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01-03-2005 | Experimental

Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation

Authors: Hajo Reissmann, Stephan H. Böhm, Fernando Suárez-Sipmann, Gerardo Tusman, Claas Buschmann, Stefan Maisch, Tanja Pesch, Oliver Thamm, Christoph Plümers, Jochen Schulte am Esch, Göran Hedenstierna

Published in: Intensive Care Medicine | Issue 3/2005

Abstract

Objective

Endotracheal suctioning can cause alveolar collapse and impede ventilation. One reason is the gas flow through a single-lumen endotracheal tube (ETT) provoking a gradient between airway opening and tracheal (P_tr) pressures. Separately extending the patient tubing limbs of a suitable ventilator into the trachea via a double-lumen ETT should maintain P_tr. Can this technique reduce the side effects?

Design and setting

Bench and animal studies in a university hospital laboratory.

Interventions

A lung model was ventilated via single and double-lumen ETTs. Closed-system suctioning was applied with catheters introduced into the single-lumen ETT or the expiratory lumen of the double-lumen ETT via swivel adapter. Seven anesthetized pigs (lungs lavaged) underwent three runs of ventilation and suctioning through (a, b) an 8.0-mm ID single-lumen ETT, (c) a double-lumen ETT (41Ch outer diameter, OD). In (a) the single-lumen ETT was disconnected for suctioning, in (b) and (c) ventilator mode was set to continuous positive airway pressure mode, and the ETTs remained connected.

Measurements and results

Bench: Suction through single-lumen ETTs impaired ventilation and led to strongly negative P_tr (common: −10 to −20 mbar); the double-lumen ETT technique maintained ventilation and pressures. Animals: Lung gas content (computed tomography, n=4) and arterial oxygen partial pressure, initially 1462±65 ml/532±76 mmHg, were significantly reduced by suctioning through single-lumen ETT: to 302±79 ml/62±6 mmHg with disconnection and to 851±211 ml/158±107 mmHg with closed suction. With double-lumen ETT they remained at 1377±95 ml/521±56 mmHg.

Conclusions

The double-lumen ETT technique minimizes side effects of suctioning by maintaining P_tr.

Available only for authorised users

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Title: Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation
Authors: Hajo Reissmann
Stephan H. Böhm
Fernando Suárez-Sipmann
Gerardo Tusman
Claas Buschmann
Stefan Maisch
Tanja Pesch
Oliver Thamm
Christoph Plümers
Jochen Schulte am Esch
Göran Hedenstierna
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2537-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Suctioning through a double-lumen endotracheal tube helps to prevent alveolar collapse and to preserve ventilation

Abstract

Objective

Design and setting

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Interventions

Measurements and results

Conclusions

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