Effects on Lung Gas Volume, Respiratory Mechanics and Gas Exchange of a Closed-Circuit Suctioning System during Volume- and Pressure-Controlled Ventilation in ARDS Patients.
J Clin Med
; 10(23)2021 Nov 30.
Article
en En
| MEDLINE
| ID: mdl-34884358
Mechanically ventilated patients periodically require endotracheal suctioning. There are conflicting data regarding the loss of lung gas volume caused by the application of a negative pressure by closed-circuit suctioning. The aim of this study was to evaluate the effects of suctioning performed by a closed-circuit system in ARDS patients during volume- or pressure-controlled ventilation. In this prospective crossover-design study, 18 ARDS patients were ventilated under volume and pressure control applied in random order. Gas exchange, respiratory mechanics and EIT-derived end-expiratory lung volume (EELV) before the suctioning manoeuvre and after 5, 15 and 30 min were recorded. The tidal volume and respiratory rate were similar in both ventilation modes; in volume control, the EELV decreased by 31 ± 23 mL, 5 min after the suctioning, but it remained similar after 15 and 30 min; the oxygenation, PaCO2 and respiratory system elastance did not change. In the pressure control, 5 min after suctioning, EELV decreased by 35 (26-46) mL, the PaO2/FiO2 did not change, while PaCO2 increased by 5 and 30 min after suctioning (45 (40-51) vs. 48 (43-52) and 47 (42-54) mmHg, respectively). Our results suggest minimal clinical advantages when a closed system is used in volume-controlled compared to pressure-controlled ventilation.
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1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Clin Med
Año:
2021
Tipo del documento:
Article
País de afiliación:
Italia
Pais de publicación:
Suiza