Indirect calorimetry in mechanically ventilated infants and children: measurement accuracy with absence of audible airleak.

Abstract:

OBJECTIVE:To establish the effect of an audible airleak (around an endotracheal tube) on oxygen consumption (VO2) measurements in pediatric ICU patients. DESIGN:Prospective trial comparing VO2 measurements before and after deflation of the endotracheal tube cuff. SETTING:Pediatric ICU in a large pediatric tertiary care center. PATIENTS:Twenty critically ill infants and children receiving mechanical ventilatory support via cuffed endotracheal tube. INTERVENTIONS:Deflation of endotracheal tube cuff. MEASUREMENTS AND MAIN RESULTS:The presence (group 1, n = 9) or absence (group 2, n = 11) of an audible airleak with the cuff deflated was confirmed by two independent observers. The percent difference in VO2 was calculated for both groups using the following formula: ([VO2 cuff up - VO2 cuff down]/VO2 cuff up) x 100. An audible airleak associated with cuff deflation (group 1) caused a significant (p = .0012) reduction of VO2 by 45.6% (mean difference in VO2 = 45.6%). In contrast, with no audible airleak after cuff deflation (group 2), only minimal changes in VO2 (mean difference in VO2 = -0.4%) were observed. CONCLUSIONS:These data suggest that if no audible airleak is detected, VO2 determined by indirect calorimetry may be reliably measured in infants and children with a noncuffed endotracheal tube.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Chwals WJ,Lally KP,Woolley MM

doi

10.1097/00003246-199206000-00012

subject

Has Abstract

pub_date

1992-06-01 00:00:00

pages

768-70

issue

6

eissn

0090-3493

issn

1530-0293

journal_volume

20

pub_type

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