Home ventilator low-pressure alarms fail to detect accidental decannulation with pediatric tracheostomy tubes.
| Autor: | Kun SS; Division of Pediatric Pulmonology, Childrens Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90027, USA., Nakamura CT, Ripka JF, Davidson Ward SL, Keens TG |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Chest [Chest] 2001 Feb; Vol. 119 (2), pp. 562-4. |
| DOI: | 10.1378/chest.119.2.562 |
| Abstrakt: | Background: Positive-pressure ventilators are equipped with low-inspiratory-pressure alarms to protect patients from hypoventilation. Small uncuffed tracheostomy tubes have a high resistance, and may not trigger these alarms during decannulation. Study Objective: To determine whether ventilator low-inspiratory-pressure alarms are effective in detecting tracheostomy decannulation. Design: We connected tracheostomy tubes of varying inner diameters (3.0 to 6.0 mm) to a home ventilator and simulated decannulation using low (tidal volume [VT], 600 mL; peak inspiratory pressure [PIP], 25 cm H(2)O), medium (VT, 800 mL; PIP, 30 cm H(2)O), and high (VT, 1,000 mL; PIP, 35 cm H(2)O) ventilator settings. Results: When the ventilator low-inspiratory-pressure alarm was set at 4 cm H(2)O below the desired PIP, it failed to alarm for simulated decannulation of tracheostomy tubes < 4.5 mm on low and medium settings, and < 4.0 mm on high settings. When the ventilator low-inspiratory-pressure alarm was set at 10 cm H(2)O below the desired PIP, it failed to alarm with tracheostomy tubes < 6.0 mm. Conclusion: We conclude that ventilator low-inspiratory-pressure alarms fail to alarm during simulated decannulation with small tracheostomy tubes commonly used in children. We speculate that low-inspiratory-pressure alarms set at 4 cm H(2)O below the desired PIP will detect more decannulation than when set at 10 cm H(2)O below the desired PIP. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|