Comparison of Endobronchial and Tracheal Insufflation for Acute RespiratoryDistress

摘要

Prototype airway catheters were developed 1) to allow ventilation with acontinuous flow of air into the mainstream bronchi (EI) and 2) to oxygenate by flowing O2 into the trachea (TRIO). Minimum flows (Vmin) using EI and TRIO were 0.2-0.3 L/kg/min air and 90 ml/min O2, respectively. Ventilation for up to 4 hours with Vmin EI was carried out in anesthetized dogs and physiological parameters were measured serially during apnea produced by neuromuscular blockade. Vmin EI was repeated after tetrodotoxin (TTX) was infused to produce apnea. Ventilation with Vmin TRIO produced oxygenation for over 2 hours in some animals, and all could be returned to normal by conventional ventilation. Vmin TRIO after TTX was less successful, but all animals survived at least 40 min before blood pressure dropped below 40 mmHg. High-flow (2L/min) TRIO successfully resuscitated all TTX-poisoned animals and kept them alive for 4 hours. Generous-flow EI (1 L/kg/min) was equally successful in TTX-poisoned animals. Keywords: Continuous-flow ventilation; Endobronchial insufflation; Eracheal insufflation of O2; Apnea; Tetrodotoxin (TTX); Organophosphorus poisoning; Field ventilation; Resuscitation; Gas supplies; Ventilation; Oxygenation. (JS)