tailieunhanh - Báo cáo khoa học: "Endotracheal tubes and imposed work of breathing: what should we do about it, if anything"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Endotracheal tubes and imposed work of breathing: what should we do about it, if anything? | Available online http content 7 5 347 Commentary Endotracheal tubes and imposed work of breathing what should we do about it if anything Richard D Branson Associate Professor of Surgery University of Cincinnati Cincinnati Ohio USA Correspondence Richard D Branson Published online 28 August 2003 Critical Care 2003 7 347-348 DOI cc2367 This article is online at http content 7 5 347 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Concerns about the work of breathing imposed by the endotracheal tube have led clinicians to routinely use pressure support to overcome this resistive component. More recently ventilator manufacturers have introduced systems to automatically overcome endotracheal tube resistance regardless of tube diameter or patient demand for flow. Despite the theoretical advantages neither method appears to provide superior performance. Stepping back the real question may be is overcoming endotracheal tube resistance really important Keywords endotracheal tube mechanical ventilation tube compensation work of breathing Techniques and equipment to accomplish endotracheal ET intubation were the precursor to modern day invasive mechanical ventilation. In recent years however the popularity of the ET tube has waned. Clinically the ET tube is seen as an impediment to spontaneous breathing a transit route for bacteria to the lower airway and - with the advent of noninvasive ventilation - a device to be avoided when possible. Of particular interest has been the effect of the ET tube on work of breathing and methods to eliminate this work. Commonly pressure support ventilation PSV has been suggested as the technique of choice for eliminating imposed work due to the ET tube. More recently the technique of automatic tube compensation ATC has become available to specifically address this issue. In this issue of Critical Care Maeda and colleagues 1 compare the technique of ATC as .