RT Journal Article
SR Electronic
T1 Effects of tracheotomy on respiratory mechanics in spontaneously breathing patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 112
OP 117
DO 10.1183/09031936.02.01342001
VO 20
IS 1
A1 V. Moscovici da Cruz
A1 S.E. Demarzo
A1 J.B.B. Sobrinho
A1 M.B.P. Amato
A1 L.P. Kowalski
A1 D. Deheinzelin
YR 2002
UL http://erj.ersjournals.com/content/20/1/112.abstract
AB Tracheotomy is a method of intubating the trachea, which is employed in several clinical settings, including the treatment of head and neck neoplasms. Tracheotomy is believed to facilitate weaning through changes in respiratory mechanics. Existing information concerning functional changes associated with tracheotomy are limited to comparisons with orotracheal intubation. In this study, respiratory mechanics were monitored in seven spontaneously breathing patients, before and after an elective tracheotomy was performed for surgical treatment of cancer. Campbell diagrams were constructed by plotting pressure, obtained with an oesophageal balloon catheter, against volume, obtained from a pneumotachograph placed at the airway opening. Work of breathing was calculated as the internal area of the Campbell diagram and was partitioned into its elastic and inspiratory and expiratory resistive components. Oesophageal pressure was also used to quantify intrinsic positive end-expiratory pressure (PEEPi) and the pressure-time product (PTP), which is considered to be proportional to the oxygen cost of breathing. PTP was divided into its resistive and elastic components. Inspiratory resistive work, PEEPi, inspiratory PTP, as well as its resistive and elastic components were significantly reduced by tracheotomy. Tracheotomy significantly reduces work of breathing and pressure-time product in spontaneously breathing patients. This study was supported by grants from the Fundação de Amparo à Pesquisa >do Estado de São Paulo (FAPESP).