PT - JOURNAL ARTICLE AU - Ben Downs AU - Denise Willis AU - Ariel Berlinski TI - Oxygen Delivery Methods in a Model of a Spontaneously Breathing Tracheostomized Child DP - 2020 Oct 01 TA - Respiratory Care PG - 3441782 VI - 65 IP - Suppl 10 4099 - http://rc.rcjournal.com/content/65/Suppl_10/3441782.short 4100 - http://rc.rcjournal.com/content/65/Suppl_10/3441782.full AB - Background: Heated tracheostomy collar (HTC) with different interfaces (direct connection or tracheostomy mask) is used to provide humidification of inspired air to spontaneously breathing tracheostomized children. At our hospital we use a HTC with a blender system (FIO2 0.21). If supplemental O2 is needed, low flow O2 (FIO2 1.0) is given through a tracheostomy ring (t-ring). This is done in the event the HTC circuit becomes disconnected. Sometimes, despite using a maximum flow, the desired O2 saturation is not achieved. We hypothesized increasing the FIO2from the blender, using a direct connection interface, and increasing t-ring flow would result in higher tracheal FIO2s. Methods: We used a model of a spontaneously breathing tracheostomized child consisting of a 4.0 pediatric tracheostomy tube with cuff inflated (Bivona TTS) inserted into a tracheal model connected in series to a t-piece with O2 analyzer (tracheal FIO2), a filter and a breathing simulator (RR 30, VT 140 mL, I-time 0.7 seconds). Oxygen was delivered through a t-ring attached to the tracheostomy (0-4 L/min), the HTC (15 L/min) at different FIO2s, or with both. We tested 2 different interfaces: a direct connection adapter and a tracheostomy mask. Tracheal FIO2was recorded after 5 minutes and each experiment was repeated 4 times. Interfaces were compared with T-test, and effect of flows and FIO2s were compared with ANOVA. A P < .05 was considered statistically significant. Results: The direct connect provided higher tracheal FIO2s than trach mask in most occasions. Increasing t-ring O2 flow and increasing HTC FIO2 increased tracheal FIO2. Conclusions: The HTC used with blender FIO2alone achieved higher tracheal Fi02s than the t-ring in a model of spontaneously breathing tracheostomized child. Increasing t-ring flow increased tracheal FIO2 with HTC FIO2 of 1. The addition of the t-ring O2flow to blender FIO2provided only minimal increases in FIO2. When the blender was set to deliver 1.0 FIO2, the addition of t-ring flow had no impact. In general, there were no significant differences in FIO2between interfaces. View this table:Results (X ± SD)