The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Alicia D. West, Tracey Neff, Brandy Seger, Cynthia White; Respiratory Care, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH

Background: ETCO2 is used as a standard of practice for mechanically ventilated patients in our 35 bed Pediatric Intensive Care Unit,(PICU). Our standard device has been the GE capnostat mainstream monitor. New microstream technology has introduced the new microbeam IR sensor into sidestream monitoring capabilities. This new technology is theorized to help isolate the ETCO2 waveform and increase accuracy in small pediatric patients compared to previous mainstream technology. One of the components of our VAP bundle is to decrease the incidence of breaking the ventilator circuit. With use of mainstream end tidal monitors, the ventilator circuit requires Respiratory Therapists to frequently break the circuit to recalibrate and/or dry the adapter. We tested the null hypothesis that there would be no difference in the number of times we were required to break the ventilator circuit with mainstream ETCO2 technology compared to a new device with sidestream technology. Methods: As we introduced the GE capnoflex sidestream monitor into clinical practice, a data collection form was developed to collect the following data: type of adapter, number of times the circuit was broken, Inline treatments administered, and a comment section to document disconnect for bagging or patient transports. The form was filled out by the bedside Respiratory Therapist for each standard 12 hour shift. Statistical analysis was performed in SPSS version 18. A one sample t test was performed to compare mean differences in the number of times the ventilator circuit was broken with the GE mainstream adapter compared to the GE sidestream adapter. Results: N=82 total sample were collected with 44 in the sidestream group and 38 in the mainstream group. Mean number of times the ventilator circuit was broken was .5 (.59) times per 12 hour shift in the sidestream group compared to 1.29 (1.08) times per 12 hour shift in the mainstream group ( p < = .001). The presence of inline treatments correlated with an increase in breaking the circuit in both groups. Conclusion:In our patient population,there was a statistically significant decrease in frequency of broken ventilator circuit for patients receiving the GE sidestream adapter compared to the mainstream adapter. The need for further research exists to evaluate the correlation in this decrease in breaking the ventilator circuit and a possible decrease in the incidence of Ventilator Associated Pneumonia. Sponsored Research - None