The Extra Work of Breathing Through Adult Endotracheal Tubes

A sinusoidal flow generator was connected to adult endotracheal tubes of sizes 5–10 and was used to simulate human ventilation. Measurement of the changes in pressure and flow allowed calculation of the work imposed on breathing by endotracheal tubes. The work of breathing increased with increasing ventilatory rate, tidal volume, and decreasing tube diameter. We discuss the suggestion that the work imposed on breathing by an endotracheal tube is a more appropriate unit for comparison than resistance to air flow.

[1]  H. Beecher.  A NOTE ON THE OPTIMAL SIZE OF ENDOTRACHEAL TUBES BASED UPON STUDIES OF BLOOD GASES , 1950, Anesthesiology.

[2]  S V Dawson,et al.  Interaction of oscillatory and unidirectional flows in straight tubes and an airway cast. , 1982, Journal of applied physiology: respiratory, environmental and exercise physiology.

[3]  M. E. Weber,et al.  Model study of flow dynamics in human central airways. Part III: Oscillatory velocity profiles. , 1984, Respiration physiology.

[4]  P. Suratt,et al.  Resistance to Breathing in Healthy Subjects following Endotracheal Intubation under Topical Anesthesia , 1980, Anesthesia and analgesia.

[5]  R. Barrow,et al.  Noninvasive Assessment by Capacitance Respirometry of Respiration Before and After Extubation , 1975, Anesthesia and analgesia.

[6]  H. Proctor,et al.  Prediction of respiratory muscle fatigue by measurements of the work of breathing. , 1973, Surgery, gynecology & obstetrics.

[7]  M Sullivan,et al.  Endotracheal tube as a factor in measurement of respiratory mechanics. , 1976, Journal of applied physiology.

[8]  J. Snow,et al.  On the inhalation of the vapour of ether in surgical operations. , 1953, British journal of anaesthesia.

[9]  I. Grossbach-Landis,et al.  Weaning from mechanical ventilation , 2005, ERS practical Handbook of Invasive Mechanical Ventilation.

[10]  M. Weil,et al.  The measurement of the work of breathing for the clinical assessment of ventilator dependence , 1977, Critical care medicine.

[11]  J. Nunn,et al.  THE RESPIRATORY EFFECTS OF RESISTANCE TO BREATHING IN ANESTHETIZED MAN , 1961, Anesthesiology.

[12]  D. Benson,et al.  The Ventilatory Response of Infants to Airway Resistance , 1966 .

[13]  M. Wall.  Infant endotracheal tube resistance: effects of changing length, diameter, and gas density , 1980, Critical care medicine.

[14]  B. Kay,et al.  Change in the work of breathing imposed by five anaesthetic breathing systems. , 1983, British journal of anaesthesia.