Document Detail


Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance.
MedLine Citation:
PMID:  21177698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Emergency ventilation through a small-bore transtracheal catheter can be lifesaving in a 'cannot intubate, cannot ventilate' situation. Ejectors, capable of creating suction by the Bernoulli principle, have been proposed to facilitate expiration through small-bore catheters. In this bench study, we compared a novel, purpose-built ventilation ejector (DE 5) with a previously proposed, modified industrial ejector (SBP 07).
METHODS: The generated insufflation pressures, suction pressures in static and dynamic situations, and also suction capacities and entrainment ratios of the SBP 07 and the DE 5 were determined. The DE 5 was also tested in a lung simulator with a simulated complete upper airway obstruction. Inspiratory and expiratory times through a transtracheal catheter were measured at various flow rates and achievable minute volumes were calculated.
RESULTS: In a static situation, the SBP 07 showed a more negative pressure build-up compared with the DE 5. However, in a dynamic situation, the DE 5 generated a more negative pressure, resulting in a higher suction capacity. Employment of the DE 5 at a flow rate of 18 litre min(-1) allowed a minute volume through the transtracheal catheter of up to 8.27 litre min(-1) at a compliance of 100 ml cm H(2)O(-1). The efficiency of the DE 5 depended on the flow rate of the driving gas and the compliance of the lung simulator.
CONCLUSION: In laboratory tests, the DE 5 is an optimized ventilation ejector suitable for applying expiratory ventilation assistance. Further research may confirm the clinical applicability as a portable emergency ventilator for use with small-bore catheters.
Authors:
A E W Hamaekers; P A J Borg; T Götz; D Enk
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-12-22
Journal Detail:
Title:  British journal of anaesthesia     Volume:  106     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  2011-03-23     Revised Date:  2011-07-04    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  403-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands. a.hamaekers@mumc.nl
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MeSH Terms
Descriptor/Qualifier:
Air Pressure
Airway Obstruction / therapy*
Airway Resistance / physiology
Cricoid Cartilage / surgery
Emergencies
Equipment Design
Exhalation / physiology
High-Frequency Jet Ventilation / instrumentation*,  methods
Humans
Insufflation / instrumentation
Suction
Thyroid Cartilage / surgery
Ventilators, Mechanical*
Comments/Corrections
Comment In:
Br J Anaesth. 2011 Jun;106(6):908-9; author reply 909   [PMID:  21576100 ]

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


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