Adjustable inspiratory occlusion valve in experimental bronchopleural fistula. A new therapeutic perspective.
OBJECTIVE
To assess the efficacy of an adjustable inspiratory occlusion valve in experimental bronchopleural fistula during mechanical ventilation.


METHODS
We studied six mechanically ventilated pigs in a surgically created, reproducible model of bronchopleural fistula managed with mechanical ventilation and water-sealed thoracic drainage. An adjustable inspiratory occlusion valve was placed between the thoracic drain and the endotracheal tube. Hemodynamic data, capnography and blood gases were recorded before and after the creation of the bronchopleural fistula as well as after every adjustment of the inspiratory occlusion valve.


RESULTS
When compared with the standard water-sealed drainage treatment, the use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume and reduced bronchopleural air leak (p<0.001), without hemodynamic compromise when compared with conventional water sealed drainage.


CONCLUSIONS
The use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume, reduced alveolar leak, in an experimental reproducible model of bronchopleural fistula, without causing any hemodynamic derangements when compared with conventional water sealed drainage.
Department of Physical Therapy, Universidade de Jaguariúna, BR.
Maria Gabriela Cavicchia
MG
Toneloto
Department of Internal Medicine, Faculty of Medical School, Universidade de Campinas, BR.
Marcos Mello
MM
Moreira
Department of Surgery, Medical School, UNICAMP, Campinas, SP, BR.
Joaquim Murray
JM
Bustorff-Silva
Department of Statistics, UNICAMP, Campinas, SP, BR.
Gabriel Franco de
GF
Souza
Department of Surgery, Medical School, UNICAMP, Campinas, SP, BR.
Luiz Claudio
LC
Martins
Department of Surgery, Medical School, UNICAMP, Campinas, SP, BR.
Desanka
D
Dragosavac
Department of Surgery, Medical School, UNICAMP, Campinas, SP, BR.
Antonio Luis Eiras
AL
Falcão
D000818:Animals; D062186:Arterial Pressure / Q000502:physiology; D001784:Blood Gas Analysis; D001983:Bronchial Fistula / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D006439:Hemodynamics / Q000502:physiology; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008488:Medical Illustration; D010995:Pleural Diseases / Q000628:therapy*; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000379:methods; D012129:Respiratory Function Tests / Q000379:methods; D013552:Swine; D060205:Therapeutic Occlusion / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D012122:Ventilators, Mechanical