Use of siliconised infant endotracheal tubes reduces work of breathing under turbulent flow

• Autorzy: Stankiewicz B. , Rawicz M. , Darowski M. , Zielinski K. , Kozarski M. , Chwojnowski A.

Identyfikatory

DOI

10.1016/j.bbe.2016.11.002

• Języki publikacji: EN

Abstrakty

EN

The high resistance of an infant endotracheal tube (ETT) can markedly impair ventilation and gas exchange. Since some manufacturers cover the inner surface of their ETTs with a silicon layer in order to diminish deposition and ease mucous evacuation from airway, via surface roughness decrease, we assessed whether the silicon layer may affect tube resistance, work of breathing and other parameters of ventilation. We compared SUMI (Poland) non-siliconised and siliconised polyvinyl chloride ETTs (2.5, 3.0 and 4.0 mm ID), twenty of each type and size combination. Simulating volume-controlled ventilation with the hybrid (numerical–physical) lung models of a premature infant and a 3-month-old baby peak inspiratory pressure (PIP), peak inspiratory and expiratory flow (PIF, PEF), (patient + ETT) inspiratory and expiratory airway resistance (Rins, Rexp) and work of breathing by ventilator (WOB_vt) were measured. Additionally, images of the both type surfaces were taken using Hitachi TM-1000 electron microscope. When 2.5 and 3.0 mm ID ETTs were examined, laminar flow (Re <2300) across the tube was observed, and there were no clinically significant differences in the ventilation param-eters between non-siliconised and siliconised tubes. Whereas, when 4 mm ID ETTs were tested, turbulent flow was observed, and PIP, R_ins, R_exp and WOB_vt were significantly lower (5%, 17%, 17%, and 7%, respectively) (P < 0.05), but PIF and PEF were significantly higher (8%, 14%) (P < 0.05). Thus, the silicone inner surface of ETT offers less resistance and WOB_vt in presence of turbulent flow. However, artifacts observed on the surface of non-siliconised and siliconised ETTs can potentially impair ventilation.

Słowa kluczowe

EN

laminar; turbulent gas flow; endotracheal tube resistance; work of breathing

PL

turbulentny przepływ gazu; intubacja dotchawicza; oddychanie

• Wydawca: Nałęcz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences ; Elsevier
• Czasopismo: Biocybernetics and Biomedical Engineering
• Rocznik: 2017
• Tom: Vol. 37, no. 1
• Strony: 59--65
• Opis fizyczny: Bibliogr. 30 poz., rys., tab., wykr.

Twórcy

autor

Stankiewicz B.

• Nalecz Institute of Biocybernetucs and Biomedical Engineering, Polish Academy of Sciences, 4 Ks. Trojdena Street, 02-109 Warsaw, Poland

autor

Rawicz M.

• Warsaw Children Hospital, Warsaw, Poland

autor

Darowski M.

• Nalecz Institute of Biocybernetucs and Biomedical Engineering, Polish Academy of Sciences, 4 Ks. Trojdena Street, 02-109 Warsaw, Poland

autor

Zielinski K.

• Nalecz Institute of Biocybernetucs and Biomedical Engineering, Polish Academy of Sciences, 4 Ks. Trojdena Street, 02-109 Warsaw, Poland

autor

Kozarski M.

• Nalecz Institute of Biocybernetucs and Biomedical Engineering, Polish Academy of Sciences, 4 Ks. Trojdena Street, 02-109 Warsaw, Poland

autor

Chwojnowski A.

• Nalecz Institute of Biocybernetucs and Biomedical Engineering, Polish Academy of Sciences, 4 Ks. Trojdena Street, 02-109 Warsaw, Poland

Bibliografia

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Uwagi

PL

Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę (zadania 2017).