Evaluation of Endotracheal Tube Scraping on Airway Resistance
| Autor: | J Brady Scott, Kyle R Jendral, Gagan Singh, Robert A. Balk, Adewunmi S Sulaiman, David Gurka, David L Vines, Meagan N Dubosky, Ankeet Patel, Carl A Kaplan |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Spontaneous breathing trial 03 medical and health sciences Work of breathing 0302 clinical medicine Airway resistance medicine Intubation Intratracheal Humans 030212 general & internal medicine Decontamination Endotracheal tube Work of Breathing Mechanical ventilation business.industry Airway Resistance General Medicine Airway obstruction medicine.disease Respiration Artificial Surgery Mucus 030228 respiratory system Anesthesia Biofilms Breathing business Ventilator Weaning Clearance |
| Zdroj: | Respiratory care. 62(11) |
| ISSN: | 1943-3654 |
| Popis: | BACKGROUND: Spontaneous breathing trials (SBTs) are used to assess the readiness for discontinuation of mechanical ventilation. When airway resistance (Raw) is elevated, the imposed work of breathing can lead to prolongation of mechanical ventilation. Biofilm and mucus build-up within the endotracheal tube (ETT) can increase Raw. Scraping the ETT can remove the biofilm build-up and decrease mechanical Raw. The primary aim of this study was to evaluate the impact of ETT scraping on Raw. The secondary aim was to determine whether decreasing Raw would impact subsequent SBT success. METHODS: Intubated, mechanically ventilated subjects were enrolled if they failed an SBT and had an Raw of > 10 cm H2O/L/s. SBT failure was based on institutional guidelines, and Raw was calculated by subtracting the difference between the measured peak and plateau pressures using a square flow waveform with an inspiratory flow set at 60 L/min. The endOclear device was inserted into the ETT and withdrawn per manufacturer9s guidelines. Scraping was repeated until the ETT was cleared. Change in Raw was compared pre- and post-ETT scraping using a paired t test. A Mann-Whitney U test evaluated the difference in percentage change in Raw between SBT groups. RESULTS: Twenty-nine subjects completed the study. The mean pre- and post-ETT scraping Raw values were 15.17 ± 3.83 and 12.05 ± 3.19 cm H2O/L/s, respectively (P CONCLUSIONS: This study demonstrated that ETT scraping can reduce Raw. The decrease in Raw post-ETT scraping did not affect subsequent SBT success. |
| Databáze: | OpenAIRE |
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