Effects of tracheal suctioning on respiratory resistances in mechanically ventilated patients

被引:49
作者
Guglielminotti, J [1 ]
Desmonts, JM [1 ]
Dureuil, B [1 ]
机构
[1] Hop Bichat Claude Bernard, Dept Anesthesie & Reanimat Chirurg, F-75877 Paris, France
关键词
beta(2)-adrenergic agonists; mechanical ventilation; respiratory mechanics; respiratory reflexes; tracheal suctioning;
D O I
10.1378/chest.113.5.1335
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To evaluate the effects of tracheal suctioning (TS) on respiratory resistances in sedated critical care patients receiving mechanical ventilation (MV). Setting: Surgical ICU of Bichat Hospital, Paris. Patients and participants: Thirteen sedated critical care patients receiving MV for various conditions. Measurements and results: Airway resistances (R-1), airway and pulmonary resistances (R-2), and intrinsic positive end-expiratory pressure (PEEPint) were measured according to the end-inspiratory and end-expiratory occlusion methods before and after TS. R-1 and R-2 increased by 49.1% and 46.3%, respectively, 0.5 min after TS (p<0.01) but returned to baseline values atl min without any change thereafter. PEEPint decreased progressively following TS to reach a significant level (-13.3%) at 10 min (p<0.05) and was persistently reduced at 30 min (p<0.01). Nine patients received 500 mu g of inhaled albuterol before another suctioning procedure. R-1 and R-2 decreased by 11.5% and 9.9%, respectively, 20 min after inhalation (p<0.05), but the R-1 and R-2 initial increase following TS did not differ between the true suctioning procedures. Conclusions: TS evokes only a transient bronchoconstrictor response, but thereafter, does not reduce respiratory resistances below presuctioning values. However, the decrease of PEEPint following TS suggests an increase of expiratory flow. Effective beta(2)-adrenergic receptor blockade fails to suppress the TS-induced bronchoconstrictor response.
引用
收藏
页码:1335 / 1338
页数:4
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