Chest
Clinical Investigations in Critical CareEffects of Tracheal Suctioning on Respiratory Resistances in Mechanically Ventilated Patients
Section snippets
MATERIALS AND METHODS
Thirteen ICU patients requiring MV for various conditions were studied. The investigation was conducted according to the local ethics committee guidelines, and informed consent was obtained from each patient or relative.
All patients were sedated with IV midazolam and fentanyl. They were well adapted to the ventilator and no triggering activity was detected.
MV was performed through a cuffed translaryngeal tube or through a tracheostomy tube. MV was achieved in a volumecontrolled mode with a
RESULTS
Demographic data regarding the patients in the study are summarized in Table 1.
R1 increased from 7.6±5.0 to 10.4±7.0 cm H2O/L/s (p<0.01) and R2 from 10.9±5.2 to 15.3±7.1 cm H2O/L/S (p<0.01) 0.5 min after tracheal suction (Table 2). R1 and R2 returned to baseline values 1 min following suction without any change thereafter. There was no change in the (R2-R1)/R2 ratio during the 30 min recording, suggesting that the increase in R1 paralleled this in R2.
PEEPint dropped from 3.70±4.10 cm H2O at
DISCUSSION
In this study, we found that TS evoked a potent bronchoconstrictor response for a short period. Indeed, R1 and R2 increased >45%, 30 s following this procedure but returned to baseline values 1 min later. More surprisingly, respiratory resistances did not decrease below presuctioning values thereafter, as could have been expected, even on the late recordings (Table 2). Dohi and Gold13 reported a similar evolution of respiratory resistances following mechanical stimulation of the trachea with a
ACKNOWLEDGMENTS
The authors wish to thank Dr. Eric Maury (Medical ICU, Saint-Antoine Hospital, Paris, France) for his critical review of the manuscript.
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