Intra-airway CO2 distribution during airway insufflation in ventilatory failure. 1995

D M Eckmann, and N Gavriely
Department of Anesthesia, Northwestern University Medical School, Chicago 60611, USA.

Low-flow intratracheal gas insufflation is known to be an effective means of providing partial ventilatory support in respiratory failure. We studied the effects of catheter position on intraluminal CO2 concentration profiles and gas transport resistance during intra-airway insufflation at 0.15 l.kg-1.min-1 in six anesthetized paralyzed mechanically hypoventilated dogs. The two positions of the distal tip of the insufflation catheter were 0.5 cm proximal to and 4.0 cm distal to the carina. Local airway CO2 concentrations were measured via a sampling catheter passed through the tracheobronchial tree. Resistance to gas transport was calculated from the measured data. Arterial PO2 and arterial PCO2 remained constant with carinal and bronchial insufflation. Distal positioning of the insufflation tip resulted in a redistribution of ventilation between the lungs, with the ipsilateral lung being relatively hyperventilated and the contralateral lung being relatively hypoventilated. Intraluminal CO2 concentrations were markedly reduced in the ipsilateral lung compared with the profile in the contralateral lung during fresh gas delivery into the main-stem bronchus. The region of peak transport resistance was found to be in the second-generation airways during carinal insufflation and in the fourth-generation airways with intrabronchial insufflation. We conclude that gas exchange during low-flow insufflation occurs by the same mechanisms responsible for CO2 elimination in constant-flow ventilation. Overall gas exchange is not affected by position of the jet catheter.

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D011659 Pulmonary Gas Exchange The exchange of OXYGEN and CARBON DIOXIDE between alveolar air and pulmonary capillary blood that occurs across the BLOOD-AIR BARRIER. Exchange, Pulmonary Gas,Gas Exchange, Pulmonary
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012131 Respiratory Insufficiency Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed) Acute Hypercapnic Respiratory Failure,Acute Hypoxemic Respiratory Failure,Hypercapnic Acute Respiratory Failure,Hypercapnic Respiratory Failure,Hypoxemic Acute Respiratory Failure,Hypoxemic Respiratory Failure,Respiratory Depression,Respiratory Failure,Ventilatory Depression,Depressions, Ventilatory,Failure, Hypercapnic Respiratory,Failure, Hypoxemic Respiratory,Failure, Respiratory,Hypercapnic Respiratory Failures,Hypoxemic Respiratory Failures,Respiratory Failure, Hypercapnic,Respiratory Failure, Hypoxemic,Respiratory Failures
D001784 Blood Gas Analysis Measurement of oxygen and carbon dioxide in the blood. Analysis, Blood Gas,Analyses, Blood Gas,Blood Gas Analyses,Gas Analyses, Blood,Gas Analysis, Blood
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations

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