Variación en la resistencia al flujo de los tubos endotraqueales pediátricos modificando su longitud

Autor: Ulloa, Maria Fernanda
Přispěvatelé: Kling Gómez, Juan Carlos
Jazyk: Spanish; Castilian
Rok vydání: 2015
Předmět:
Zdroj: E. Bautista, J. Lázaro, L. Domínguez JH. WOB FUNDAMENTO FISIOLOGICO.pdf. Rev la Asoc Mex Med crítica y Ter intensiva. 1996;x(4):171–80.
Slee TA, Sharar SR, Macintyre PE, Pavlin EG. The Effects of Airway Impedance on Work of Breathing during Halo thane Anesthesia. 1989;374–8.
Banner JM, Kirby RR, Blanch PB et al. Decreasing imposed work of breathing apparatus to zero using pressure support ventilation. Crit Care Med. 1993;21:1333–8.
Fine GF, Borland LM. The future of the cuffed endotracheal tube. Paediatr Anaesth [Internet]. 2004 Jan;14(1):38–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14717872
Keidan I1, Fine GF, Kagawa T, Schneck FX ME. Work of breathing during spontaneous ventilation in anesthetized children: a comparative study among the face mask, laryngeal mask airway and endotracheal tube. Anesth Analg. 2000;91(6):1381–99.
West JB. Fisología Respiratoria. Septima. Panamericana; 2005.
Whitelock DE1 de BD. The use of filters with small infants. Respir Care Clin N Am. 2006;12(3):307–20.
Raman V, Tobias JD, Bryant J, Rice J, Jatana K, Merz M, et al. Effect of cuffed and uncuffed endotracheal tubes on the oropharyngeal oxygen and volatile anesthetic agent concentration in children. Int J Pediatr Otorhinolaryngol [Internet]. Elsevier Ireland Ltd; 2012 Jun [cited 2014 Sep 17];76(6):842–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22444738
Eschertzhuber S, Salgo B, Schmitz a, Roth W, Frotzler a, Keller CH, et al. Cuffed endotracheal tubes in children reduce sevoflurane and medical gas consumption and related costs. Acta Anaesthesiol Scand [Internet]. 2010 Aug [cited 2014 Dec 15];54(7):855–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20560884
Dullenkopf a., Gerber a. C, Weiss M. Fit and seal characteristics of a new paediatric tracheal tube with high volume-low pressure polyurethane cuff. Acta Anaesthesiol Scand. 2005;49(2):232–7.
Weiss M, Dullenkopf a, Fischer JE, Keller C, Gerber a C. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth [Internet]. 2009 Dec [cited 2014 Dec 2];103(6):867–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19887533
Coté C, Lerman J TD. A practice of anesthesia for infants and children. 2009. 237-273 p.
Crawford MW, Arrica M, Macgowan CK YS. Extent and localization of changes in upper airway caliber with varying concentrations of sevoflurane in children. Anesthesiology. 2006;105:1147–52.
Crawford MW, Rohan D, Macgowan CK et al. Effect of propofol anes-thesia and continuous positive airway pressure on upper airway size and configuration in infants. Anesthesiology. 2006;(105):45–50.
Khine H, Corddry D, Kettrick R, Martin T, McCloskey J RJ. Comparison of cuffed and uncuffed endotracheal tubes in young children during general anaesthesia. Anesthesiology. 1997;86:627–31.
Steward D, Lerman J. Steward, DJ, Lerman, J, eds. Manual ofPediatric Anesthesia. Churchill Livingstone; 2001. 69-127 p.
Salgo B, Schmitz a., Henze G, Stutz K, Dullenkopf a., Neff S, et al. Evaluation of a new recommendation for improved cuffed tracheal tube size selection in infants and small children. Acta Anaesthesiol Scand. 2006;50(5):557–61.
Bhardwaj N. Pediatric cuffed endotracheal tubes. J Anaesthesiol Clin Pharmacol [Internet]. India: Medknow Publications & Media Pvt Ltd; 2013;29(1):13–8. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590525/
Weiss M. Shortcomings of cuffed paediatric tracheal tubes . Br J Anaesth [Internet]. 2004 Jan 1 [cited 2014 Sep 17];92(1):78–88. Available from: http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aeh023
Uejima T. Cuffed Endotracheal Tubes in Pediatric Patients. Anesth Analg. 1989;7:1989.
Main E, Castle R, Stocks J, Hames I HD. The influence of tracheal tube leak on the assessment of respiratory function in ventilated children. Intensive Care Med. 2001;27:1788–97.
Chang WP, Kau C HS. Exposure of anesthesiologists to nitrous oxide during pediatric anesthesia. Ind Heal. 1997;35:112–8.
Hoerauf KH, Wallner T, Akca O, Taslimi R S DI. Exposure to sevoflurane and nitrous oxide during four different methods of anesthetic induction. Anesth Analg. 1999;88(925-929).
