Document Detail

The impact of endotracheal suctioning on gas exchange and hemodynamics during lung-protective ventilation in acute respiratory distress syndrome.
MedLine Citation:
PMID:  16638159     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the respiratory and hemodynamic effects of open suctioning (OS) versus closed suctioning (CS) during pressure-control (PC) and volume-control (VC) ventilation, using a lung-protective ventilation strategy in an animal model of acute respiratory distress syndrome (ARDS).
SETTING: Animal laboratory in a university hospital.
DESIGN: Randomized cross-over evaluation.
ANIMALS: Eight female Dorset sheep.
INTERVENTIONS: Lung lavage was used to simulate ARDS. We applied VC and PC mechanical ventilation with a tidal volume of 6 mL/kg and positive end-expiratory pressure (PEEP), adjusted based on a table of PEEP versus fraction of inspired oxygen (FIO2). Suctioning was performed for 10 s with a suction pressure of -100 mm Hg, during both OS and CS. OS and CS were randomly performed with each animal. Hemodynamics and arterial blood gases were recorded before, during, and after endotracheal suctioning.
RESULTS: The PaO2/FIO2 ratios before suctioning were similar in all groups, as were the PEEP and FIO2. PaO2/FIO2 was lower after OS than after CS/VC or CS/PC. There was no post-suctioning difference in oxygenation between CS/VC and CS/PC. PaCO2 recorded 10 min after suctioning was greater than the presuctioning value, in all groups. Intrapulmonary shunt fraction increased between baseline and 10 min post-suctioning with OS and CS/VC, but did not significantly increase with CS/PC. There were no significant changes in hemodynamics pre-suctioning versus post-suctioning with OS, CS/VC, or CS/PC.
CONCLUSION: PaO2/FIO2) was better maintained during CS with both VC and PC modes during lung-protective ventilation for ARDS, as compared with OS, and shunt fraction post-suctioning changed least with PC.
Maria Paula Caramez; Guilherme Schettino; Klaudiusz Suchodolski; Tomoyo Nishida; R Scott Harris; Atul Malhotra; Robert M Kacmarek
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Respiratory care     Volume:  51     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-26     Completed Date:  2006-10-12     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  497-502     Citation Subset:  IM    
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MeSH Terms
Blood Gas Analysis
Cross-Over Studies
Intubation, Intratracheal*
Pulmonary Gas Exchange*
Pulmonary Ventilation / physiology*
Respiratory Distress Syndrome, Adult*
Suction / methods*
Grant Support
K23 AG024837/AG/NIA NIH HHS; K23 AG024837-02/AG/NIA NIH HHS; R01 HL073146/HL/NHLBI NIH HHS; R01 HL073146-01/HL/NHLBI NIH HHS

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

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