Do commonly used ventilator settings for mechanically ventilated adults have the potential to embed secretions or promote clearance?
- Publication Type:
- Journal Article
- Citation:
- Respiratory care, 2011, 56 (12), pp. 1887 - 1892
- Issue Date:
- 2011-12
Closed Access
Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Ntoumenopoulos, G | en_US |
dc.contributor.author | Shannon, H | en_US |
dc.contributor.author | Main, E | en_US |
dc.date.issued | 2011-12 | en_US |
dc.identifier.citation | Respiratory care, 2011, 56 (12), pp. 1887 - 1892 | en_US |
dc.identifier.issn | 0020-1324 | en_US |
dc.identifier.uri | http://hdl.handle.net/10453/115335 | |
dc.description.abstract | BACKGROUND: Intubation and mechanical ventilation can impair mucociliary clearance and cause secretion retention, airway occlusion, atelectasis, and pneumonia. Animal and laboratory work has demonstrated that mechanical ventilator settings can generate a flow bias (inspiratory or expiratory) that may result in mucus movement either away from the ventilator (deeper into the lungs) or toward the ventilator (toward the mouth), respectively. An absolute difference of 17 L/min, and a relative difference of ≥ 10%, between the expiratory and inspiratory flow have been reported as thresholds for mucus movement. METHODS: We measured baseline peak inspiratory and expiratory flows during quiet mechanical ventilation in a convenience sample of 20 intubated and ventilated adult patients. RESULTS: Nineteen patients had an inspiratory flow bias of ≥ 10%. Eight patients had an absolute mean inspiratory flow bias of ≥ 17 L/min. CONCLUSIONS: Commonly used mechanical ventilator settings generate an inspiratory flow bias that may promote secretion retention. | en_US |
dc.format | Print-Electronic | en_US |
dc.language | eng | en_US |
dc.relation.ispartof | Respiratory care | en_US |
dc.relation.isbasedon | 10.4187/respcare.01229 | en_US |
dc.subject.classification | Respiratory System | en_US |
dc.subject.mesh | Mucus | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Airway Obstruction | en_US |
dc.subject.mesh | Mucociliary Clearance | en_US |
dc.subject.mesh | Inspiratory Capacity | en_US |
dc.subject.mesh | Pulmonary Ventilation | en_US |
dc.subject.mesh | Peak Expiratory Flow Rate | en_US |
dc.subject.mesh | Respiration, Artificial | en_US |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Aged | en_US |
dc.subject.mesh | Aged, 80 and over | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Young Adult | en_US |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Aged | en_US |
dc.subject.mesh | Aged, 80 and over | en_US |
dc.subject.mesh | Airway Obstruction | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Inspiratory Capacity | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Mucociliary Clearance | en_US |
dc.subject.mesh | Mucus | en_US |
dc.subject.mesh | Peak Expiratory Flow Rate | en_US |
dc.subject.mesh | Pulmonary Ventilation | en_US |
dc.subject.mesh | Respiration, Artificial | en_US |
dc.subject.mesh | Young Adult | en_US |
dc.title | Do commonly used ventilator settings for mechanically ventilated adults have the potential to embed secretions or promote clearance? | en_US |
dc.type | Journal Article | |
utslib.description.version | Published | en_US |
utslib.citation.volume | 12 | en_US |
utslib.citation.volume | 56 | en_US |
utslib.for | 1103 Clinical Sciences | en_US |
utslib.for | 1102 Cardiovascular Medicine And Haematology | en_US |
utslib.for | 1102 Cardiovascular Medicine And Haematology | en_US |
utslib.for | 1103 Clinical Sciences | en_US |
pubs.embargo.period | Not known | en_US |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Graduate School of Health | |
utslib.copyright.status | closed_access | |
pubs.issue | 12 | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 56 | en_US |
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Filename | Description | Size | |||
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1887.full.pdf | Published Version | 245.59 kB | Adobe PDF |
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Abstract:
BACKGROUND: Intubation and mechanical ventilation can impair mucociliary clearance and cause secretion retention, airway occlusion, atelectasis, and pneumonia. Animal and laboratory work has demonstrated that mechanical ventilator settings can generate a flow bias (inspiratory or expiratory) that may result in mucus movement either away from the ventilator (deeper into the lungs) or toward the ventilator (toward the mouth), respectively. An absolute difference of 17 L/min, and a relative difference of ≥ 10%, between the expiratory and inspiratory flow have been reported as thresholds for mucus movement. METHODS: We measured baseline peak inspiratory and expiratory flows during quiet mechanical ventilation in a convenience sample of 20 intubated and ventilated adult patients. RESULTS: Nineteen patients had an inspiratory flow bias of ≥ 10%. Eight patients had an absolute mean inspiratory flow bias of ≥ 17 L/min. CONCLUSIONS: Commonly used mechanical ventilator settings generate an inspiratory flow bias that may promote secretion retention.
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