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Canadian Anaesthetists’ Society Journal

, Volume 33, Issue 2, pp 157–161 | Cite as

Does peep reduce the incidence of aspiration around endotracheal tubes?

  • Brad A. Janson
  • Thomas J. Poulton
Article

Abstract

Despite improved endotracheal tube designs, aspiration remains a cause of pulmonary complications. This in vitro study evaluates the efficacy of positive end-expiratory pressure (PEEP) in reducing the incidence of seepage around endotracheal tubes during mechanical (MV) and spontaneous ventilation (SV). Two transparent plastic “tracheas” with cuffed and uncuffed endotracheal tubes simulated adult andpaediatric airways respectively. Ten trials without PEEP and ten with PEEP at each of two different levels were completed for each model using both SV and MV. Simulated SV in both models was associated with seepage nearly 100 per cent of the time, regardless of PEEP level. During MV without PEEP, seepage occurred in 55 per cent of the adult trials and 100 per cent of the paediatric trials. In contrast, MV with 5 cm H2O PEEP produced seepage rates of15 per cent in the adult model andOper cent in the paediatric model. Comparedto trials without PEEP, seepage occurred less frequently, was reduced in amount and delayed in onset. MV with PEEP significantly (p < 0.05) decreased the incidence of seepage around endotracheal tubes.

Key words

equipment tubes endotracheal complications aspiration ventilation PEEP mechanical spontaneous 

Résumé

Malgré l’ amélioration de la forme du tube endotrachéal, l’aspiration demeure une cause de complication pulmonaire. Cette itude in vitro evalue I’efficacite de la pression positive en fin d’expiration (PEEP) afin de réduire l’ incidence de fuite autour des tubes endotrachéaux pendant la ventilation mécanique et la ventilation spontanée.

Deux trochées en plastique transparent avec des tubes endotrachéaux à ballonnets et sans ballonnets ont été pris comme modelèe de voies aériennes adultes et d’enfants.

Dix essais avec PEEP et dix sans PEEP è des niveaux différents ont été accomplis pour chaque modèle utilisant la ventilation spontanée ou la ventilation mécanique. La ventilation spontanée pour les deux modèles a été associies avec une fuite à chaque fois indépendamment du niveau du PEEP. Lors de la ventilation mécanique sans PEEP la fuite survint dans 55 pour cent des essais adultes et 100 pour cent des essais pédiatriques. En contraste, la ventilation mécanique avec 5 cm H2O PEEP produit un taux de fuite de 15 pour cent pour le modèle adulte et O pour cent pour le modèle pédiatrique. Comparativement aux essais sans PEEP, la fuite survint moins fréquemment, a été réduite en quantité retardée à s’établir. La ventilation mécanique avec PEEP a significativement (p < 0.05) diminué l’incidence de fuite autour des tubes endotrachéaux.

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Copyright information

© Canadian Anesthesiologists 1986

Authors and Affiliations

  • Brad A. Janson
    • 1
  • Thomas J. Poulton
    • 1
  1. 1.Department of AnesthesiologyCreighton University School of MedicineOmaha

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