Eschertzhuber S, Salgo B, Schmitz A, Roth W, Frotzler A KC. Cuffed endotracheal tubes in children reduce sevoflurane and medical gas consumption and related costs. Acta Anaesthesiol Scand. 2010;54:855–8.
Gopalareddy V, He Z, Sounder S, Bolling L, Shah M PS. Assessment of the prevalence of microaspiration by gastric pepsin in the airway of ventilated children. Acta Paediatr. 2008;97:55–60.
Browning DH GS. Incidence of aspiration with endotracheal tubes in children. J Pediatr. J Pediatr. 1983;102:582–4.
Tobias JD, Schwartz L, Rice J, Jatana K, Kang DR. Cuffed endotracheal tubes in infants and children: Should we routinely measure the cuff pressure? Int J Pediatr Otorhinolaryngol [Internet]. Elsevier Ireland Ltd; 2012 Jan [cited 2014 Sep 17];76(1):61–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22024576
Goldmann K. Recent developments in airway management of the paediatric patient. Curr Opin Anaesthesiol [Internet]. 2006 Jun;19(3):278–84. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16735811
Boerboom SL, Muthukrishnan SM, de Graaff JC, Jonker G. Cuffed or uncuffed endotracheal tubes in pediatric anesthesia: a survey of current practice in the United Kingdom and The Netherlands. Pediatr Anesth [Internet]. 2015;25(4):431–2. Available from: http://doi.wiley.com/10.1111/pan.12594
Rameshwar M, Nandini D, Madhu G. Use of Microcuff® endotracheal tubes in paediatric laparoscopic surgeries. Indian J Anaesth. 2015;59(2):85–8.
Tobias JD. Pediatric airway anatomy may not be what we thought: implications for clinical practice and the use of cuffed endotracheal tubes. Pediatr Anesth [Internet]. 2015;25(1):9–19. Available from: http://doi.wiley.com/10.1111/pan.12528
Oca M, Becker M, Dechert R, Donn S. Relationship of neonatal endotracheal tube size and airway resistance. Respir Care. 2002;47(9):994–7.
Weiss M, Gerber AC. Cuffed tracheal tubes in children--things have changed. Paediatr Anaesth. 2006;16(10):1005–7.
Repositorio EdocUR-U. Rosario
Universidad del Rosario
instacron:Universidad del Rosario
DOI: 10.1093/bja/aeh023
Popis: Introducción: Se conocen los beneficios del uso de los tubos endotraqueales con neumotaponador, aunque dicha práctica tiene un impacto sobre el trabajo respiratorio durante el acto anestésico sin embargo se propone estudiar las consecuencias físicas de la variación en la longitud de los tubos para compensar dicha perdida de flujo, con base en la ley de Hagen-Poiseuille. Metodología: Se realizó un estudio experimental in vitro, en el cual se realizaron mediciones repetidas de flujo, variando la longitud y diámetro de diferentes tubos endotraqueales pediátricos (desde calibre 3.5mm hasta 6.5mm), con longitudes de 20cm, 15 cm, 10 cm y manteniendo su longitud original. Se analizaron los datos con el fin de medir el impacto sobre el flujo. Resultados: A pesar que los resultados muestran diferencias estadísticamente significativas (p0,000), la variación en la longitud de los tubos endotraqueales pediátricos tiene mucho menor impacto sobre la variación en el flujo, que la modificación del diámetro. Discusión: Si bien la práctica de acortar la longitud de un tubo endotraqueal pediátrico puede ayudar a reducir el espacio muerto y la retención de CO2, el impacto que tiene sobre el flujo es poco. Cuando se trata de disminuir el trabajo respiratorio de un niño en ventilación espontánea durante el acto anestésico, se debe escoger de forma apropiada el calibre de tubo correspondiente para la edad. Introduction: The benefits of using endotracheal tubes with cuff are well-known, although this practice has an impact on the work of breathing during pediatric anesthesia; however, it´s intended to study the physical consequences of variation in the length of the tubes to compensate for the loss flow, based on the law of Hagen-Poiseuille. Methodology: An experimental study was conducted in vitro, in which repeated measurements of flow were performed, varying the length and diameter thereof, with pediatric endotracheal tubes of different sizes (from 3.5mm to 6.5mm), with lengths 20 cm, 15 cm, 10 cm and its original length. Data were analyzed to measure the impact on flow. Results: Although the results show significant differences statistically (p 0,000), the modification of the length of the endotracheal tubes has less effect on flow, compared to the impact that the change in diameter has on it. Discussion: Although the change in length of endotracheal tubes can help to reduce the death space and CO2 retention, the impact that it has on flow in minimal. When it comes about reducing the work of breathing of a child in spontaneous ventilation during general anesthesia, physicians must choose the proper diameter according to the age.
Databáze: OpenAIRE
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