Bacterial colonization of the respiratory tract following tracheal intubation—Effect of gravity: An experimental study*

Panigada, Mauro; Greco, Guido; Stylianou, Mario; Kolobow, Theodor

doi:10.1097/01.ccm.0000049943.01252.e5

Cited by 65 publications

(51 citation statements)

References 17 publications

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“…The study by Zanella et al supports previous laboratory findings indicating no altered airway colonization and excellent gas exchange and lung function after horizontal orientation of the ET and neck of the animals, through a lateral body rotation [14]. Moreover, another randomized animal study by Li Bassi et al [15] showed that following tracheal intubation, gravitational force influences tracheal mucus clearance.…”

supporting

confidence: 56%

Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?

Pneumatikos

2012

Intensive Care Med

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supporting

confidence: 56%

Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?

Pneumatikos

2012

Intensive Care Med

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“…Previous investigations have demonstrated that the lateral and 45º semi-lateral position decreases the incidence of aspiration and the risk of ventilator-associated pneumonia. [13,18,19] Measuring the difference in the height between these tissues may be effective in deciding the degree of the semi-lateral position required to prevent ventilatorassociated pneumonia.…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory studies have suggested that the lateral Trendelenburg position is effective in preventing ventilator-associated pneumonia. [18,19] Pulmonary aspiration may be prevented during intubation attempt by the use of a combination of the head-down tilt and the semi-lateral position. Further investigations are needed.…”

Section: Discussionmentioning

confidence: 99%

Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions

Takenaka

Aoyama²

2016

World Journal of Emergency Medicine

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BACKGROUND: Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency patients. Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications. Although it has been considered that aspiration can be prevented in the lateral position, few studies have evaluated the ability to prevent aspiration. Moreover, this position is not always a favorable position for tracheal intubation. If aspiration can be prevented in a clinically relevant semi-lateral position, it may be advantageous. We assessed the ability to prevent aspiration in the lateral position and various degrees of the semi-lateral position using a vomiting-regurgitation manikin model. METHODS:A manikin's head was placed in the neutral, simple extension, or sniffing position. The amount of aspirated saline into the bronchi during simulated vomiting was measured at semilateral position angles of 0º to 90º in 10º increments. The difference in the vertical height between the mouth corner and the inferior border of the vocal cord was measured radiologically at each semilateral position in the three head-neck positions.RESULTS: Pulmonary aspiration was prevented at the ≥70º, ≥80º, and 90º semi-lateral positions in the neutral, simple extension, and sniffi ng positions, respectively. The mouth was lower than the vocal cord in the semi-lateral position in which aspiration was prevented. CONCLUSION:The lateral or excessive semi-lateral position was necessary to protect the lung from aspiration in the head-neck positions commonly used for tracheal intubation. Prevention of aspiration was diffi cult within clinically relevant semi-lateral positions.

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“…The trachea/ETT orientation promoted the outward drainage of bacteria-laden mucus, avoiding bacterial translocation from the oropharynx into the lungs. 4,5 Detailed knowledge of the orientation of the human trachea is therefore imperative for VAP prevention strategy in intubated patients. 6 In this retrospective analysis of computed tomography (CT) images, the length, diameter, orientation, and compliance of tracheas from mechanically ventilated subjects at different airway pressures (P aw ) were investigated.…”

Section: Introductionmentioning

confidence: 99%

Spatial Orientation and Mechanical Properties of the Human Trachea: A Computed Tomography Study

Zanella

Cressoni

Ferlicca³

et al. 2014

Respir Care

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BACKGROUND:The literature generally describes the trachea as oriented toward the right and back, but there is very little detailed characterization. Therefore, the aim of this study was to precisely determine the spatial orientation and to better characterize the physical properties of the human trachea. METHODS: We analyzed lung computed tomography scans of 68 intubated and mechanically ventilated subjects suffering from acute lung injury/ARDS at airway pressures (P aw )

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Bacterial colonization of the respiratory tract following tracheal intubation—Effect of gravity: An experimental study*

Abstract: The horizontal orientation of the endotracheal tube and neck, through lateral body rotation, showed no altered airway colonization and maintained excellent gas exchange and lung function in our animal model.

Cited by 65 publications

References 17 publications

Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?

Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?

Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions

Spatial Orientation and Mechanical Properties of the Human Trachea: A Computed Tomography Study

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