Monitoring and humidification during tracheal gas insufflation.
نویسندگان
چکیده
In order to use tracheal gas insufflation (TGI) in a safe and effective manner, it is important to understand potential interactions between TGI and the mechanical ventilator that may impact upon gas delivery and carbon dioxide (CO2) elimination. Furthermore, potentially serious complications secondary to insufflation of cool, dry gas directly into the airway and the possibility of tube occlusion must be considered during use of this adjunct modality to mechanical ventilation. Regardless of the delivery modality (continuous TGI, expiratory TGI, reverse TGI, or bidirectional TGI), conventional respiratory monitoring is required. However, TGI with mechanical ventilation can alter tidal volume and peak inspiratory pressure and can lead to the development of intrinsic positive end-expiratory pressure. Therefore, depending on the gas delivery technique used, it is important to carefully monitor these ventilatory parameters for TGI-induced changes and understand the potential need for adjustments to ventilator settings to facilitate therapy and avoid problems. Optimally, gas insufflated by the TGI catheter should be conditioned by addition of heat and humidity to prevent mucus plug formation and potential damage to the tracheal mucosa. Finally, patients must be closely monitored for increases in peak inspiratory pressure from obstruction of the tracheal tube and should have the TGI catheter removed and inspected every 8-12 hours to assess for plugs.
منابع مشابه
Effect of tracheal gas insufflation during weaning from prolonged mechanical ventilation: a preliminary study.
BACKGROUND Tracheal gas insufflation reduces inspired tidal volume and minute ventilation in spontaneously breathing patients and may facilitate weaning from mechanical ventilation. OBJECTIVE To determine if tracheal gas insufflation can reduce ventilatory demand during weaning trials in patients who require prolonged mechanical ventilation. METHODS A reduction in ventilatory demand was def...
متن کاملGastric insufflation during IAC-CPR and standard CPR in a canine model.
This study was undertaken to determine the effect of interposed abdominal compressions (IAC) during cardiopulmonary resuscitation (CPR) on gastric insufflation when the airway is not secured with an endotracheal tube. A canine model was used in which a common ventilation pressure was applied to separate cuffed esophageal and tracheal tubes. Gas entering the stomach was collected by a pre-placed...
متن کاملExtremely low flow tracheal gas insufflation of helium-oxygen mixture improves gas exchange in a rabbit model of piston-type high-frequency oscillatory ventilation
OBJECTIVE The purpose of this study was to show the effects of the tracheal gas insufflation (TGI) technique on gas exchange using helium-oxygen mixtures during high-frequency oscillatory ventilation (HFOV). We hypothesized that a helium-oxygen mixture delivered into the trachea using the TGI technique (0.3 L/min) would enhance gas exchange during HFOV. METHODS Three rabbits were prepared and...
متن کاملCombination of tracheal gas insufflation and airway pressure release ventilation.
STUDY OBJECTIVE We hypothesized that the continuous gas flow administration delivered through an insufflation catheter positioned above the carina during airway pressure release ventilation (APRV) would facilitate carbon dioxide (CO2) elimination, resulting in normocarbia with a substantially reduced peak airway pressure (Paw). To test this hypothesis, we compared intermittent positive pressure...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Respiratory care
دوره 46 2 شماره
صفحات -
تاریخ انتشار 2001