Document Detail

A computed tomographic scan assessment of endotracheal suctioning-induced bronchoconstriction in ventilated sheep.
MedLine Citation:
PMID:  11069832     Owner:  NLM     Status:  MEDLINE    
This study was directed at assessing changes in bronchial cross-sectional surface areas (BCSA) and in respiratory resistance induced by endotracheal suctioning in nine anesthetized sheep. Cardiorespiratory parameters (Swan-Ganz catheter), respiratory resistance (inspiratory occlusion technique), BCSA, and lung aeration (computed tomography) were studied at baseline, during endotracheal suctioning, and after 20 consecutive hyperinflations. Measurements performed initially at an inspired oxygen fraction (FI(O(2))) of 0.3 were repeated at an FI(O(2)) of 1.0. At an FI(O(2)) of 0.3, endotracheal suctioning resulted in atelectasis, a reduction in BCSA of 29 +/- 23% (mean +/- SD), a decrease in arterial oxygen saturation from 95 +/- 3% to 87 +/- 12% (p = 0.02), an increase in venous admixture from 19 +/- 10% to 31 +/- 19% (p = 0. 006), and an increase in lung tissue resistance (DR(rs)) (p = 0. 0003). At an FI(O(2)) of 1.0, despite an extension of atelectasis and an increase in pulmonary shunt from 19 +/- 5% to 36 +/- 2% (p < 0.0001), arterial O(2) desaturation was prevented and BCSA decreased by only 7 +/- 32%. A recruitment maneuver after endotracheal suctioning entirely reversed the suctioning-induced increase in DR(rs) and atelectasis. In three lidocaine-pretreated sheep, the endotracheal suctioning-induced reduction of BCSA was entirely prevented. These data suggest that the endotracheal suctioning-induced decrease in BCSA is related to atelectasis and bronchoconstriction. Both effects can be reversed by hyperoxygenation maneuver before suctioning in combination with recruitment maneuver after suctioning.
Q Lu; A Capderou; P Cluzel; E Mourgeon; L Abdennour; J D Law-Koune; C Straus; P Grenier; M Zelter; J J Rouby
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  162     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-04     Completed Date:  2000-12-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1898-904     Citation Subset:  AIM; IM    
Surgical Intensive Care Unit Pierre Viars and Departments of Anesthesiology, Physiology, and Radiology, La Pitié-Salpêtrière Hospital, University of Paris, Paris, France.
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MeSH Terms
Airway Resistance
Intubation, Intratracheal / adverse effects*
Lung / radiography*
Lung Compliance
Oxygen / blood
Pulmonary Atelectasis / etiology,  radiography
Pulmonary Gas Exchange
Respiratory Mechanics
Suction / adverse effects*
Tomography, X-Ray Computed*
Reg. No./Substance:

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