Tracheal double-lumen ventilation attenuates hypercapnia and respiratory acidosis in lung injured pigs

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Abstract

Objective: Evaluation of ventilatory and circulatory effects with coaxial double-lumen tube ventilation for dead-space reduction as compared with standard endotracheal tube ventilation. Design: Experimental study in a pig model of lung lavage induced acute lung injury. Setting: University research laboratory. Measurements and results: Tidal volumes of 6, 8 and 10 ml/kg body weight with a set respiratory rate of 20 breaths per minute were used in a random order with both double-lumen ventilation and standard endotracheal tube ventilation. Measurements of ventilatory and circulatory parameters were obtained after steady state at each experimental stage. With a tidal volume of 6 ml/kg, PaCO2 was reduced from 10.9 kPa (95% CI 9.0-12.9) with a standard endotracheal tube to 8.2 kPa (95% CI 7.0-9.4) with double-lumen ventilation. This corresponds to a reduction in carbon dioxide levels by 25%. At 6 ml/kg, pH increased from 7.17 (95% CI 7.09-7.24) with a standard endotracheal tube to 7.27 (95% CI 7.21-7.32) with double-lumen ventilation. Tracheal pressure was monitored continuously and no difference between single- or double-lumen ventilation was noted at corresponding levels of ventilation. There was no formation of auto-PEEP. Partial tube obstruction due to secretions was not observed during the experiments. Conclusions: Coaxial double-lumen tube ventilation is an effective adjunct to reduce technical dead space. It attenuates hypercapnia and respiratory acidosis in a lung injury pig model. © Springer-Verlag 2004.

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Lethvall, S., Lindgren, S., Lundin, S., & Stenqvist, O. (2004). Tracheal double-lumen ventilation attenuates hypercapnia and respiratory acidosis in lung injured pigs. Intensive Care Medicine, 30(4), 686–692. https://doi.org/10.1007/s00134-004-2197-5

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