Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation
Tracheotomy is widely performed in the intensive care unit after long-term oral intubation. The present study investigates the immediate influence of tracheotomy on respiratory mechanics and blood gases during mechanical ventilation. Tracheotomy was performed in 32 orally intubated patients for 10.5...
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| Veröffentlicht in: | Critical care (London, England) England), 2004-08, Vol.8 (4), p.R243-R247, Article R243 |
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| creator | Amygdalou, Argyro Dimopoulos, George Moukas, Markos Katsanos, Christos Katagi, Athina Mandragos, Costas Constantopoulos, Stavros H Behrakis, Panagiotis K Vassiliou, Miltos P |
| description | Tracheotomy is widely performed in the intensive care unit after long-term oral intubation. The present study investigates the immediate influence of tracheotomy on respiratory mechanics and blood gases during mechanical ventilation.
Tracheotomy was performed in 32 orally intubated patients for 10.5 +/- 4.66 days (all results are means +/- standard deviations). Airway pressure, flow and arterial blood gases were recorded immediately before tracheotomy and half an hour afterwards. Respiratory system elastance (Ers), resistance (Rrs) and end-expiratory pressure (EEP) were evaluated by multiple linear regression. Respiratory system reactance (Xrs), impedance (Zrs) and phase angle (phirs) were calculated from Ers and Rrs. Comparisons of the mechanical parameters, blood gases and pH were performed with the aid of the Wilcoxon signed-rank test (P = 0.05).
Ers increased (7 +/- 11.3%, P = 0.001), whereas Rrs (-16 +/- 18.4%, P = 0.0003), Xrs (-6 +/- 11.6%, P = 0.006) and phi rs (-14.3 +/- 16.8%, P = |
| doi_str_mv | 10.1186/cc2886 |
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Tracheotomy was performed in 32 orally intubated patients for 10.5 +/- 4.66 days (all results are means +/- standard deviations). Airway pressure, flow and arterial blood gases were recorded immediately before tracheotomy and half an hour afterwards. Respiratory system elastance (Ers), resistance (Rrs) and end-expiratory pressure (EEP) were evaluated by multiple linear regression. Respiratory system reactance (Xrs), impedance (Zrs) and phase angle (phirs) were calculated from Ers and Rrs. Comparisons of the mechanical parameters, blood gases and pH were performed with the aid of the Wilcoxon signed-rank test (P = 0.05).
Ers increased (7 +/- 11.3%, P = 0.001), whereas Rrs (-16 +/- 18.4%, P = 0.0003), Xrs (-6 +/- 11.6%, P = 0.006) and phi rs (-14.3 +/- 16.8%, P = <0.001) decreased immediately after tracheotomy. EEP, Zrs, blood gases and pH did not change significantly.
Lower Rrs but also higher Ers were noted immediately after tracheotomy. The net effect is a non-significant change in the overall Rrs (impedance) and the effectiveness of respiratory function. The extra dose of anaesthetics (beyond that used for sedation at the beginning of the procedure) or a higher FiO2 (fraction of inspired oxygen) during tracheotomy or aspiration could be related to the immediate elastance increase.</description><identifier>ISSN: 1364-8535</identifier><identifier>EISSN: 1466-609X</identifier><identifier>EISSN: 1364-8535</identifier><identifier>DOI: 10.1186/cc2886</identifier><identifier>PMID: 15312224</identifier><language>eng</language><publisher>England: National Library of Medicine - MEDLINE Abstracts</publisher><subject>Adult ; Aged ; Airway Resistance - physiology ; Blood Gas Analysis ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Monitoring, Physiologic ; Postoperative Period ; Regression Analysis ; Respiration, Artificial ; Respiratory Mechanics ; Tidal Volume - physiology ; Tracheotomy ; Treatment Outcome ; Work of Breathing - physiology</subject><ispartof>Critical care (London, England), 2004-08, Vol.8 (4), p.R243-R247, Article R243</ispartof><rights>Copyright National Library of Medicine - MEDLINE Abstracts Aug 2004</rights><rights>Copyright © 2004 Amygdalou et al.; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b440t-18fda581d1826a0d4462667a526c09d58dae52ff67fe43c67f824fe63e4a35403</citedby><cites>FETCH-LOGICAL-b440t-18fda581d1826a0d4462667a526c09d58dae52ff67fe43c67f824fe63e4a35403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC522848/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC522848/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15312224$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amygdalou, Argyro</creatorcontrib><creatorcontrib>Dimopoulos, George</creatorcontrib><creatorcontrib>Moukas, Markos</creatorcontrib><creatorcontrib>Katsanos, Christos</creatorcontrib><creatorcontrib>Katagi, Athina</creatorcontrib><creatorcontrib>Mandragos, Costas</creatorcontrib><creatorcontrib>Constantopoulos, Stavros H</creatorcontrib><creatorcontrib>Behrakis, Panagiotis K</creatorcontrib><creatorcontrib>Vassiliou, Miltos P</creatorcontrib><title>Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation</title><title>Critical care (London, England)</title><addtitle>Crit Care</addtitle><description>Tracheotomy is widely performed in the intensive care unit after long-term oral intubation. The present study investigates the immediate influence of tracheotomy on respiratory mechanics and blood gases during mechanical ventilation.
