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Peak intratracheal pressure during controlled ventilation in infants and children
Author(s) -
SYNNOTT A.,
WREN W. S.,
DAVENPORT J.
Publication year - 1987
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1987.tb05316.x
Subject(s) - medicine , peak inspiratory pressure , anesthesia , ventilation (architecture) , respiratory system , artificial ventilation , tracheal tube , airway , mean airway pressure , tidal volume , lung , respiratory disease , mechanical engineering , engineering
Summary The mathematical relationship between peak ventilator breathing system pressure displayed on the digital meter of the Siemens SV900C ventilator, and peak intratracheal pressure measured at the distal end of the tracheal tube, was defined and incorporated into a computer program. The mean difference between peak airway pressure calculated by the computer and directly measured peak intratracheal pressure was 0.02 kPa (SD 0.10) in 18 infants and children. The mean difference between ventilator breathing system pressure and intratracheal pressure in the same group was 0.82 kPa (SD 0.91). Bench tests established that the decrease in peak pressure displayed by the ventilator (from 1.36 to 0.38 kPa) while inspiratory lime was increased from 20 to 80% of the respiratory period, concealed an increase (from 0.2 to 0.38 kPa) in intratracheal pressure which occurs during this process; and that the large increase in pressure displayed by the ventilator (from 0.3 to 6 kPa) while respiratory frequency was increased from 20 to 120 breaths I minute, concealed a small increase in peak intratracheal pressure (0.2–0.3 kPa) which occurs during this process. These changes were accurately predicted by the computer program. The increase in intratracheal pressure associated with prolonged inspiratory times explains the high incidence of baro‐trauma which has recently been associated with this procedure in infants.