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Volume Not Guaranteed: Closed Endotracheal Suction Compromises Ventilation in Volume-Targeted Mode

Citation

Kiraly, NJ and Tingay, DG and Mills, JF and Dargaville, PA and Copnell, B, Volume Not Guaranteed: Closed Endotracheal Suction Compromises Ventilation in Volume-Targeted Mode, Neonatology, 99, (1) pp. 78-82. ISSN 1661-7800 (2011) [Refereed Article]


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Copyright Statement

Copyright 2010 S. Karger AG, Basel

DOI: doi:10.1159/000316854

Abstract

Background: Closed endotracheal suction interferes with mechanical ventilation received by infants, but the change to ventilation may be different when ventilator modes that target expired tidal volume (V T e ) are used. Objective: To measure airway pressure and tidal volume distal to the endotracheal tube (ETT) during and after closed suction in a volume-targeted ventilation mode with the Dräger Babylog 8000+, and to determine the time until V T e returns to the baseline level. Methods: In this benchtop study, closed suction was performed on 2.5- to 4.0-mm ETTs connected to a test lung. 5–8 French suction catheters were used at suction pressures of 80–200 mm Hg during tidal-volume-targeted ventilation. Results: During catheter insertion and suction, circuit inflating pressure increased and tidal volume was maintained, except when a large catheter relative to the ETT was used, in which case tidal volume decreased. End-expira- tory pressure distal to the ETT was reduced during suction by up to 75 cm H 2 O while circuit end-expiratory pressure was unchanged. Reduction in end-expiratory pressure distal to the ETT was greatest with large catheters and high suction pressures. Following suction, circuit and tracheal inflat - ing pressures increased and tidal volume increased before returning to baseline in 8–12 s. Conclusions: Closed endotracheal suction interferes with ventilator function in volumetargeted mode, with substantially negative intra tracheal pressure during suction, and the potential for high airway pressures and tidal volumes following the procedure. These effects should be considered and pressure limits set appropriately whenever using volume-targeted ventilation.

Item Details

Item Type:Refereed Article
Keywords:Endotracheal suction; Mechanical ventilation; Neonatal intensive care; Newborn infant
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Dargaville, PA (Professor Peter Dargaville)
ID Code:78058
Year Published:2011
Web of Science® Times Cited:5
Deposited By:Menzies Institute for Medical Research
Deposited On:2012-06-13
Last Modified:2012-08-30
Downloads:1 View Download Statistics

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