Tracheal double-lumen ventilation attenuates hypercapnia and respiratory acidosis in lung injured pigs.
OBJECTIVE
Evaluation of ventilatory and circulatory effects with coaxial double-lumen tube ventilation for dead-space reduction as compared with standard endotracheal tube ventilation.


METHODS
Experimental study in a pig model of lung lavage induced acute lung injury.


METHODS
University research laboratory.


RESULTS
Tidal volumes of 6, 8 and 10 ml/kg body weight with a set respiratory rate of 20 breaths per minute were used in a random order with both double-lumen ventilation and standard endotracheal tube ventilation. Measurements of ventilatory and circulatory parameters were obtained after steady state at each experimental stage. With a tidal volume of 6 ml/kg, PaCO(2) was reduced from 10.9 kPa (95% CI 9.0-12.9) with a standard endotracheal tube to 8.2 kPa (95% CI 7.0-9.4) with double-lumen ventilation. This corresponds to a reduction in carbon dioxide levels by 25%. At 6 ml/kg, pH increased from 7.17 (95% CI 7.09-7.24) with a standard endotracheal tube to 7.27 (95% CI 7.21-7.32) with double-lumen ventilation. Tracheal pressure was monitored continuously and no difference between single- or double-lumen ventilation was noted at corresponding levels of ventilation. There was no formation of auto-PEEP. Partial tube obstruction due to secretions was not observed during the experiments.


CONCLUSIONS
Coaxial double-lumen tube ventilation is an effective adjunct to reduce technical dead space. It attenuates hypercapnia and respiratory acidosis in a lung injury pig model.
Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. sven.lethvall@medic.gu.se
Sven
S
Lethvall
Sophie
S
Lindgren
Stefan
S
Lundin
Ola
O
Stenqvist
D000142:Acidosis, Respiratory / Q000378:metabolism / Q000517:prevention & control*; D000403:Airway Resistance; D000818:Animals; D002245:Carbon Dioxide / Q000378:metabolism; D002496:Central Venous Pressure / Q000502:physiology; D004195:Disease Models, Animal; D005260:Female; D006935:Hypercapnia / Q000378:metabolism / Q000517:prevention & control*; D008297:Male; D011659:Pulmonary Gas Exchange / Q000502:physiology; D011897:Random Allocation; D012121:Respiration, Artificial / Q000379:methods*; D012126:Respiratory Dead Space / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000503:physiopathology*; D013552:Swine; D014132:Trachea / Q000503:physiopathology*
D002245:Carbon Dioxide