; David G Tingay; Risha Bhatia; Peter M Loughnan; Beverley Copnell |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-30 |
Journal Detail:
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Title: Pediatric pulmonology Volume: - ISSN: 1099-0496 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8510590 Medline TA: Pediatr Pulmonol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Wiley Periodicals, Inc. |
Affiliation:
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Neonatal Research, Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia; Department of Neonatology, Royal Children's Hospital, Flemington Road, Melbourne, Victoria, Australia. michele.hepponstall@rch.org.au. |
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