Chest
Clinical Investigations in Critical CareMucociliary Transport in ICU Patients
Section snippets
Determination of BTV
To measure BTV, we used a method based on that of Chopra et al8 who had determined the motion of a radioactive bolus in the trachea. The measurement of transport velocity in the trachea of intubated patients presents a problem, since the distance from the distal end of the trachea to the tip of the tube and thus the measuring distance can in some cases be very short.9 For this reason, we decided to measure the transport velocity in the right and left primary bronchus. The measurements were
Bronchial Transport Velocities
Table 1 provides information about diagnoses or operations, respectively. Demographic data, medication, duration of mechanical ventilation (MV) up to the time of measurement, APACHE II score,17 and BTV are listed in Table 2. The median BTV in the right primary bronchus was 0.8 mm/min and in the left it was 1.4 mm/min. In 9 of 32 patients studied, both radioactive drops remained at the application site. In these patients, a further measurement was performed 1 h later. Once again, no transport
Discussion
In man, the average tracheal transport velocity using bronchofiberscopic methods is reported to be about 10 mm/min.18 We determined the transport velocity in both primary bronchi, not in the trachea, in order to avoid methodical errors, specifically related to intubated patients. Depending on the anatomic conditions, the distance from the distal end of the trachea to the tip of the tube, and thus the measuring distance, can be very short.9 In addition, mucus transport presumably ends at the
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