CO2-controlled sampling of alveolar gas in mechanically ventilated patients

2001 ◽  
Vol 90 (2) ◽  
pp. 486-492 ◽  
Author(s):  
Jochen K. Schubert ◽  
Karl-Heinz Spittler ◽  
Guenther Braun ◽  
Klaus Geiger ◽  
Josef Guttmann
Keyword(s):  
Dead Space ◽  
Coefficient Of Variation ◽  
Sampling Technique ◽  
Sampling Device ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Selective Enrichment ◽  
Gas Sampling ◽  
End Tidal ◽  
Ventilated Patients

A newly designed gas-sampling device using end-tidal CO2to separate dead space gas from alveolar gas was evaluated in 12 mechanically ventilated patients. For that purpose, CO2-controlled sampling was compared with mixed expiratory sampling. Alveolar sampling valves were easily controlled via CO2concentration. Concentrations of four volatile substances were determined in the expired and inspired gas. Isoflurane and isoprene, which did not occur in the inspired air, had ratios of end-tidal to mixed expired concentrations of 1.75 and 1.81, respectively. Acetone and pentane, found in both the inspired and expired air, showed ratios of 0.96 and 1.0, respectively. Precision of concentration measurements was between 2.4% (isoprene) and 11.2% (isoflurane); reproducibility (as coefficient of variation) was 5%. Because the only possible source of isoflurane and isoprene in this setting was patients' blood, selective enrichment of alveolar gas was demonstrated. By using the new sampling technique, sensitivity of breath analysis was nearly doubled.

scholarly journals Aspiration of airway dead space (ASPIDS) in mechanically ventilated patients

Critical Care ◽  
10.1186/cc213 ◽  
1998 ◽  
Vol 2 (Suppl 1) ◽  
pp. P083
Author(s):  
E De Robertis ◽  
G Servillo ◽  
F Rossano ◽  
B Jonson ◽  
R Tufano
Keyword(s):  
Dead Space ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Airway Dead Space ◽  
Ventilated Patients

scholarly journals Management of hypercapnia in critically ill mechanically ventilated patients—A narrative review of literature

2020 ◽  
Vol 21 (4) ◽  
pp. 327-333
Author(s):  
Ravindranath Tiruvoipati ◽  
Sachin Gupta ◽  
David Pilcher ◽  
Michael Bailey
Keyword(s):  
Mechanical Ventilation ◽  
Tidal Volume ◽  
Dead Space ◽  
Hypercapnic Acidosis ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Low Tidal Volume ◽  
Volume Ventilation ◽  
Low Volume ◽  
Ventilated Patients

The use of lower tidal volume ventilation was shown to improve survival in mechanically ventilated patients with acute lung injury. In some patients this strategy may cause hypercapnic acidosis. A significant body of recent clinical data suggest that hypercapnic acidosis is associated with adverse clinical outcomes including increased hospital mortality. We aimed to review the available treatment options that may be used to manage acute hypercapnic acidosis that may be seen with low tidal volume ventilation. The databases of MEDLINE and EMBASE were searched. Studies including animals or tissues were excluded. We also searched bibliographic references of relevant studies, irrespective of study design with the intention of finding relevant studies to be included in this review. The possible options to treat hypercapnia included optimising the use of low tidal volume mechanical ventilation to enhance carbon dioxide elimination. These include techniques to reduce dead space ventilation, and physiological dead space, use of buffers, airway pressure release ventilation and prone positon ventilation. In patients where hypercapnic acidosis could not be managed with lung protective mechanical ventilation, extracorporeal techniques may be used. Newer, minimally invasive low volume venovenous extracorporeal devices are currently being investigated for managing hypercapnia associated with low and ultra-low volume mechanical ventilation.

Prognostic Value of Different Dead Space Indices in Mechanically Ventilated Patients With Acute Lung Injury and ARDS

CHEST Journal ◽  
2008 ◽  
Vol 133 (1) ◽  
pp. 62-71 ◽  
Author(s):  
Umberto Lucangelo ◽  
Francesca Bernabè ◽  
Sara Vatua ◽  
Giada Degrassi ◽  
Ana Villagrà ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Dead Space ◽  
Prognostic Value ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

scholarly journals A STUDY TO ASSESS THE EFFECTIVENESS OF COMMUNICATION BOARD ON THE SATISFACTION LEVEL REGARDING COMMUNICATION PATTERN AMONG MECHANICALLY VENTILATED PATIENTS

