Accurate, noninvasive quantitation of expiratory gas leak from uncuffed infant endotracheal tubes

Pediatric Pulmonology
A Knauth, S Baumgart

Abstract

Accurate measurement of expiratory gas leak from uncuffed infant endotracheal tubes is an important requirement for evaluating the rates of metabolic gas exchange by indirect calorimetry in neonates receiving mechanical ventilation. The present study reports a new, noninvasive technique for the efficient collection and analysis of expiratory gases leaked from a closed-circuit metabolic monitoring system recently described. A loose-fitting face mask is placed over the infant's endotracheal appliance and air is entrained from the mask cavity at 100 mL/min for CO2 analysis by infrared capnometry. In vitro calibration of this apparatus demonstrates a relative error of less than 5% of simulated endotracheal tube leak. In vivo application to metabolic rate assessment (using the MGM Jr. metabolic cart) in 12 intubated, ventilated infants ranging from 1.56 to 4.07 kg study weight demonstrated endotracheal tube leaks from 0.49 to 7.40% of net CO2 production, which ranged 10.67 to 70.91 mL/min (or mean 8.22 +/- 0.93 SEM mL/kg/min). The magnitude of tube leakage of mixed expiratory gases could not be predicted from endotracheal tube diameter, ventilator settings, or infant activity or posture. As new instrumentation becomes available to m...Continue Reading

References

May 1, 1978·IEEE Transactions on Bio-medical Engineering·J G SchwartzT H Shaffer
Jul 1, 1985·Canadian Anaesthetists' Society Journal·D A FinholtR C Raphaely
Jan 1, 1962·Biologia Neonatorum. Neo-natal Studies·K BRUECKM BRUECK

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Citations

Sep 5, 2018·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Mark C Mammel
Jan 8, 2008·Physiological Measurement·H S FischerG Schmalisch

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