Tracheal Gas Insufflation in Pediatric Patients with Severe Respiratory Failure

Overview

Objective:
To evaluate the effects of tracheal gas insufflation (TGI) on blood gases exchange (especially paCO2) in children with severe respiratoryfailure.Study design: Prospective observational study.Setting: Department of Anesthesiology and Intensive Care ECMO Center; University Children’s Hospital, Brno.Patients: 8 children with acute hypoxemic respiratory failure with pronounced hypercapnia.Methods: Patients were mechanically ventilated in PCV or PRVC mode; oxygenation was optimalized with increase of mean airway pressure (Paw)by increasing PEEP with limited peak airway pressure (PIP) with respect to the lowest possible FiO2. Tidal volumes were < 10 ml/kg, minute ventilationwas increased by increasing respiratory rate (RR). If there were reached values of paCO2 > 10.0 kPa and/or pH < 7.2, tracheal gas insufflation wasinstituted, with catheter gas flow from 150 to 200 ml/kg/min. We monitored the values of pH, paO2, p aCO2, p aO2/FiO2, oxygenation index and ventilationindex. Paired t-test was used to compare mean parameters obtained at time 0 and after 3 hours of TGI.Results: After 3 hours of TGI, pH increased from 7.25 to 7.42 (p = 0.0002), paCO2 decreased from 10.58 to 4.79 kPa (p

Key words:
tracheal gas insufflation – respiratory failure – CO2 elimination – children