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  • 1
    Digitale Medien
    Digitale Medien
    A new device to remove obstruction from endotracheal tubes during mechanical ventilation in critically ill patients (1994)
    Springer
    Intensive care medicine 20 (1994), S. 573-576 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Mechanical ventilation ; Endotracheal tubes ; Obstruction ; Acute respiratory failure
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: 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; 1l/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 0.25l/s,p〈0.05; from 9±2.4 to 3.8±0.8 cmH2O/l/s at 0.51l/s; from 12.2±3.5 to 5.7±1.2 cmH2O/l/s at 0.75l/s; from 16.9±6 to 9.3±3.8 cmH2O/l/s at 1l/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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01705724
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  • 2
    Digitale Medien
    Digitale Medien
    Pressure support ventilation (PSV) reverses hyperinflation induced isorhythmic A-V dissociation (1989)
    Springer
    Intensive care medicine 15 (1989), S. 319-321 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Auto-PEEP ; COPD ; Pressure support ventilation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying “pressure support ventilation” (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasing the expiratory time reduced the level of auto-PEEP. In order to explain this result the Authors recorded, in the same patient, the level of auto-PEEP and ΔFRC obtained with Intermittent Positive Pressure Ventilation (IPPV), Intermittent Mandatory Ventilation (IMV) and PSV at the same gas exchange values. PSV showed a dramatic reduction of both these parameters. (Auto-PEEP: IPPV 12 cmH2O, IMV 17 cmH2O, PSV 7 cmH2O).
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00263868
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Auto-PEEP and dynamic hyperinflation in COPD patients during controlled mechanical ventilation and high frequency jet ventilation (1990)
    Springer
    Intensive care medicine 16 (1990), S. 81-84 
    Details
    ISSN: 1432-1238
    Schlagwort(e): COPD ; High frequency jet ventilation ; Auto-PEEP
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We investigated the levels of auto-PEEP and dynamic hyperinflation during high frequency jet ventilation (HFJV) and controlled mechanical ventilation (CMV) in six patients with chronic obstructive pulmonary disease within the first 36 h of acute exacerbation. The comparative evaluation was performed at similar conditions of gas exchange in HFJV and CMV: PaO2 77.6±11 mmHg vs 80.8±12 mmHg; PaCO2 46.8±2.5 mmHg vs 47±2.8 mmHg; pH 7.38 vs 7.38. In this situation, the values of auto-PEEP and dynamic hyperinflation, expressed as Δ over the apneic functional residual capacity (FRC) did not differ: (auto-PEEPHFJV 8.9±3.8 cmH2O; auto-PEEPCMV 8.8±4.7 cmH2O; ΔFRCHFJV 0.56±0.19 l; ΔFRCCMV 0.54±0.2 l). This result suggests that, with a suitable machine setting and similar gas exchanges, HFJV produces the same level of auto-PEEP and dynamic hyperinflation as CMV in patients with chronic obstructive pulmonary disease.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01699850
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