title: Efficacy of coaxial ventilation with a novel endotracheal catheter equipped with a functional cuff: A swine model study.
abstract: BACKGROUND
  We have developed an endotracheal catheter with a functional cuff (ECFC) that inflates during inspiration and deflates during expiration. This catheter, together with a regular ICU ventilator, can provide coaxial ventilation.
  
  
  OBJECTIVE
  The aim of this study was to determine the efficacy of ventilation in adult human-sized swine using an ECFC and a regular ICU ventilator.
  
  
  METHODS
  A prospective animal study.
  
  
  METHODS
  Experimental, Trauma Transplant Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
  
  
  METHODS
  Eight adult Yorkshire swine, weighing 45 to 50  kg, were studied.
  
  
  METHODS
  To create the ECFC, a 5  cm long latex cuff was placed over the distal side ports of either a 14 or 19-Fr gauge endotracheal catheter and a 1  cm long piece of plastic tube was inserted into the tip of the endotracheal catheter to create an internal resistance. The ECFC was placed into the trachea and the proximal end of the ECFC was connected to an ICU ventilator in pressure-control mode, with peak pressures set at either 25, 50 or 70  cmH2O.
  
  
  METHODS
  Tidal volume was calculated using plethysmography.
  
  
  RESULTS
  During pressure control ventilation with the 14-Fr gauge ECFC at set inspiratory pressures of 25, 50 and 75  cmH2O, the tidal volumes generated were 209 ± 36, 309 ± 61 and 367 ± 85  ml, respectively, and with the 19-Fr gauge ECFC these were 277 ± 51, 442 ± 91 and 538 ± 123  ml, respectively. No complications were observed.
  
  
  CONCLUSIONS
  An ECFC combined with a regular pressure-controlled ICU ventilator can produce adequate tidal volumes in adult human-sized swine. Our results establish the feasibility of ventilation with this new alternative technique. The safety and advantages of such a technique remain to be determined in humans.
authors.affiliation: From the Emergency and Critical Care Medicine, Tokushima University Hospital (JO), Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital (ZS, JW), Trauma Transplant Surgery, Massachusetts General Hospital (MD, DRK), Respiratory Care Services, Massachusetts General Hospital (RMK), Clinical Anesthesiology, Vanderbilt University, Nashville, Tennessee, USA (YJ).
authors.forename: Jun
authors.initials: J
authors.lastname: Oto
authors.forename: Zhenbo
authors.initials: Z
authors.lastname: Su
authors.forename: Michael
authors.initials: M
authors.lastname: Duggan
authors.forename: Jingwen
authors.initials: J
authors.lastname: Wang
authors.forename: David R
authors.initials: DR
authors.lastname: King
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kacmarek
authors.forename: Yandong
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000818:Animals; D049628:Body Size; D057785:Catheters; D004867:Equipment Design; D045853:Exhalation; D005260:Female; D001239:Inhalation; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008168:Lung / Q000502:physiology*; D023421:Models, Animal; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D013552:Swine; D013990:Tidal Volume; D013997:Time Factors