Instrumental dead space in neonatology, and its elimination by continuous tracheal gas insufflation during conventional ventilation

Kalous, P; Kokśtein, Z

doi:10.1111/j.1651-2227.2003.tb02499.x

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…This high flow rate of fresh gas streaming into the nasal cavity results in a flushing effect which removes expired carbon dioxide from the nasal cavity, thereby reducing the effective nasopharyngeal dead space while also providing a distending pressure somewhat proportional to the supplied flow rate . The improved carbon dioxide washout observed with HFNC may be considered analogous to the flushing effect seen with tracheal gas insufflation (TGI) which has been shown to effectively reduce nasopharyngeal dead space, improve gas exchange, and potentially lessen the level of respiratory support or effort . In upper airway models, Möller et al demonstrated rapid, flow dependent clearance of tracer‐gas from simulated adult nasal cavities upon application of simulated high flow therapy .…”

Section: Introductionmentioning

confidence: 99%

Carbon dioxide washout during high flow nasal cannula versus nasal CPAP support: An in vitro study

Sivieri

Foglia

Abbasi

2017

Pediatric Pulmonology

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Section: Introductionmentioning

confidence: 99%

Carbon dioxide washout during high flow nasal cannula versus nasal CPAP support: An in vitro study

Sivieri

Foglia

Abbasi

2017

Pediatric Pulmonology

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“…The split‐flow circuit design allows aDS washout without an increase of the total inspiratory flow, differently from continuous tracheal gas insufflation (CTGI), another method of aDS reduction introduced by Stresemann in 1969 and further elaborated and described in adults and children including preterm infants in numerous publications (7,8). aDS washout by leakage flow is another option to functionally reduce aDS (9).…”

Section: Discussionmentioning

confidence: 99%

A Flow Sensor Suitable for Use With Split‐flow Ventilation—First Preclinical Data

Wald¹,

Jeitler²,

Lawrenz³

et al. 2006

Artificial Organs

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Volutrauma caused by artificial ventilation represents a major morbidity risk for premature infants. Our working group has recently developed an innovative "split-flow ventilation" system aiming at the reduction of tidal volumes (TVs). The main problem for the practical use of this system is the fact that conventional measurements of commercially available flow sensors are distorted by the split flow. In this study, we present the first preclinical data from testing an adapted flow sensor combination recognizing the split flow. A preterm infant test lung was conventionally ventilated, modified by insertion of a split-flow line. In addition to the customary flow sensor (FS-1), a second flow sensor (FS-2) was integrated into the split-flow line, and a third (FS-3) was placed at the exit of the test lung for reference measurements. The signals of all three flow sensors were read and processed by a computer. The program was set to graphically add up flow curves 1, 2, and 3 during one ventilation loop. After 10 runs, a mean curve of FS-1+2 was calculated and compared to the mean curve of FS-3. Furthermore, the mean TV of 10 runs measured by FS-1+2 was calculated and compared with the mean TV calculated by FS-3. The summation curve FS-1+2 proved identical to the reference curve FS-3. FS-1+2 yielded a TV of 6.6 +/- 0.01 mL (inspiratory) and 6.7 +/- 0.02 mL (expiratory). The corresponding values of FS-3 were 6.5 +/- 0.20 mL and 6.6 +/- 0.09 mL, respectively. According to our results, the presented flow sensor constellation allows exact flow measurements in the experimental setting and appears suitable for usage in a split-flow ventilation circuit under clinical conditions.

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“…Kakous et al [14] reported the effects of continuous TGI in conventional ventilation. The effect of TGI is based mainly on the replacement of end-tidal gas in the instrumental dead space with an inspiratory gas mixture.…”

Section: Introductionmentioning

confidence: 99%

Extremely low flow tracheal gas insufflation of helium-oxygen mixture improves gas exchange in a rabbit model of piston-type high-frequency oscillatory ventilation

et al. 2013

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ObjectiveThe purpose of this study was to show the effects of the tracheal gas insufflation (TGI) technique on gas exchange using helium-oxygen mixtures during high-frequency oscillatory ventilation (HFOV). We hypothesized that a helium-oxygen mixture delivered into the trachea using the TGI technique (0.3 L/min) would enhance gas exchange during HFOV.MethodsThree rabbits were prepared and ventilated by HFOV with carrier 70% helium/oxygen or 70% nitrogen/oxygen gas mixture with TGI in a crossover study. Changing the gas mixture from nitrogen70% to helium70% and back was performed three times per animal with constant ventilation parameters.ResultsCompared with the nitrogen-oxygen mixture, the helium-oxygen mixture of TGI reduced PaCO2 by 7.6 mmHg (p < 0.01) and improved PaO2 by 14 mmHg (p < 0.01). Amplitude during TGI was significantly lower with the helium-oxygen mixture than with the nitrogen-oxygen mixture (p < 0.01) and did not significantly affect mean airway pressure.ConclusionsThis study demonstrated that a helium-oxygen mixture delivered into the trachea using the TGI technique would enhance CO2 elimination and improve oxygenation during HFOV.

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Instrumental dead space in neonatology, and its elimination by continuous tracheal gas insufflation during conventional ventilation

Cited by 7 publications

References 26 publications

Carbon dioxide washout during high flow nasal cannula versus nasal CPAP support: An in vitro study

Carbon dioxide washout during high flow nasal cannula versus nasal CPAP support: An in vitro study

A Flow Sensor Suitable for Use With Split‐flow Ventilation—First Preclinical Data

Extremely low flow tracheal gas insufflation of helium-oxygen mixture improves gas exchange in a rabbit model of piston-type high-frequency oscillatory ventilation

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