Tracheotomy was performed in 32 orally intubated patients for 10.5 +/- 4.66 days (all results are means +/- standard deviations). Airway pressure, flow and arterial blood gases were recorded immediately before tracheotomy and half an hour afterwards. Respiratory system elastance (Ers), resistance (Rrs) and end-expiratory pressure (EEP) were evaluated by multiple linear regression. Respiratory system reactance (Xrs), impedance (Zrs) and phase angle (phirs) were calculated from Ers and Rrs. Comparisons of the mechanical parameters, blood gases and pH were performed with the aid of the Wilcoxon signed-rank test (P = 0.05).
Ers increased (7 +/- 11.3%, P = 0.001), whereas Rrs (-16 +/- 18.4%, P = 0.0003), Xrs (-6 +/- 11.6%, P = 0.006) and phi rs (-14.3 +/- 16.8%, P = <0.001) decreased immediately after tracheotomy. EEP, Zrs, blood gases and pH did not change significantly.
Lower Rrs but also higher Ers were noted immediately after tracheotomy. The net effect is a non-significant change in the overall Rrs (impedance) and the effectiveness of respiratory function. The extra dose of anaesthetics (beyond that used for sedation at the beginning of the procedure) or a higher FiO2 (fraction of inspired oxygen) during tracheotomy or aspiration could be related to the immediate elastance increase.</description><subject>Adult</subject><subject>Aged</subject><subject>Airway Resistance - physiology</subject><subject>Blood Gas Analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>Postoperative Period</subject><subject>Regression Analysis</subject><subject>Respiration, Artificial</subject><subject>Respiratory Mechanics</subject><subject>Tidal Volume - physiology</subject><subject>Tracheotomy</subject><subject>Treatment Outcome</subject><subject>Work of Breathing - physiology</subject><issn>1364-8535</issn><issn>1466-609X</issn><issn>1364-8535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UU1rHDEMNSEhX21_QjE55Datv9dzyCGEpAkEekkgN-P1yFmHmfHU9izsv6_DLt2m0JOE3nuSnoTQF0q-UarVd-eY1uoAnVKhVKNI-3JYc65EoyWXJ-gs5zdC6EIrfoxOqOSUMSZOETwMA3TBFsBTzKWJEyRbwhoweA-uZBw9Lsm6FcQShw2OI06Qp1BZMW2wn0dXQi12cwrjKx7ArewYnO3xGsYSevuOfkJH3vYZPu_iOXq-u326uW8ef_54uLl-bJZCkNJQ7TsrNe2oZsqSTgjFlFpYyZQjbSd1Z0Ey79XCg-CuBs2EB8VBWC4F4efoatt3mpfVlqsbJNubKYXBpo2JNpiPyBhW5jWujWRMC1317Va_DPE_-o-Ii4PZnr5qL3ezU_w1Qy5mCNlB39sR4pxNNdIyThaVePEP8S3Oaax3MbSVQmhJ-b6bSzHnBP7PEpSY94_vx3792_Ketnsx_w3cH6qk</recordid><startdate>20040801</startdate><enddate>20040801</enddate><creator>Amygdalou, Argyro</creator><creator>Dimopoulos, George</creator><creator>Moukas, Markos</creator><creator>Katsanos, Christos</creator><creator>Katagi, Athina</creator><creator>Mandragos, Costas</creator><creator>Constantopoulos, Stavros H</creator><creator>Behrakis, Panagiotis K</creator><creator>Vassiliou, Miltos P</creator><general>National Library of Medicine - MEDLINE Abstracts</general><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20040801</creationdate><title>Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation</title><author>Amygdalou, Argyro ; Dimopoulos, George ; Moukas, Markos ; Katsanos, Christos ; Katagi, Athina ; Mandragos, Costas ; Constantopoulos, Stavros H ; Behrakis, Panagiotis K ; Vassiliou, Miltos P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b440t-18fda581d1826a0d4462667a526c09d58dae52ff67fe43c67f824fe63e4a35403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Airway Resistance - physiology</topic><topic>Blood Gas Analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>Postoperative Period</topic><topic>Regression Analysis</topic><topic>Respiration, Artificial</topic><topic>Respiratory Mechanics</topic><topic>Tidal Volume - physiology</topic><topic>Tracheotomy</topic><topic>Treatment Outcome</topic><topic>Work of Breathing - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amygdalou, Argyro</creatorcontrib><creatorcontrib>Dimopoulos, George</creatorcontrib><creatorcontrib>Moukas, Markos</creatorcontrib><creatorcontrib>Katsanos, Christos</creatorcontrib><creatorcontrib>Katagi, Athina</creatorcontrib><creatorcontrib>Mandragos, Costas</creatorcontrib><creatorcontrib>Constantopoulos, Stavros H</creatorcontrib><creatorcontrib>Behrakis, Panagiotis K</creatorcontrib><creatorcontrib>Vassiliou, Miltos P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Critical care (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amygdalou, Argyro</au><au>Dimopoulos, George</au><au>Moukas, Markos</au><au>Katsanos, Christos</au><au>Katagi, Athina</au><au>Mandragos, Costas</au><au>Constantopoulos, Stavros H</au><au>Behrakis, Panagiotis K</au><au>Vassiliou, Miltos P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation</atitle><jtitle>Critical care (London, England)</jtitle><addtitle>Crit Care</addtitle><date>2004-08-01</date><risdate>2004</risdate><volume>8</volume><issue>4</issue><spage>R243</spage><epage>R247</epage><pages>R243-R247</pages><artnum>R243</artnum><issn>1364-8535</issn><eissn>1466-609X</eissn><eissn>1364-8535</eissn><abstract>Tracheotomy is widely performed in the intensive care unit after long-term oral intubation. The present study investigates the immediate influence of tracheotomy on respiratory mechanics and blood gases during mechanical ventilation.
Tracheotomy was performed in 32 orally intubated patients for 10.5 +/- 4.66 days (all results are means +/- standard deviations). Airway pressure, flow and arterial blood gases were recorded immediately before tracheotomy and half an hour afterwards. Respiratory system elastance (Ers), resistance (Rrs) and end-expiratory pressure (EEP) were evaluated by multiple linear regression. Respiratory system reactance (Xrs), impedance (Zrs) and phase angle (phirs) were calculated from Ers and Rrs. Comparisons of the mechanical parameters, blood gases and pH were performed with the aid of the Wilcoxon signed-rank test (P = 0.05).
Ers increased (7 +/- 11.3%, P = 0.001), whereas Rrs (-16 +/- 18.4%, P = 0.0003), Xrs (-6 +/- 11.6%, P = 0.006) and phi rs (-14.3 +/- 16.8%, P = <0.001) decreased immediately after tracheotomy. EEP, Zrs, blood gases and pH did not change significantly.
Lower Rrs but also higher Ers were noted immediately after tracheotomy. The net effect is a non-significant change in the overall Rrs (impedance) and the effectiveness of respiratory function. The extra dose of anaesthetics (beyond that used for sedation at the beginning of the procedure) or a higher FiO2 (fraction of inspired oxygen) during tracheotomy or aspiration could be related to the immediate elastance increase.</abstract><cop>England</cop><pub>National Library of Medicine - MEDLINE Abstracts</pub><pmid>15312224</pmid><doi>10.1186/cc2886</doi><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central (Open Access); SpringerOpen; MEDLINE; DOAJ Directory of Open Access Journals; Alma/SFX Local Collection; EZB Electronic Journals Library; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Airway Resistance - physiology Blood Gas Analysis Female Humans Intensive Care Units Male Middle Aged Monitoring, Physiologic Postoperative Period Regression Analysis Respiration, Artificial Respiratory Mechanics Tidal Volume - physiology Tracheotomy Treatment Outcome Work of Breathing - physiology |
| title | Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation |
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