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Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography
Endotracheal suctioning is a widely used procedure to remove secretions from the airways of ventilated patients. Despite its prevalence, regional effects of this maneuver have seldom been studied. In this study, we explore its effects on regional lung aeration in neonates and young infants using ele...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682352/ https://www.ncbi.nlm.nih.gov/pubmed/38012186 http://dx.doi.org/10.1038/s41598-023-42965-7 |
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author | Händel, Claas Becher, Tobias Miedema, Martijn Kallio, Merja Papadouri, Thalia Waldmann, Andreas D. Sophocleous, Louiza Karaoli, Christina Yerworth, Rebecca Bayford, Richard Rimensberger, Peter C. van Kaam, Anton H. Frerichs, Inéz |
author_facet | Händel, Claas Becher, Tobias Miedema, Martijn Kallio, Merja Papadouri, Thalia Waldmann, Andreas D. Sophocleous, Louiza Karaoli, Christina Yerworth, Rebecca Bayford, Richard Rimensberger, Peter C. van Kaam, Anton H. Frerichs, Inéz |
author_sort | Händel, Claas |
collection | PubMed |
description | Endotracheal suctioning is a widely used procedure to remove secretions from the airways of ventilated patients. Despite its prevalence, regional effects of this maneuver have seldom been studied. In this study, we explore its effects on regional lung aeration in neonates and young infants using electrical impedance tomography (EIT) as part of the large EU-funded multicenter observational study CRADL. 200 neonates and young infants in intensive care units were monitored with EIT for up to 72 h. EIT parameters were calculated to detect changes in ventilation distribution, ventilation inhomogeneity and ventilation quantity on a breath-by-breath level 5–10 min before and after suctioning. The intratidal change in aeration over time was investigated by means of regional expiratory time constants calculated from all respiratory cycles using an innovative procedure and visualized by 2D maps of the thoracic cross-section. 344 tracheal suctioning events from 51 patients could be analyzed. They showed no or very small changes of EIT parameters, with a dorsal shift of the center of ventilation by 0.5% of the chest diameter and a 7% decrease of tidal impedance variation after suctioning. Regional time constants did not change significantly. Routine suctioning led to EIT-detectable but merely small changes of the ventilation distribution in this study population. While still a measure requiring further study, the time constant maps may help clinicians interpret ventilation mechanics in specific cases. |
format | Online Article Text |
id | pubmed-10682352 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-106823522023-11-30 Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography Händel, Claas Becher, Tobias Miedema, Martijn Kallio, Merja Papadouri, Thalia Waldmann, Andreas D. Sophocleous, Louiza Karaoli, Christina Yerworth, Rebecca Bayford, Richard Rimensberger, Peter C. van Kaam, Anton H. Frerichs, Inéz Sci Rep Article Endotracheal suctioning is a widely used procedure to remove secretions from the airways of ventilated patients. Despite its prevalence, regional effects of this maneuver have seldom been studied. In this study, we explore its effects on regional lung aeration in neonates and young infants using electrical impedance tomography (EIT) as part of the large EU-funded multicenter observational study CRADL. 200 neonates and young infants in intensive care units were monitored with EIT for up to 72 h. EIT parameters were calculated to detect changes in ventilation distribution, ventilation inhomogeneity and ventilation quantity on a breath-by-breath level 5–10 min before and after suctioning. The intratidal change in aeration over time was investigated by means of regional expiratory time constants calculated from all respiratory cycles using an innovative procedure and visualized by 2D maps of the thoracic cross-section. 344 tracheal suctioning events from 51 patients could be analyzed. They showed no or very small changes of EIT parameters, with a dorsal shift of the center of ventilation by 0.5% of the chest diameter and a 7% decrease of tidal impedance variation after suctioning. Regional time constants did not change significantly. Routine suctioning led to EIT-detectable but merely small changes of the ventilation distribution in this study population. While still a measure requiring further study, the time constant maps may help clinicians interpret ventilation mechanics in specific cases. Nature Publishing Group UK 2023-11-27 /pmc/articles/PMC10682352/ /pubmed/38012186 http://dx.doi.org/10.1038/s41598-023-42965-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Händel, Claas Becher, Tobias Miedema, Martijn Kallio, Merja Papadouri, Thalia Waldmann, Andreas D. Sophocleous, Louiza Karaoli, Christina Yerworth, Rebecca Bayford, Richard Rimensberger, Peter C. van Kaam, Anton H. Frerichs, Inéz Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
title | Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
title_full | Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
title_fullStr | Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
title_full_unstemmed | Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
title_short | Effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
title_sort | effect of routine suction on lung aeration in critically ill neonates and young infants measured with electrical impedance tomography |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682352/ https://www.ncbi.nlm.nih.gov/pubmed/38012186 http://dx.doi.org/10.1038/s41598-023-42965-7 |
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