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Use of siliconised infant endotracheal tubes reduces work of breathing under turbulent flow

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Abstract The high resistance of an infant endotracheal tube (ETT) can markedly impair ventilation and gas exchange. Since some manufacturers cover the inner surface of their ETTs with a silicon… Click to show full abstract

Abstract The high resistance of an infant endotracheal tube (ETT) can markedly impair ventilation and gas exchange. Since some manufacturers cover the inner surface of their ETTs with a silicon layer in order to diminish deposition and ease mucous evacuation from airway, via surface roughness decrease, we assessed whether the silicon layer may affect tube resistance, work of breathing and other parameters of ventilation. We compared SUMI (Poland) non-siliconised and siliconised polyvinyl chloride ETTs (2.5, 3.0 and 4.0 mm ID), twenty of each type and size combination. Simulating volume-controlled ventilation with the hybrid (numerical–physical) lung models of a premature infant and a 3-month-old baby peak inspiratory pressure (PIP), peak inspiratory and expiratory flow (PIF, PEF), (patient + ETT) inspiratory and expiratory airway resistance ( R ins , R exp ) and work of breathing by ventilator (WOB vt ) were measured. Additionally, images of the both type surfaces were taken using Hitachi TM-1000 electron microscope. When 2.5 and 3.0 mm ID ETTs were examined, laminar flow ( Re R ins , R exp and WOB vt were significantly lower (5%, 17%, 17%, and 7%, respectively) ( P P vt in presence of turbulent flow. However, artifacts observed on the surface of non-siliconised and siliconised ETTs can potentially impair ventilation.

Keywords: turbulent flow; infant endotracheal; flow; work breathing

Journal Title: Biocybernetics and Biomedical Engineering
Year Published: 2017

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