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Research ArticleOriginal Research

Tracheal Secretion Management in the Mechanically Ventilated Patient: Comparison of Standard Assessment and an Acoustic Secretion Detector

Alberto Lucchini, Alberto Zanella, Giacomo Bellani, Roberto Gariboldi, Giuseppe Foti, Antonio Pesenti and Roberto Fumagalli
Respiratory Care May 2011, 56 (5) 596-603; DOI: https://doi.org/10.4187/respcare.00909
Alberto Lucchini
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.
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Alberto Zanella
Department of Experimental Medicine, University of Milan-Bicocca, Monza, Italy.
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Giacomo Bellani
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.
Department of Experimental Medicine, University of Milan-Bicocca, Monza, Italy.
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Roberto Gariboldi
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.
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Giuseppe Foti
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.
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Antonio Pesenti
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.
Department of Experimental Medicine, University of Milan-Bicocca, Monza, Italy.
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Roberto Fumagalli
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.
Department of Experimental Medicine, University of Milan-Bicocca, Monza, Italy.
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  • Fig. 1.
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    Fig. 1.

    The TBA Care acoustic secretion detector module connects to a sensor at the Y-piece. When secretions are detected in the airway the module generates an acoustic and visual signal.

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    Fig. 2.

    Flow chart.

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    Fig. 3.

    Secretions collected during endotracheal suctioning, measured with a semi-quantitative method. 0 = no secretions collected (unnecessary suctioning), 1 = scarce, 2 = few, 3 = moderate, 4 = abundant. All the difference are statistically significant.

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    Fig. 4.

    Indications for the suctionings that collected no secretions.

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    Fig. 5.

    Indications for all the suctionings. Routine = scheduled suctioning, which occurred only in the control group, once per shift (ie, at least 3 times a day). Dyspnea = dyspnea or cough or apparent increased work of breathing Auscultation = coarse breath sounds on auscultation. > PIP = increased peak inspiratory pressure during volume controlled or pressure controlled volume guaranteed ventilation. < VT = decreased tidal volume during pressure controlled ventilation. Visible secretions = visible secretions in the endotracheal tube or ventilator circuit. < SpO2 = SpO2 decrease not otherwise explained. Other = clinical reasons other than the previous. In all the categories the difference was significant.

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    Fig. 6.

    Number of suctioning passes. The first 1, 2, or 3 passes were always with the closed suctioning system. If more than 3 passes were required, the operator changed to the open suctioning system. All the difference are statistically significant.

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    Fig. 7.

    Survival to extubation.

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Respiratory Care: 56 (5)
Respiratory Care
Vol. 56, Issue 5
1 May 2011
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Tracheal Secretion Management in the Mechanically Ventilated Patient: Comparison of Standard Assessment and an Acoustic Secretion Detector
Alberto Lucchini, Alberto Zanella, Giacomo Bellani, Roberto Gariboldi, Giuseppe Foti, Antonio Pesenti, Roberto Fumagalli
Respiratory Care May 2011, 56 (5) 596-603; DOI: 10.4187/respcare.00909

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Tracheal Secretion Management in the Mechanically Ventilated Patient: Comparison of Standard Assessment and an Acoustic Secretion Detector
Alberto Lucchini, Alberto Zanella, Giacomo Bellani, Roberto Gariboldi, Giuseppe Foti, Antonio Pesenti, Roberto Fumagalli
Respiratory Care May 2011, 56 (5) 596-603; DOI: 10.4187/respcare.00909
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Keywords

  • mechanical ventilation
  • endotracheal suctioning
  • secretion detector
  • secretion management
  • ventilator-associated pneumonia

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