Document Detail

Glottic-modulated lung ventilation during continuous transtracheal gas insufflation: an experimental study.
MedLine Citation:
PMID:  12771619     Owner:  NLM     Status:  MEDLINE    
We investigated a new method of pulmonary ventilation that included a minitracheostomy, a reverse thrust catheter to deliver continuous flow of gas to the carina, and a threshold valve to avoid lung overinflation. In six lightly sedated healthy sheep, at a continuous flow of 5, 10, or 15 L/min and a threshold valve of 5, 10, 15, or 20 cm H(2)O, we observed a novel respiratory pattern that was characterized either by active lung inflation followed by passive and prolonged inspiratory hold (mixed pattern) or by an absence of all active inspiratory effort and only passive inflation of the lungs (passive pattern). We correlated airway pressure changes with direct visualization of the glottic opening through a fiberoptic bronchoscope. We measured airway pressures at the level of the carina, the subglottic level, and in the pleural space, and respiratory events were monitored through inductive plethysmography. An increase in continuous flow, threshold valve, or both resulted in 1) an increase in glottic breathing; 2) a decrease in respiratory rate, with a decrease in inspiratory pleural pressure excursion; or 3) an increased inspiratory/expiratory ratio and mean airway pressure. During transtracheal gas insufflation, as in this study, a novel respiratory pattern evolved that was modulated by the glottis, accompanied by a decreased effort of breathing; coughing and swallowing remained, and vocalization remained unimpaired.
Nicolo Patroniti; Muriel Verweij; Theodor Kolobow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-28     Completed Date:  2003-06-16     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1461-7     Citation Subset:  AIM; IM    
Department of Surgical Science and Intensive Care, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
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MeSH Terms
Airway Resistance
Cough / physiopathology
Deglutition / physiology
Equipment Design
Glottis / physiology*
Insufflation / instrumentation,  methods*
Models, Animal
Monitoring, Physiologic
Oxygen Inhalation Therapy / instrumentation,  methods*
Respiration, Artificial / instrumentation,  methods*
Respiratory Mechanics / physiology*
Tracheostomy* / methods
Video Recording
Vocalization, Animal / physiology
Work of Breathing / physiology

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

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