PMID- 2649863
OWN - NLM
STAT- MEDLINE
DCOM- 19890515
LR  - 20190912
IS  - 8755-6863 (Print)
IS  - 1099-0496 (Linking)
VI  - 6
IP  - 1
DP  - 1989
TI  - Reducing inadvertent PEEP by controlling end-tidal pressures in the trachea.
PG  - 31-5
AB  - Mechanical ventilation using exhalation times too brief for completion of 
      exhalation results in inadvertent positive end-expiratory pressure (IPEEP) and 
      increased functional residual capacity (FRC). The endotracheal (ET) tube with 
      side lumen allows us to monitor tracheal airway pressures and to determine the 
      contributions of the ET tube to IPEEP. We hypothesized that, during rapid rate 
      ventilation, controlling the positive end-expiratory pressure (PEEP) level in the 
      trachea rather than at the ET tube adaptor will counter effects of the ET tube on 
      IPEEP and result in less increase of FRC. Thirteen anesthetized rabbits were 
      ventilated at rates of 30, 60, 90, and 120 breaths per minute (BPM). Peak 
      inspiratory pressure was held constant, and PEEP was adjusted to 2 cmH2O, 
      measured conventionally at the proximal end of the ET tube. Pulmonary function 
      tests were made and then repeated while PEEP was held constant in the trachea, 
      measured at the distal end of the ET tube. Controlling PEEP conventionally 
      resulted in mean (+/- SE) FRC values of 13.7 +/- 3.8, 14.8 +/- 3.9, 17.1 +/- 4.5, 
      and 21.1 +/- 5.3 ml/kg at 30, 60, 90, and 120 BPM, respectively. Controlling PEEP 
      at the trachea yielded FRC values of 13.7 +/- 3.8, 13.6 +/- 3.4, 15.3 +/- 4.4, 
      and 16.3 +/- 5.4 ml/kg, respectively. Increasing the ventilator rate above 60 BPM 
      did not affect minute ventilation or blood gases. These results suggest that 
      controlling PEEP in the trachea reduces effects of IPEEP on FRC by countering the 
      contribution of the ET tube to the resistance of gas flow during exhalation.
FAU - Gonzalez, F
AU  - Gonzalez F
AD  - Department of Pediatrics, University of Utah, School of Medicine, Salt Lake City 
      84132.
FAU - Carlstrom, J
AU  - Carlstrom J
FAU - Richardson, P
AU  - Richardson P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Pediatr Pulmonol
JT  - Pediatric pulmonology
JID - 8510590
SB  - IM
MH  - Animals
MH  - Intubation, Intratracheal/methods
MH  - Positive-Pressure Respiration/instrumentation/*methods
MH  - Pulmonary Gas Exchange
MH  - Rabbits
MH  - Tidal Volume
MH  - Trachea/*physiology
EDAT- 1989/01/01 00:00
MHDA- 1989/01/01 00:01
CRDT- 1989/01/01 00:00
PHST- 1989/01/01 00:00 [pubmed]
PHST- 1989/01/01 00:01 [medline]
PHST- 1989/01/01 00:00 [entrez]
AID - 10.1002/ppul.1950060109 [doi]
PST - ppublish
SO  - Pediatr Pulmonol. 1989;6(1):31-5. doi: 10.1002/ppul.1950060109.