Tracheal double-lumen ventilation attenuates hypercapnia and respiratory acidosis in lung injured pigs

Intensive Care Med. 2004 Apr;30(4):686-92. doi: 10.1007/s00134-004-2197-5. Epub 2004 Mar 4.

Abstract

Objective: Evaluation of ventilatory and circulatory effects with coaxial double-lumen tube ventilation for dead-space reduction as compared with standard endotracheal tube ventilation.

Design: Experimental study in a pig model of lung lavage induced acute lung injury.

Setting: University research laboratory.

Measurements and results: Tidal volumes of 6, 8 and 10 ml/kg body weight with a set respiratory rate of 20 breaths per minute were used in a random order with both double-lumen ventilation and standard endotracheal tube ventilation. Measurements of ventilatory and circulatory parameters were obtained after steady state at each experimental stage. With a tidal volume of 6 ml/kg, PaCO(2) was reduced from 10.9 kPa (95% CI 9.0-12.9) with a standard endotracheal tube to 8.2 kPa (95% CI 7.0-9.4) with double-lumen ventilation. This corresponds to a reduction in carbon dioxide levels by 25%. At 6 ml/kg, pH increased from 7.17 (95% CI 7.09-7.24) with a standard endotracheal tube to 7.27 (95% CI 7.21-7.32) with double-lumen ventilation. Tracheal pressure was monitored continuously and no difference between single- or double-lumen ventilation was noted at corresponding levels of ventilation. There was no formation of auto-PEEP. Partial tube obstruction due to secretions was not observed during the experiments.

Conclusions: Coaxial double-lumen tube ventilation is an effective adjunct to reduce technical dead space. It attenuates hypercapnia and respiratory acidosis in a lung injury pig model.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis, Respiratory / metabolism
  • Acidosis, Respiratory / prevention & control*
  • Airway Resistance
  • Animals
  • Carbon Dioxide / metabolism
  • Central Venous Pressure / physiology
  • Disease Models, Animal
  • Female
  • Hypercapnia / metabolism
  • Hypercapnia / prevention & control*
  • Male
  • Pulmonary Gas Exchange / physiology
  • Random Allocation
  • Respiration, Artificial / methods*
  • Respiratory Dead Space / physiology
  • Respiratory Distress Syndrome / chemically induced
  • Respiratory Distress Syndrome / physiopathology*
  • Swine
  • Trachea / physiopathology*

Substances

  • Carbon Dioxide