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Constant-flow ventilation of apneic dogs.

The adequacy of constant airway gas flow sustenance of arterial blood gas tensions was investigated in anesthetized-paralyzed mongrel dogs. Gas delivery was achieved via a main-stem bronchi cannulation system constructed of two polyethylene tubes bifurcating at the carina, which rested on the posterior surface of the trachea outside of an endotracheal tube positioned in the upper third of the trachea. Equal flows (total flow = Vin) of humidified air were delivered through each limb of the cannulation system at constant flow rates with Vin ranging from 8 to 28 l/min. Intratracheal pressures at these flows characteristically ranged from 0.1 to 1 cmH2O. Arterial O2 tension varied directly (PaO2 = 0.72 Vin + 74.6), and arterial CO2 tension varied inversely (PaCO2 = -0.73 Vin + 51.2) with Vin during ambient gas, constant-flow ventilation (CFV). During prolonged CFV (greater than 2 h), no evidence of CO2 accumulation or deterioration of PaO2, was observed. This study demonstrates that in apneic dogs normal blood gases can be achieved and maintained over prolonged periods with constant airway flow at low intratracheal pressures.

Animals↗

Ballotability of cuff to confirm the correct intratracheal position of the endotracheal tube in the intensive care unit.

The cuff ballotability method was used in 120 adult patients to confirm the correct depth of insertion of the endotracheal tube after tracheal intubation. The correct tube position was assumed when the cuff of the endotracheal tube could be felt to distend over the suprasternal notch when the pilot balloon was squeezed and the pilot balloon was felt to distend when pressure was applied over the suprasternal notch. Chest radiography was performed later to confirm the position of the endotracheal tube. In all patients the tip of the endotracheal tube was found to be in the desired position, i.e. 3-7 cm from the carina--the level of T3-T4 vertebrae. We concluded this technique to be a simple and reproducible way to confirm the correct depth of insertion of endotracheal tubes.

Adult↗

Site of respiratory reaction in allergic rats challenged via the airways.

Rats systemically sensitized to DNP-ovalbumin show a characteristic respiratory response to antigen challenge delivered via the airway. The slowing of expiratory air flow which occurs on aerosol challenge still occurs when the antigen is injected via a tracheostomy but not when it is delivered solely to the upper airways. Disodium cromoglycate administered via the tracheostomy 1 min before intratracheal antigen challenge reduces the respiratory response.

Administration, Intranasal↗