Effects of tracheal suctioning on respiratory resistances in mechanically ventilated patients.
OBJECTIVE
To evaluate the effects of tracheal suctioning (TS) on respiratory resistances in sedated critical care patients receiving mechanical ventilation (MV).


METHODS
Surgical ICU of Bichat Hospital, Paris.


METHODS
Thirteen sedated critical care patients receiving MV for various conditions.


RESULTS
Airway resistances (R1), airway and pulmonary resistances (R2), and intrinsic positive end-expiratory pressure (PEEPint) were measured according to the end-inspiratory and end-expiratory occlusion methods before and after TS. R1 and R2 increased by 49.1% and 46.3%, respectively, 0.5 min after TS (p<0.01) but returned to baseline values at 1 min without any change thereafter. PEEPint decreased progressively following TS to reach a significant level (-13.3%) at 10 min (p<0.05) and was persistently reduced at 30 min (p<0.01). Nine patients received 500 microg of inhaled albuterol before another suctioning procedure. R1 and R2 decreased by 11.5% and 9.9%, respectively, 20 min after inhalation (p<0.05), but the R1 and R2 initial increase following TS did not differ between the two suctioning procedures.


CONCLUSIONS
TS evokes only a transient bronchoconstrictor response, but thereafter, does not reduce respiratory resistances below presuctioning values. However, the decrease of PEEPint following TS suggests an increase of expiratory flow. Effective beta2-adrenergic receptor blockade fails to suppress the TS-induced bronchoconstrictor response.
Guglielminotti
J
J
Département d'Anesthésie et de Réanimation Chirurgicale, Hôpital Bichat, Paris, France.
Desmonts
J M
JM
Dureuil
B
B
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000403:Airway Resistance / Q000502:physiology*; D000420:Albuterol / Q000008:administration & dosage; D016084:Bronchoconstriction / Q000502:physiology*; D003422:Critical Care; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D015656:Respiratory Mechanics / Q000502:physiology; D013396:Suction / Q000009:adverse effects / Q000295:instrumentation
D000318:Adrenergic beta-Agonists; D000420:Albuterol