Respiratory effects of tracheal gas insufflation in spontaneously breathing COPD patients

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dc.contributor.authorNakos, G.en
dc.contributor.authorLachana, A.en
dc.contributor.authorPrekates, A.en
dc.contributor.authorPneumatikos, J.en
dc.contributor.authorGuillaume, M.en
dc.contributor.authorPappas, K.en
dc.contributor.authorTsagaris, H.en
dc.date.accessioned2015-11-24T18:53:54Z
dc.date.available2015-11-24T18:53:54Z
dc.identifier.issn0342-4642-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/18623
dc.rightsDefault Licence-
dc.subjectAcute Diseaseen
dc.subjectAgeden
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectInsufflation/*methodsen
dc.subjectLung Diseases, Obstructive/*complicationsen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectOxygen Inhalation Therapy/*methodsen
dc.subjectProspective Studiesen
dc.subjectPulmonary Gas Exchangeen
dc.subjectRespiratory Insufficiency/etiology/physiopathology/*therapyen
dc.subjectTidal Volumeen
dc.subjectTracheostomyen
dc.subjectVentilator Weaning/*methodsen
dc.subject*Work of Breathingen
dc.titleRespiratory effects of tracheal gas insufflation in spontaneously breathing COPD patientsen
heal.abstractOBJECTIVE: To evaluate the effect of tracheal gas insufflation (TGI) in spontaneously breathing, intubated patients with chronic obstructive pulmonary disease (COPD) undergoing weaning from the mechanical ventilation. DESIGN: A prospective study in humans. SETTING: Polyvalent intensive care unit (14-bed ICU) in a 700-bed general university hospital. PATIENTS: Twelve patients with chronic obstructive pulmonary disease (COPD) who required intubation and mechanical ventilation were studied. All patients met standard criteria for weaning from mechanical ventilation. Seven patients (group 1) had been transorally intubated during episodes of acute respiratory failure. Five patients, all men (group 2), had previously undergone tracheostomy and had a transtracheal tube in place. INTERVENTIONS: Intratracheal, humidified, O2-mixture insufflation (TGI) was given via a catheter placed in distal or proximal position. Gas delivered through the intratracheal catheter was blended to match the fractional of inspired gas through the endotracheal tube. Continuous flows of 3 and 6 l/min in randomized order were used in each catheter position. Prior to data collection at each stage, an equilibration period of at least 30 min was observed, and thereafter blood gases were analyzed every 5 min. A new steady state was assumed to have been established when values of both PaCO2 and V CO2 changed by less than 5% between adjacent measurements. The last values of blood gases were taken as representative. The new steady state was confirmed within 35-50 min. Baseline measurements with zero Vcath were made at the beginning and end of the experiment. RESULTS: This study shows that VT, MV, PaCO2, and VD/VT are reduced in a flow-dependent manner when gas is delivered through an oral-tracheal tube (group 1). The distal catheter position was more effective than the proximal one. In contrast, when gas was delivered through tracheostomy (group 2), TGI was ineffective in the proximal position and less effective than in group 1 in distal position. CONCLUSION: Under the experimental conditions, tracheal gas insufflation decreased dead space, increased alveolar ventilation and possibly reduced work of breathing. From the preliminary data reported here, we believe that TGI may help patients experiencing difficulty during weaning.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/8636522-
heal.identifier.secondaryhttp://www.springerlink.com/content/u6t07h50157031r5/fulltext.pdf-
heal.journalNameIntensive Care Meden
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate1995-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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