Document Detail

Effect of endotracheal tube leak on capnographic measurements in a ventilated neonatal lung model.
MedLine Citation:
PMID:  22986303     Owner:  NLM     Status:  Publisher    
Uncuffed endotracheal tubes (ET) are commonly used for mechanically ventilated infants to protect airways, but this bears the risk of an air leak around the ET. In contrast to the measurements of tidal volume and respiratory mechanics, very little is known about the effect of ET leaks on capnographic measurements. To investigate the relationship between ET leakage and the CO(2) measuring error of the exhaled breathing gas a neonatal lung model was used consisting of two silicon bellows. A constant but very low flow of pure CO(2) was injected so that the exhaled breathing gas contained an adjustable CO(2) plateau. This lung model was ventilated via a 3 mm inner diameter ET with different respiratory rates (RR) (20, 40 and 60 min(-1)). ET leaks (0-80%) were simulated by a needle valve. The end-expiratory CO(2) partial pressure (P(et)CO(2)) was reduced up to zero when an air leak was simulated. Provided that the exhaled CO(2) reached a plateau before entering the CO(2) washout of the sample chamber by the leak flow, the magnitude of the CO(2) decreased independently of RR, and only slightly with increasing ET leak. For ET leaks of up to 20% the CO(2) plateau error was <10%. However, in newborns with stiff lungs and a short alveolar plateau capnographic measurements should be interpreted with caution if the ET leak is considerable.
G Schmalisch; S Al-Gaaf; H Proquitté; C C Roehr
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-18
Journal Detail:
Title:  Physiological measurement     Volume:  33     ISSN:  1361-6579     ISO Abbreviation:  Physiol Meas     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9306921     Medline TA:  Physiol Meas     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1631-1641     Citation Subset:  -    
Department of Neonatology, Charité University Medical Center, Charitéplatz 1, 10117, Berlin, Germany.
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