Adjustable inspiratory occlusion valve in experimental bronchopleural fistula. A new therapeutic perspective

Abstract

PURPOSE:To assess the efficacy of an adjustable inspiratory occlusion valve in experimental bronchopleural fistula during mechanical ventilation. METHODS:We studied six mechanically ventilated pigs in a surgically created, reproducible model of bronchopleural fistula managed with mechanical ventilation and water-sealed thoracic drainage. An adjustable inspiratory occlusion valve was placed between the thoracic drain and the endotracheal tube. Hemodynamic data, capnography and blood gases were recorded before and after the creation of the bronchopleural fistula as well as after every adjustment of the inspiratory occlusion valve. RESULTS:When compared with the standard water-sealed drainage treatment, the use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume and reduced bronchopleural air leak (p<0.001), without hemodynamic compromise when compared with conventional water sealed drainage. CONCLUSION:The use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume, reduced alveolar leak, in an experimental reproducible model of bronchopleural fistula, without causing any hemodynamic derangements when compared with conventional water sealed drainage.

PetCO2, VCO2 and CorPP Values in the Successful Prediction of the Return of Spontaneous Circulation: An Experimental Study on Unassisted Induced Cardiopulmonary Arrest

“…Capnography presents itself as a non-invasive method, applicable at the bedside, that allows for the assessment of cardiorespiratory status both in experimental 2 - 6 ] and clinical studies [ 7 - 12 ] . In addition, it is considered an indicator and/or guide for decisions that enables the assessment of the quality of the CPR maneuvers [ 13 ] .…”

Evaluation of the Efficiency of the Atraumatic Endotracheal Tube in the Pulmonary-Gas Exchange: an Experimental Study

“…Examples of assessment of pulmonary gas exchange (capnographic and blood gas analysis) are found in experimental [ 13 , 14 ] and clinical trials [ 15 , 16 ] of pulmonary thromboembolism, as well as in clinical [ 17 - 19 ] and experimental [ 20 , 21 ] studies on acute respiratory distress syndrome (ARDS) and bronchopleural fistula [ 22 , 23 ] .…”