title: Evaluation of the Efficiency of the Atraumatic Endotracheal Tube in the Pulmonary-Gas Exchange: an Experimental Study.
abstract: OBJECTIVE
  Mechanical ventilation is frequently necessary, in which case the use of an endotracheal tube is mandatory. The tube has an inflatable balloon in its distal extremity, whose aim is, among other functions, an efficient arterialization. However, serious injuries in the place of contact of the balloon with the trachea can be frequent. Some studies point out that balloons with permanent pressure may reduce this complication. Nevertheless, air scape, expressed by the inspiratory (IV) and expiratory volume (EV) variation (Δ IV-EV), may occur, possibly leading to hypoxemia. Thus, the goal of this study was to verify the efficiency of a modified endotracheal tube on arterializations compared to the traditional endotracheal tube.
  
  
  METHODS
  The modified endotracheal tube presents intermittent insufflation, with three drillings in the internal region of the cuff, allowing for insufflation in the inspiratory phase of the mechanical ventilation. Three animals were used for the control group, with a cuff pressure of 30 cmH2O, and seven pigs had the modified endotracheal tube. Each animal was kept under mechanical ventilation (FIO2=0.21) for 6 hours. Arterial and venous gases were measured every three hours (T0; T3; T6).
  
  
  RESULTS
  The gases confirmed the lack of hypoxia between the Groups, with a difference in the ΔIV-EV at T0 (P=0.0486).
  
  
  CONCLUSIONS
  In this study, the lack of hypoxia showed the efficiency of the modified endotracheal tube. However, new studies are necessary, particularly in diseased lungs, in order to evaluate the real efficiency of the mentioned device on the pulmonary gas exchange.
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Raíssa Quaiatti
authors.initials: RQ
authors.lastname: Antonelli
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Marcos Mello
authors.initials: MM
authors.lastname: Moreira
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Luiz Claudio
authors.initials: LC
authors.lastname: Martins
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Maíra Soliani Del
authors.initials: MS
authors.lastname: Negro
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Tiago Antonio
authors.initials: TA
authors.lastname: Baldasso
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Alfio José
authors.initials: AJ
authors.lastname: Tincani
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis; D019296:Capnography; D004526:Efficiency; D007327:Insufflation / Q000379:methods; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D023421:Models, Animal; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012121:Respiration, Artificial / Q000295:instrumentation*; D013552:Swine