Washout of Anatomical Dead Space for Alveolar Hypoventilation

Stresemann, Erwin; Votteri, Ba.; Fp, Sattler

doi:10.1159/000192623

Cited by 33 publications

(8 citation statements)

References 9 publications

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“…Elimination of dead air from the anatomical dead space by insufflation during expiration (washout) has recently been studied in emphysematous patients with COa retention [1], Experimental work has also been done on the influence of washout of dead air from an added dead space in normal subjects [2]. The method of washout of dead air as practised in these studies served for assessing the effect of such measure on various physiological parameters in the normal dog under anesthesia.…”

Section: And F P Sattlermentioning

confidence: 99%

Effect of Washout of Anatomical Dead Space on Ventilation, pH and Blood Gas Composition in Anesthetized Dogs

Stresemann¹,

Sattler²

1969

Respiration

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Section: And F P Sattlermentioning

confidence: 99%

Effect of Washout of Anatomical Dead Space on Ventilation, pH and Blood Gas Composition in Anesthetized Dogs

Stresemann¹,

Sattler²

1969

Respiration

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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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“…The technique of tracheal gas insufflation was described as long ago as 1969 [28], and has P a co 2 reduction with tracheal gas insufflation as an adjunct to pressure or volume controlled ventilation [8,9,11,12,15,16,29]. Expiratory washout is potentially attractive as it does not augment inspiratory tidal volume and may cause less dynamic hyperinflation than continuous tracheal gas insufflation.…”

Section: Discussionmentioning

confidence: 99%

Tracheal gas insufflation

Dingley¹,

Findlay²,

Foëx³

et al. 2001

Anaesthesia

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SummaryTracheal gas insufflation is a technique in which gas is injected intratracheally during positive pressure ventilation. The fresh gas rinses expired gas from the tracheal tube and anatomical dead space, aiding carbon dioxide elimination. This reduces ventilatory volume and pressure, helping to reduce ventilator-induced lung damage. Complications of tracheal gas insufflation include interference with ventilator function, tracheal damage and barotrauma. Expiratory washout is a variation of tracheal gas insufflation. We designed and constructed an original expiratory washout system and evaluated its safety and performance in lung and animal models. We found that expiratory limb and tracheal tube occlusion tests caused the device to disable itself at acceptable intratracheal pressures. We also demonstrated up to 31% reduction in tidal volume compared with conventional ventilation, supporting the possibility of using this device clinically to lessen volutrauma. We concluded that aspects of this design might alleviate many of the safety concerns of using tracheal gas insufflation.

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Washout of Anatomical Dead Space for Alveolar Hypoventilation

Cited by 33 publications

References 9 publications

Effect of Washout of Anatomical Dead Space on Ventilation, pH and Blood Gas Composition in Anesthetized Dogs

Effect of Washout of Anatomical Dead Space on Ventilation, pH and Blood Gas Composition in Anesthetized Dogs

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

Tracheal gas insufflation

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