Document Detail


Monitoring and humidification during tracheal gas insufflation.
MedLine Citation:
PMID:  11175247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to use tracheal gas insufflation (TGI) in a safe and effective manner, it is important to understand potential interactions between TGI and the mechanical ventilator that may impact upon gas delivery and carbon dioxide (CO2) elimination. Furthermore, potentially serious complications secondary to insufflation of cool, dry gas directly into the airway and the possibility of tube occlusion must be considered during use of this adjunct modality to mechanical ventilation. Regardless of the delivery modality (continuous TGI, expiratory TGI, reverse TGI, or bidirectional TGI), conventional respiratory monitoring is required. However, TGI with mechanical ventilation can alter tidal volume and peak inspiratory pressure and can lead to the development of intrinsic positive end-expiratory pressure. Therefore, depending on the gas delivery technique used, it is important to carefully monitor these ventilatory parameters for TGI-induced changes and understand the potential need for adjustments to ventilator settings to facilitate therapy and avoid problems. Optimally, gas insufflated by the TGI catheter should be conditioned by addition of heat and humidity to prevent mucus plug formation and potential damage to the tracheal mucosa. Finally, patients must be closely monitored for increases in peak inspiratory pressure from obstruction of the tracheal tube and should have the TGI catheter removed and inspected every 8-12 hours to assess for plugs.
Authors:
E Delgado; L A Hoffman; F J Tasota; M R Pinsky
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Respiratory care     Volume:  46     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-29     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-92     Citation Subset:  IM    
Affiliation:
Respiratory Care Department, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh PA 15213. delgadoe@msx.upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Airway Resistance
Carbon Dioxide / physiology
Humans
Humidity*
Insufflation / methods*
Intubation, Intratracheal*
Monitoring, Physiologic*
Positive-Pressure Respiration, Intrinsic
Respiration, Artificial / methods*
Respiratory Mechanics*
Tidal Volume
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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