The effect of hyperinflation, inspiratory hold, and oxygenation on cardiopulmonary status during suctioning in a lung-injured model

Lynne M Buchanan, M. M. Baun

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

This study determined the effects of a 5-second inspiratory hold during ventilatory maneuvers on cardiopulmonary status before, during, and after endotracheal suctioning in an acute lung-injured model. Eight mongrel dogs were anesthetized, paralyzed, mechanically ventilated, and given intravenous oleic acid to produce pulmonary edema. Four protocols were tested in alternate order in which either tidal volume inflations or hyperinflations at an Fi(O2) of 0.6 were given with and without an inspiratory hold of 5 seconds before and after each of three sequential suctioning passes. In those protocols in which an inspiratory hold was used, statistically significant changes occurred in right atrial, pulmonary arterial, and aortic systolic and diastolic pressures (p < 0.04). The use of an inspiratory hold with hyperinflation maintained Pa(O2) during suctioning (range of 81 to 91 mm Hg), but had the greatest decrease in P(O2) (8%) after return to the ventilator. In all protocols, with the exception of the one in which hyperinflations without an inspiratory hold were used, there was a cumulative increase in Pa(CO2) with tidal volume inflation protocols reaching peak Pa(CO2) values of 49 (± 7.5) mm Hg. In protocol 4 in which hyperinflation without inspiratory hold was used, Pa(O2) ranged from 75 (± 16) to 92 (± 34) mm Hg, and Pa(CO2) ranged from 37 (± 7) to 42 (± 6) mm Hg. In conclusion, the use of hyperinflation without an inspiratory hold resulted in the least undesirable changes in the variables studied. However, this protocol needs to be replicated in an acutely ill clinical population before recommended for practice.

Original languageEnglish (US)
Pages (from-to)127-134
Number of pages8
JournalHeart and Lung: Journal of Acute and Critical Care
Volume15
Issue number2
StatePublished - Jan 1 1986

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Tidal Volume
Economic Inflation
Blood Pressure
Lung
Pulmonary Edema
Mechanical Ventilators
Oleic Acid
Arterial Pressure
Dogs
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Critical Care and Intensive Care Medicine
  • Pulmonary and Respiratory Medicine

Cite this

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title = "The effect of hyperinflation, inspiratory hold, and oxygenation on cardiopulmonary status during suctioning in a lung-injured model",
abstract = "This study determined the effects of a 5-second inspiratory hold during ventilatory maneuvers on cardiopulmonary status before, during, and after endotracheal suctioning in an acute lung-injured model. Eight mongrel dogs were anesthetized, paralyzed, mechanically ventilated, and given intravenous oleic acid to produce pulmonary edema. Four protocols were tested in alternate order in which either tidal volume inflations or hyperinflations at an Fi(O2) of 0.6 were given with and without an inspiratory hold of 5 seconds before and after each of three sequential suctioning passes. In those protocols in which an inspiratory hold was used, statistically significant changes occurred in right atrial, pulmonary arterial, and aortic systolic and diastolic pressures (p < 0.04). The use of an inspiratory hold with hyperinflation maintained Pa(O2) during suctioning (range of 81 to 91 mm Hg), but had the greatest decrease in P(O2) (8{\%}) after return to the ventilator. In all protocols, with the exception of the one in which hyperinflations without an inspiratory hold were used, there was a cumulative increase in Pa(CO2) with tidal volume inflation protocols reaching peak Pa(CO2) values of 49 (± 7.5) mm Hg. In protocol 4 in which hyperinflation without inspiratory hold was used, Pa(O2) ranged from 75 (± 16) to 92 (± 34) mm Hg, and Pa(CO2) ranged from 37 (± 7) to 42 (± 6) mm Hg. In conclusion, the use of hyperinflation without an inspiratory hold resulted in the least undesirable changes in the variables studied. However, this protocol needs to be replicated in an acutely ill clinical population before recommended for practice.",
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N2 - This study determined the effects of a 5-second inspiratory hold during ventilatory maneuvers on cardiopulmonary status before, during, and after endotracheal suctioning in an acute lung-injured model. Eight mongrel dogs were anesthetized, paralyzed, mechanically ventilated, and given intravenous oleic acid to produce pulmonary edema. Four protocols were tested in alternate order in which either tidal volume inflations or hyperinflations at an Fi(O2) of 0.6 were given with and without an inspiratory hold of 5 seconds before and after each of three sequential suctioning passes. In those protocols in which an inspiratory hold was used, statistically significant changes occurred in right atrial, pulmonary arterial, and aortic systolic and diastolic pressures (p < 0.04). The use of an inspiratory hold with hyperinflation maintained Pa(O2) during suctioning (range of 81 to 91 mm Hg), but had the greatest decrease in P(O2) (8%) after return to the ventilator. In all protocols, with the exception of the one in which hyperinflations without an inspiratory hold were used, there was a cumulative increase in Pa(CO2) with tidal volume inflation protocols reaching peak Pa(CO2) values of 49 (± 7.5) mm Hg. In protocol 4 in which hyperinflation without inspiratory hold was used, Pa(O2) ranged from 75 (± 16) to 92 (± 34) mm Hg, and Pa(CO2) ranged from 37 (± 7) to 42 (± 6) mm Hg. In conclusion, the use of hyperinflation without an inspiratory hold resulted in the least undesirable changes in the variables studied. However, this protocol needs to be replicated in an acutely ill clinical population before recommended for practice.

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