Impact of endotracheal tube size on preextubation respiratory variables

Mehta, Sangeeta; Heffer, Matthew J.; Maham, Nava; Nelson, David L.; Klinger, James R.; Levy, Mitchell M.

doi:10.1016/j.jcrc.2009.11.005

Cited by 10 publications

(11 citation statements)

References 18 publications

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“…This is according to Poiseuille equation, as the resistance to gas flow through a tube varies inversely with the internal diameter of the tube (in particular, to the 4th power of the radius of the tube when flow is laminar). Secondly, secretions (stimulated even more by the presence of the tube) still play an important role: adhering to the inner lumen of the tube, they can lead to significant luminal narrowing, according to Wilson et al [ 6 ], 15% of tubes are shrunk three sizes; other experiences from literature ultimately come to the same conclusions [ 7 , 8 ]. It has been supposed that the inner diameter of a smaller tracheostomy tube may induce increased flow resistance and WOB, if compared to spontaneous breathing.…”

Section: Introductionmentioning

confidence: 99%

A systematic review on tracheostomy decannulation: a proposal of a quantitative semiquantitative clinical score

et al. 2014

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BackgroundTracheostomy is one of the most common surgical procedures performed in critical care patient management; more specifically, ventilation through tracheal cannula allows removal of the endotracheal tube (ETT). Available literature about tracheostomy care and decannulation is mainly represented by expert opinions and no certain knowledge arises from it.MethodsIn lack of statistical requirements, a systematic and critical review of literature regarding tracheostomy tube removal was performed in order to assess predictor factors of successful decannulation and to propose a predictive score. We combined 3 terms and a literature search has been performed using the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via Ovid SP; EMBASE via Ovid SP; EBSCO. Abstracts were independently reviewed: for those studies fitting the inclusion criteria on the basis of the title and abstract, full-text was achieved. We included studies published from January 1, 1995 until March 31, 2014; any sort of review and expert opinion has been excluded by our survey. English language restriction was applied. Ten studies have been considered eligible for inclusion in the review and were analysed further.ResultsCough effectiveness and ability to tolerate tracheostomy tube capping are the most considered parameters in clinical practice; other parameters are taken into different consideration by many authors in order to proceed to decannulation. Among them, we distinguished between objective quantitative parameters and semi-quantitative parameters more dependent from clinician’s opinion. We then built a score (the Quantitative semi Quantitative score: QsQ score) based on selected parameters coming from literature.ConclusionsOn our knowledge, this review provides the first proposal of decannulation score system based on current literature that is hypothetical and requires to be validated in daily practice. The key point of our proposal is to give a higher value to the objective parameters coming from literature compared to less quantifiable clinical ones.

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Section: Introductionmentioning

confidence: 99%

A systematic review on tracheostomy decannulation: a proposal of a quantitative semiquantitative clinical score

et al. 2014

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“…Further study on respiratory complexity and variability during other modes of weaning, such as T-piece and pressure support, is needed. Finally, even endotracheal tube size has an impact on breathing patterns, and its effect on complexity needs to be studied [29].…”

Section: Discussionmentioning

confidence: 99%

A comparison of the rapid shallow breathing index and complexity measures during spontaneous breathing trials after cardiac surgery

Engoren

Blum

2013

Journal of Critical Care

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“…22 Mehta and colleagues made similar observations, finding a higher f/V T in patients with 7-7.5 mm ETTs, compared to those with 8 mm tubes. 23 In studying the effects of breathing through a narrowed tracheotomy tube, Valentini et al also examined the effect on f/V T . In agreement with our work and that of Mehta et al, Valentini found a higher f/V T when breathing occurred through the 6.5 mm inner cannula, compared to the 8 mm internal diameter without the cannula (f/V T 93 vs 77).…”

Section: See the Original Study On Page 2012mentioning

confidence: 99%

“Narrow” Thinking About Difficult Weaning: Don't Forget the Endotracheal Tube

Epstein

2012

Respir Care

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Impact of endotracheal tube size on preextubation respiratory variables

Cited by 10 publications

References 18 publications

A systematic review on tracheostomy decannulation: a proposal of a quantitative semiquantitative clinical score

A systematic review on tracheostomy decannulation: a proposal of a quantitative semiquantitative clinical score

A comparison of the rapid shallow breathing index and complexity measures during spontaneous breathing trials after cardiac surgery

“Narrow” Thinking About Difficult Weaning: Don't Forget the Endotracheal Tube

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