Document Detail


The effect of endotracheal suction on regional tidal ventilation and end-expiratory lung volume.
MedLine Citation:
PMID:  20232038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine the impact of different endotracheal tube (ETT) suction techniques on regional end-expiratory lung volume (EELV) and tidal volume (V(T)) in an animal model of surfactant-deficient lung injury.
METHODS: Six 2-week old piglets were intubated (4.0 mm ETT), muscle-relaxed and ventilated, and lung injury was induced with repeated saline lavage. In each animal, open suction (OS) and two methods of closed suction (CS) were performed in random order using both 5 and 8 French gauge (FG) catheters. The pre-suction volume state of the lung was standardised on the inflation limb of the pressure-volume relationship. Regional EELV and V(T) expressed as a proportion of the impedance change at vital capacity (%Z (VCroi)) within the anterior and posterior halves of the chest were measured during and for 60 s after suction using electrical impedance tomography.
RESULTS: During suction, 5 FG CS resulted in preservation of EELV in the anterior (non-dependent) and posterior (dependent) lung compared to the other permutations, but these only reached significance in the anterior regions (p < 0.001 repeated-measures ANOVA). V(T) within the anterior, but not posterior lung was significantly greater during 5FG CS compared to 8 FG CS; the mean difference was 15.1 [95% CI 5.1, 25.1]%Z (VCroi). Neither catheter size nor suction technique influenced post-suction regional EELV or V(T) compared to pre-suction values (repeated-measures ANOVA).
CONCLUSIONS: ETT suction causes transient loss of EELV and V(T) throughout the lung. Catheter size exerts a greater influence than suction method, with CS only protecting against derecruitment when a small catheter is used, especially in the non-dependent lung.
Authors:
D G Tingay; B Copnell; C A Grant; P A Dargaville; K R Dunster; A Schibler
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-16
Journal Detail:
Title:  Intensive care medicine     Volume:  36     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-07-19     Revised Date:  2011-12-20    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  888-96     Citation Subset:  IM    
Affiliation:
Department of Neonatology, Royal Children's Hospital, Melbourne, VIC, Australia. david.tingay@rch.org.au
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Intubation, Intratracheal / adverse effects,  instrumentation,  methods
Lung Injury / etiology*,  physiopathology
Lung Volume Measurements
Male
Models, Animal
Positive-Pressure Respiration / adverse effects,  methods*
Pulmonary Surfactants / administration & dosage,  adverse effects*
Pulmonary Ventilation / physiology
Suction / adverse effects,  instrumentation,  methods*
Swine
Tidal Volume
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants
Comments/Corrections
Comment In:
Intensive Care Med. 2011 Dec;37(12):2052-3   [PMID:  21946928 ]

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


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