2010 OPEN FORUM Abstracts
EVALUATION OF THE IMPACT OF ENDOTRACHEAL TUBE SUCTIONING DURING HIGH FREQUENCY JET VENTILATION.
Kevin Crezee, Rick Carter, Steve Howes, Terry Madsen; Respiratory Care, Primary Childrens Medical Center, Salt Lake City, UT
Background: Primary Childrens Medical Center (PCMC) has used the High Frequency Jet Ventilator (HFJV) since its inception. Suctioning is a common procedure for mechanically ventilated patients with known side effects. We decided to evaluate the recommended double suction method (DSM) developed for the Hi-Lo Jet ETT compared to conventional single suction method (SSM) with the current change to the LifePort ETT adapter. Method: The Bunnell High Frequency Jet Ventilator (HFJV) was connected to an infant lung model with 2 pressure and 2 airflow sensors. The HFJV set on rate 360, PIP 25 cmH2O, and PEEP 8 cmH2O provided by a Drager Babylog. Various sizes of ETT sizes, closed suction catheters, suction (SXN) pressures 80-120 mmhg and a 3.5 LifePort adapter were used to evaluate changes in operational characteristics of the test lung. The test lung measurements were electronically recorded and stored for analysis. Each ETT, catheter, SXN pressure combination was measured and recorded 3 times. The SXN method was standardized to maintain consistency during testing and mirrored current clinical practice at PCMC. SXN was completed using the DSM and SSM. 3 phases of the SXN time measurements were compared to the total time from the last HFJV PIP until the target PIP was achieved post suction. Alarm conditions were observed and recorded for all SXN procedures. Results: We found that deflation times ranged from 5-39% using the DSM compared to 36-50% with the SSM. Test lung down times ranged from 51%-91% using DSM compared to 39-57%with the SSM. Reinflation times ranged 4-10%using the DSM and 4-13%with the SSM. The average deflation time was 16% for the DSM and 42% with the SSM. The average test lung down time was 76% for the DSM and 50% for the SSM. The average reinflation times were comparable with 8% for the DSM and 9% for the SSM. Alarm conditions were comparable between both methods. See results table. Conclusion: Our data showed that using DSM deflated the test lung more rapidly and had longer test lung down times. Further animal and clinical studies are recommended to fully understand the clinical benefits of a change to SSM. Our data from the test lung shows that a practice change to SSM may reduce potential negative effects of DSM in relation to deflation and down times. Sponsored Research - None