A fibre optics system for the evaluation of airway pressure in mechanically ventilated patients

The present study was intended to evaluate the "in vivo" endotracheal (ET) tube resistance and respiratory mechanics in mechanically ventilated patients with respiratory failure by using fiber optic catheters. Two fiber optic catheters, consisting of a thin probe with a pressure transducer...

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Veröffentlicht in:Intensive care medicine 1992-07, Vol.18 (7), p.405-409
Hauptverfasser: DE BLASI, R. A, CONTI, G, ANTONELLI, M, BUFI, M, GASPARETTO, A
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creator DE BLASI, R. A
CONTI, G
ANTONELLI, M
BUFI, M
GASPARETTO, A
description The present study was intended to evaluate the "in vivo" endotracheal (ET) tube resistance and respiratory mechanics in mechanically ventilated patients with respiratory failure by using fiber optic catheters. Two fiber optic catheters, consisting of a thin probe with a pressure transducer on the tip, were used. The first was placed at the proximal side of the ET tube and the second was positioned distally beyond the end. A low compliant air-filled catheter connected to a traditional pressure transducer was placed close to the proximal fiber optic device to compare the pressure values obtained with both systems. The study was performed in the General Intensive Care Unit of Rome "La Sapienza", University Hospital. Seven patients admitted for the management of acute respiratory failure of different etiologies were included in the protocol. All the patients were intubated and mechanically ventilated for at least 48 h prior to the investigation. The endotracheal tube resistance was obtained both by the end-inspiratory occlusion method and measuring pressure proximally and distally to the ET tube. The measurement of respiratory mechanics was obtained proximally and distally to the ET tube. Different flows and tidal volume changes were performed. The results showed that the fiber optic device gives an adequate evaluation of airway pressure and the possibility for an easy detection of obstructions and/or deformations of the ET tube. The area described by inspiratory and expiratory pressure recorded at both sides of the ET tube showed a positive relationship between the surface and flows while no surface changes were shown when the tidal volumes were modified. Thoraco-pulmonary compliance measured proximally and distally to the ET tube gave rise to a small and statistically insignificant difference. This study confirms that 48 h after the positioning of ET tubes the airflow resistance is significantly higher than might be expected from the "in vitro" data. The presence of the endotracheal tube can interfere with the evaluation of thoraco-pulmonary mechanics, particularly in dynamic conditions. The fiber optic system represents an interesting and simple tool for the evaluation of ET tube resistance and pulmonary mechanics in patients undergoing mechanical ventilation.
doi_str_mv 10.1007/BF01694342
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Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive respiratory care</topic><topic>Evaluation Studies as Topic</topic><topic>Female</topic><topic>Fiber Optic Technology - instrumentation</topic><topic>Fiber Optic Technology - methods</topic><topic>Fiber Optic Technology - standards</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Least-Squares Analysis</topic><topic>Linear Models</topic><topic>Lung Compliance</topic><topic>Male</topic><topic>Manometry - instrumentation</topic><topic>Manometry - methods</topic><topic>Manometry - standards</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Optical Fibers</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Respiration, Artificial - standards</topic><topic>Respiratory Insufficiency - physiopathology</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Respiratory Mechanics</topic><topic>Rheology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DE BLASI, R. 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A low compliant air-filled catheter connected to a traditional pressure transducer was placed close to the proximal fiber optic device to compare the pressure values obtained with both systems. The study was performed in the General Intensive Care Unit of Rome "La Sapienza", University Hospital. Seven patients admitted for the management of acute respiratory failure of different etiologies were included in the protocol. All the patients were intubated and mechanically ventilated for at least 48 h prior to the investigation. The endotracheal tube resistance was obtained both by the end-inspiratory occlusion method and measuring pressure proximally and distally to the ET tube. The measurement of respiratory mechanics was obtained proximally and distally to the ET tube. Different flows and tidal volume changes were performed. The results showed that the fiber optic device gives an adequate evaluation of airway pressure and the possibility for an easy detection of obstructions and/or deformations of the ET tube. The area described by inspiratory and expiratory pressure recorded at both sides of the ET tube showed a positive relationship between the surface and flows while no surface changes were shown when the tidal volumes were modified. Thoraco-pulmonary compliance measured proximally and distally to the ET tube gave rise to a small and statistically insignificant difference. This study confirms that 48 h after the positioning of ET tubes the airflow resistance is significantly higher than might be expected from the "in vitro" data. The presence of the endotracheal tube can interfere with the evaluation of thoraco-pulmonary mechanics, particularly in dynamic conditions. The fiber optic system represents an interesting and simple tool for the evaluation of ET tube resistance and pulmonary mechanics in patients undergoing mechanical ventilation.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>1469178</pmid><doi>10.1007/BF01694342</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Airway Resistance
Analysis of Variance
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Emergency and intensive respiratory care
Evaluation Studies as Topic
Female
Fiber Optic Technology - instrumentation
Fiber Optic Technology - methods
Fiber Optic Technology - standards
Humans
Intensive care medicine
Intensive Care Units
Least-Squares Analysis
Linear Models
Lung Compliance
Male
Manometry - instrumentation
Manometry - methods
Manometry - standards
Medical sciences
Middle Aged
Optical Fibers
Respiration, Artificial - adverse effects
Respiration, Artificial - standards
Respiratory Insufficiency - physiopathology
Respiratory Insufficiency - therapy
Respiratory Mechanics
Rheology
title A fibre optics system for the evaluation of airway pressure in mechanically ventilated patients
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