Document Detail


Effective inspired oxygen concentration measured via transtracheal and oral gas analysis.
MedLine Citation:
PMID:  20406513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The fraction of inspired oxygen (F(IO(2))) is quoted for different oxygen delivery systems, but variations in inspiratory flow and tidal volume make precise measurement difficult. We developed a reliable method of measuring the effective F(IO(2)) in patients receiving supplemental oxygen. METHODS: Ten subjects with chronic hypoxemia breathed through a mouthpiece with a sampling probe connected to a mass spectrometer. Four of the 10 subjects had transtracheal catheters that allowed direct sampling of tracheal gas. We used oxygen concentrations of 47% and 97%, and flow rates between 1 L/min and 8 L/min. We also compared oxygen delivery via nasal cannula and transtracheal catheter. Effective F(IO(2)) was derived from plots of the fractional concentrations of carbon dioxide versus oxygen. RESULTS: We found excellent correlation between the effective F(IO(2)) values from tracheal and oral sampling (r = 0.960, P < .001). With 97% oxygen via nasal cannula, effective F(IO(2)) increased by 2.5% per liter of increased flow (P < .001); effective F(IO(2)) reached 32.7% at 5 L/min while P(aO(2)) increased by 12 mm Hg per liter of increased flow. In 4 subjects with a transtracheal catheter, effective F(IO(2)) increased 5.0% (P < .001) per liter of increased flow, and P(aO(2)) increased by 13 mm Hg per liter of increased flow, whereas in the same 4 subjects using nasal cannula for oxygen delivery, P(aO(2)) increased by only 6 mm Hg per liter of increased flow. CONCLUSIONS: Exhaled gas sampled at the mouth accurately reflected the effective F(IO(2)) in the trachea. In relation to inspired oxygen flow, the effective F(IO(2)) was lower than is conventionally thought. Compared to nasal cannula, transtracheal catheter approximately doubled the effective F(IO(2)) at a given flow rate. Accurate knowledge of F(IO(2)) should aid clinicians in managing patients with acute and chronic lung diseases.
Authors:
Gerald H Markovitz; James Colthurst; Thomas W Storer; Christopher B Cooper
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Respiratory care     Volume:  55     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  453-9     Citation Subset:  IM    
Affiliation:
Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, CA 90095-1690, USA.
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MeSH Terms
Descriptor/Qualifier:
Anoxia / metabolism,  physiopathology,  therapy*
Breath Tests / instrumentation*
Catheterization*
Equipment Design
Female
Humans
Intubation, Intratracheal / instrumentation*
Lung Diseases, Obstructive / complications,  metabolism,  therapy
Male
Obesity Hypoventilation Syndrome / complications,  metabolism,  therapy
Oxygen / analysis*
Oxygen Inhalation Therapy / instrumentation*
Reproducibility of Results
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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


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