Distal projection of insufflated gas during tracheal gas insufflation.

نویسندگان

  • Christopher S Carter
  • John R Hotchkiss
  • Alexander B Adams
  • Mary K Stone
  • John J Marini
چکیده

Tracheal gas insufflation (TGI) flushes expired gas from the ventilator circuitry and central airways, augmenting CO2 clearance. Whereas a significant portion of this washout effect may occur distal to the injection orifice, the penetration and mixing behavior of TGI gas has not been studied experimentally. We examined the behavior of 100% oxygen TGI injected at set flow rates of 1-20 l/min into a simulated trachea consisting of a smooth-walled, 14-mm-diameter tube. Models incorporating a separate coaxial TGI injector, a rough-walled trachea, and a bifurcated trachea were also studied. One-hundred percent nitrogen, representing expiratory flow, passed in the direction opposite to TGI at set flow rates of 1-25 l/min. Oxygen concentration within the "trachea" was mapped as a function of axial and radial position. Three consistent findings were observed: 1) mixing of expiratory and TGI gases occurred close to the TGI orifice; 2) the oxygenated domain extended several centimeters beyond the endotracheal tube, even at high-expiratory flows, but had a defined distal limit; and 3) more distally from the site of gas injection, the TGI gas tended to propagate along the tracheal wall, rather than as a central projection. We conclude that forward-directed TGI penetrates a substantial distance into the central airways, extending the compartment susceptible to CO2 washout.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Monitoring and humidification during tracheal gas insufflation.

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 occlusi...

متن کامل

Severe hypoxaemia in field-anaesthetised white rhinoceros (Ceratotherium simum) and effects of using tracheal insufflation of oxygen.

White rhinoceros anaesthetised with etorphine and azaperone combination develop adverse physiological changes including hypoxia, hypercapnia, acidosis, tachycardia and hypertension. These changes are more marked in field-anaesthetised rhinoceros. This study was designed to develop a technique to improve safety for field-anaesthetised white rhinoceros by tracheal intubation and oxygen insufflati...

متن کامل

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 کامل

Equipment review: Tracheal gas insufflation

47cc-2-2-043 Introduction Tracheal gas insufflation (TGI) is an adjunctive ventilatory technique that delivers fresh gas into the trachea either continuosly or only during a specific segment of the respiratory cycle (phasic flow) [1-4]. Two mechanisms are responsible for improving the efficacy of conventional tidal breaths during TGI [5-7]. First, fresh gas introduced by the catheter during exp...

متن کامل

Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs

Carbon dioxide embolism is a rare but potentially devastating complication of laparoscopy. To determine the effects of insufflation pressure on the mortality from carbon dioxide embolism, six swine had intravascular insufflation with carbon dioxide for 30 seconds using a Karl Storz insufflator at a flow rate of 35 mL/kg/min. The initial insufflation pressure was 15 mm Hg. Following recovery fro...

متن کامل

ذخیره 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 نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of applied physiology

دوره 92 5  شماره 

صفحات  -

تاریخ انتشار 2002