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A new device to remove obstruction from endotracheal tubes during mechanical ventilation in critically ill patients.

Abstract：

OBJECTIVE:To evaluate the efficiency of a new device developed to remove obstructions from endotracheal tubes (ETT) in mechanically ventilated patients. DESIGN:Open study in mechanically ventilated sedated and paralyzed ICU patients. SETTING:General ICU and Laboratory of Respiratory Mechanics of the University of Rome "La Sapienza". PATIENTS:8 consecutive unselected mechanically ventilated, critically ill patients in which a partial obstruction of ETT was suspected on the basis of an increase of the peak inspiratory pressure (> 20%) plus the difficult introduction of a standard suction catheter. INTERVENTIONS:Obstructions to ETT were removed with an experimental "obstruction remover" (OR) MEASUREMENTS: "In vivo" ETT airflow resistance (0.25; 0.5; 0.75; 11/s) was evaluated before and after use of the OR; the work of breathing necessary to overcome ETT resistance (WOBett) was also evaluated before and after OR use. RESULTS:The use of OR significantly reduced in all patients the ETT "in vivo" resistance (From 5.5 +/- 2.3 to 2.9 +/- 0.5 cmH2O/l/s at 0.25 l/s, p < 0.05; from 9 +/- 2.4 to 3.8 +/- 0.8 cmH2O/l/s at 0.5 l/s; from 12.2 +/- 3.5 to 5.7 +/- 1.2 cmH2O/l/s at 0.75 l/s; from 16.9 +/- 6 to 9.3 +/- 3.8 cmH2O/l/s at 1 l/s, p < 0.01 respectively). Also the WOBett was significantly reduced after use of the OR (from 0.66 +/- 0.19 to 0.34 +/- 0.08 J/l; p < 0.05). CONCLUSION:this experimental device can be safely and successfully used to remove obstructions from the ETT lumen, without suspending mechanical ventilation, reducing the need for rapid ETT substitution in emergency and life-threatening situations.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Conti G,Rocco M,De Blasi RA,Lappa A,Antonelli M,Bufi M,Gasparetto A

doi

10.1007/BF01705724

subject

Has Abstract

pub_date

1994-11-01 00:00:00

pages

573-6

issue

8

eissn

0342-4642

issn

1432-1238

journal_volume

20

pub_type

临床试验,杂志文章

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