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Continuous and expiratory tracheal gas insufflation produce equal levels of total PEEP

Delgado, E and Miro, AM and Hoffman, LA and Tasota, FJ and Pinsky, MR (1999) Continuous and expiratory tracheal gas insufflation produce equal levels of total PEEP. Respiratory Care, 44 (4). 428 - 433. ISSN 0020-1324

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BACKGROUND: Tracheal gas insufflation (TGI) used in conjunction with mechanical ventilation can increase total positive end-expiratory pressure (total PEEP). We tested the theory that TGI delivered throughout the entire respiratory cycle (c-TGI) increases total PEEP more than expiratory phase TGI (e-TGI). We also studied whether a pressure relief valve in the ventilator circuit could prevent increase in total PEEP during TGI. METHODS: Using an artificial lung model and pressure control ventilation, we studied the effect of c-TGI and e-TGI, with and without a pressure relief valve, and with and without maintenance of a constant minute ventilation (V̇(E)), at 3 different inspiratory-expiratory ratios. RESULTS: Under constant V̇(E) conditions, the increase in total PEEP was equivalent with c-TGI and e-TGI. Without adjustments to maintain V̇(E) constant, V̇(E) increased during c-TGI and decreased during e-TGI. Under all conditions increasing the inspiratory- expiratory ratio increased total PEEP. CONCLUSION: When V̇(E) is maintained constant, c-TGI and e-TGI produce equivalent levels of total PEEP. Failure to adjust the ventilator settings during TGI creates changes in ventilatory parameters that are unique to each delivery system.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Delgado, E
Miro, AM
Hoffman, LA
Tasota, FJ
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 April 1999
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: Respiratory Care
Volume: 44
Number: 4
Page Range: 428 - 433
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0020-1324
Date Deposited: 13 Mar 2012 14:35
Last Modified: 30 Jan 2020 16:55


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