当前位置： SCI文献检索 > INTENSIVE CARE MEDICINE期刊下所有文献 > Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation.

Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation.

Abstract：

OBJECTIVE:Endotracheal suctioning can cause alveolar collapse and impede ventilation. One reason is the gas flow through a single-lumen endotracheal tube (ETT) provoking a gradient between airway opening and tracheal (P(tr)) pressures. Separately extending the patient tubing limbs of a suitable ventilator into the trachea via a double-lumen ETT should maintain P(tr). Can this technique reduce the side effects? DESIGN AND SETTING:Bench and animal studies in a university hospital laboratory. INTERVENTIONS:A lung model was ventilated via single and double-lumen ETTs. Closed-system suctioning was applied with catheters introduced into the single-lumen ETT or the expiratory lumen of the double-lumen ETT via swivel adapter. Seven anesthetized pigs (lungs lavaged) underwent three runs of ventilation and suctioning through (a, b) an 8.0-mm ID single-lumen ETT, (c) a double-lumen ETT (41Ch outer diameter, OD). In (a) the single-lumen ETT was disconnected for suctioning, in (b) and (c) ventilator mode was set to continuous positive airway pressure mode, and the ETTs remained connected. MEASUREMENTS AND RESULTS:Bench: Suction through single-lumen ETTs impaired ventilation and led to strongly negative P(tr) (common: -10 to -20 mbar); the double-lumen ETT technique maintained ventilation and pressures. ANIMALS:Lung gas content (computed tomography, n=4) and arterial oxygen partial pressure, initially 1462+/-65 ml/532+/-76 mmHg, were significantly reduced by suctioning through single-lumen ETT: to 302+/-79 ml/62+/-6 mmHg with disconnection and to 851+/-211 ml/158+/-107 mmHg with closed suction. With double-lumen ETT they remained at 1377+/-95 ml/521+/-56 mmHg. CONCLUSIONS:The double-lumen ETT technique minimizes side effects of suctioning by maintaining P(tr).

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Reissmann H,Böhm SH,Suárez-Sipmann F,Tusman G,Buschmann C,Maisch S,Pesch T,Thamm O,Plümers C,Schulte am Esch J,Hedenstierna G

doi

10.1007/s00134-004-2537-5

keywords:

subject

Has Abstract

pub_date

2005-03-01 00:00:00

pages

431-40

issue

eissn

0342-4642

issn

1432-1238

journal_volume

pub_type

杂志文章

在线工具

Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation.