2000 OPEN FORUM Abstracts
Current Status of Tracheal Gas Insufflation
Lluis Blanch, MD Hospital de Sabadell, Spain
Tracheal gas insufflation (TGI) is an adjunct to mechanical ventilation that allows ventilation with small tidal volumes while CO2 is satisfactorily cleared. Pioneering studies demonstrated in healthy experimental animals and in humans with respiratory failure that the expiratory flushing of proximal dead space decreased minute ventilation with no change in PaCO2. Recent work demonstrates that conventional mechanical ventilation aided by TGI may represent a novel ventilatory strategy that succeeds in limiting both the distending forces acting on the lung and the level of PaCO2 elevation that invariably occurs during permissive hypercapnia. Furthermore, some studies suggest that weaning aided by TGI may allow a reduction in patient's respiratory demands. However, routine use of TGI in intensive care warrants further investigation to solve some technical problems and, to confirm with randomized clinical trials the beneficial effects in the absence of complications.