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Mrs Irven Kaur kaur ◽  
Dr Tarandeep kaur
Keyword(s):  
Sampling Technique ◽  
Control Group ◽  
Communication Pattern ◽  
Satisfaction Level ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Significant Difference ◽  
Experimental Group ◽  
Ventilated Patients ◽  
Communication Board

The research statement was titled as “A Study to assess the effectiveness of Communication Board on the Satisfaction level regarding Communication Pattern among Mechanically Ventilated Patients.” The data was collected from 60 mechanically ventilated patients (30 in experimental group and 30 in control group) admitted in selected hospital, Amritsar, Punjab using Purposive sampling technique. Two groups were selected for the study, one experimental and one control group. The experimental group was provided with the communication board as an intervention to meet their communication needs (4-5 times during morning time) by researcher, until they are extubated. The control group was not provided with communication board, they relied on standard care and on the experience of nurses. Modified likert scale was used to assess the post-interventional satisfaction level regarding communication pattern after extubation, in both experimental and control group. Study findings revealed that, according to post-interventional satisfaction level regarding communication pattern, majority (80%) of mechanically ventilated patients in experimental group were satisfied regarding communication pattern, followed by (20%) dissatisfied, whereas in control group majority (88.9%) of mechanically ventilated patients were dissatisfied regarding communication pattern, followed by (11.1%) satisfied. According to comparison of post-interventional satisfaction level regarding communication pattern among mechanically ventilated in control and experimental group, a significant difference was found with t value 7.69 at p<0.05 level of significance.

scholarly journals Safe and Efficient Practice of Bronchoscopic Sampling from Mechanically Ventilated Patients: A Structured Evaluation of the Ambu Bronchosampler-Ascope 4 Integrated System

Respiration ◽  
2021 ◽  
pp. 1-7
Author(s):  
Suveer Singh ◽  
Pallav L. Shah
Keyword(s):  
Sampling Technique ◽  
Integrated System ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Safety Standards ◽  
Standard Sampling ◽  
The Mean ◽  
Set Up ◽  
Sampling Procedures ◽  
Ventilated Patients

<b><i>Background:</i></b> Bronchoscopic sampling of bronchoalveolar fluid (BAL) should be safe and effective. Current sampling practice risks loss of sample to the attached negative flow, aerosolisation, or spillage, due to repeated circuit breaks, when replacing sample containers. Such concerns were highlighted during the recent coronavirus pandemic. <b><i>Objectives:</i></b> Evaluation of an alternative integrated sampling solution, with the Ambu Bronchosampler with aScope 4, by an experienced bronchoscopist in ICU. <b><i>Methods:</i></b> An observational study of 20 sequential bronchoscopic diagnostic sampling procedures was performed on mechanically ventilated patients with suspected ventilator-associated pneumonia. Mixed methods assessment was done. The predefined outcome measures were (1) ease of set up, (2) ease of specimen collection, (3) ease of protecting specimen from loss or spillage, and (4) overall workflow. The duration of the procedure and the % volume of sample retrieved were recorded. <b><i>Results:</i></b> The mean (±standard deviation [SD]) time for collecting 1 sample was 2.5 ± 0.8 min. The mean (±SD) specimen yield for instilled miniBAL was 54.2 ± 17.9%. Compared with standard sampling, the set-up was <i>much easier</i> in 18 (90%), or <i>easier</i> in 2 (10%) of procedures, reducing the connection steps. It was <i>much more</i> intuitive to use in 14 (70%), <i>more</i> intuitive in 4 (20%), and <i>no more</i> intuitive to use in 2 (10%). The overall set-up and workflow was <i>much easier</i> in 69% of the 13 intraprocedural connections and <i>easier</i> or <i>as easy</i> in the remaining 31% procedures. All procedures where pre connection was established were <i>much easier</i> (7, 100%). The Ambu Bronchosampler remained upright in all procedures with no loss or spillage of sample. Obtaining a sample was <i>much easier</i> in 60%, <i>easier</i> in 10%, <i>no different</i> in 20%, and <i>worse</i> in 10%. The ability to protect a sample from start to finish compared to standard procedures was <i>much easier</i> in 80%, <i>easier</i> in 15%, and <i>no different</i> in 5% of procedures. Overall workflow was <i>much easier</i> in 14 (70%), <i>easier</i> in 4 (20%), and <i>no different</i> in 2 (10%) of procedures. <b><i>Conclusions:</i></b> The Ambu Bronchosampler unit was a reliable, effective, and possibly safer technique for diagnostic sampling in ICU. It may improve safety standards during the coronavirus pandemic. A randomized control trial against the standard sampling technique is warranted.

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