Work of breathing through different sized endotracheal tubes

Shapiro, Michael C.; Wilson, Roy D.; Casar, Gregorio; Bloom, Kim; Teague, R.D. MacNeil M.L.

doi:10.1097/00003246-198612000-00007

Cited by 198 publications

(58 citation statements)

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“…Summarizing, the energy dissipated to overcome Pres,t is related to decreases in Pel,rs and Pres,rs at the first moments of inspiration, whereas at TI it is strongly related to a decrease in Pel,rs. Figure 5 shows that Wres,tot increases when tracheal tubes are used, and, furthermore, the smaller the tube diameter the larger is Wres,tot, in accordance with previous reports [1,2,4,7,13,25]. For R=R'rs, when P°ao is doubled and quadrupled ( fig.…”

Section: Discussionsupporting

confidence: 89%

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Modelling the mechanical effects of tracheal tubes in normal subjects

Rocco

Zin²

1995

Eur Respir J

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M Mo od de el ll li in ng g t th he e m me ec ch ha an ni ic ca al l e ef ff fe ec ct ts s o of f t tr ra ac ch he ea al l t tu ub be es s i in n n no or rm ma al l s su ub bj je ec ct ts s On the basis of experimental data from the literature and on a previously reported mathematical model of the inspirogram, we wished to study predictions of pressures, volume, flow and work of breathing during the use of tracheal tubes.The present investigation indicates that: 1) the loss in volume is greater at the beginning of inspiration and with narrower tubes; 2) in order to preserve tidal volume the inspiratory drive must be increased at any time during inspiration with the use of diminishing internal diameter of the tubes; 3) alternatively, tidal volume can be maintained by increasing inspiratory duration; and 4) the addition of tubes with internal diameter of 9 mm (no. 9) and 8 mm (no. 8) increases the total resistive work by 115 and 154%, respectively, whilst total elastic work decreases 9 and 16% in relation to the nonintubated patient.These findings are consequent to the turbulent flow pattern that normally occurs within the tracheal tubes and connectors themselves. We believe they are relevant to the physician confronted with a patient needing tracheal intubation.

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Section: Discussionsupporting

confidence: 89%

“…The addition of tracheal tubes to the airways contributes an extra mechanical burden to the respiratory system (rs) [1][2][3][4][5]. Their resistance is highly flow-dependent, augmenting disproportionately with increasing flow rates [6][7][8].…”

mentioning

confidence: 99%

Modelling the mechanical effects of tracheal tubes in normal subjects

Rocco

Zin²

1995

Eur Respir J

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“…Therefore, breathing spontaneously through an artificial airway induces a specific work of breathing. 10 The normal cough function is expected to be impaired by an artificial airway, by increasing the airway resistance and thus reducing the expiratory flow, and by preventing glottis closure and thus reducing the cough pressure. In 8 healthy volunteers intubated with a 8.0-mm ETT, in whom maximum voluntary coughing was initiated after inspiration to total lung capacity, the maximum cough pressure and total volume expelled were similar to the control values, but the flow was significantly lower than control.…”

Section: Effects Of Artificial Airways On Peak Flow During Exsufflationmentioning

confidence: 99%

Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study

et al. 2011

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“…a' = 1 .a126 ( 5 ) assuming that variations in channel resistances were directly proportional to their length, other factors being unchanged, and independently from differences in the values (a,,,,,,) and those calculated in that way (aeolc), fitted the equation in Figure 4. The approximate inner diameter of standard TT whose resistances at = 1 litre/second (a) correspond to those of double-lumen tubes was also calculated from equation (4) ( Table 4).…”

Section: 0mentioning

confidence: 84%

Measurement of the flow‐resistive properties of double‐lumen bronchial tubes in vitro

Chiaranda¹,

Rossi²,

Manani³

et al. 1989

Anaesthesia

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SummaryThis study measures the resistance to gas flow of different double-lumen bronchial tubes used for separate ventilation of each lung in critically ill patients. Different-sized Robertshaw and Carlens' tubes were studied, as well as a new device that consisted of a cuffed bronchial catheter introduced through a standard tracheal tube. The pressure-flow relationship was curvilinear in all cases. Robertshaw and Carlens' tubes were generally found to have bronchial and tracheal channels with almost similar resistance and offered total resistances similar to those of 7.0-8.0 mm internal diameter tracheal tubes. The new device had a higher resistance than others of equal external diameter. This must be taken into account when its use is recommended for prolonged respiratory support.

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Work of breathing through different sized endotracheal tubes

Cited by 198 publications

References 0 publications

Modelling the mechanical effects of tracheal tubes in normal subjects

Modelling the mechanical effects of tracheal tubes in normal subjects

Performance of the CoughAssist Insufflation-Exsufflation Device in the Presence of an Endotracheal Tube or Tracheostomy Tube: A Bench Study

Measurement of the flow‐resistive properties of double‐lumen bronchial tubes in vitro

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