Flow dynamics in pediatric rigid bronchoscopes using computer-aided design modeling software.
Objectives/hypothesis: Observed complications during rigid bronchoscopy, including hypercarbia and hypoxemia, prompted us to assess how well rigid bronchoscopes serve as an airway device. We performed computer-aided design flow analysis of pediatric rigid bronchoscopes to gain insight into flow dyna...
| Publicado en: | Laryngoscope Vol. 126; no. 8; pp. 1940 - 1946 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116857165&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116857165 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0023852X 1GR jtl: Laryngoscope issn: 0023852X maglogo: Y pubinfo: dt: Aug2016 vid: 126 iid: 8 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 116857165 116857165 NLM26422815 116857165 10.1002/lary.25690 NLM26422815 116857165 ppf: 1940 ppct: 6 formats: tig: atl: Flow dynamics in pediatric rigid bronchoscopes using computer-aided design modeling software. aug: au: Barneck, Mitchell D. Webb, J. Taylor Robinson, Ryan E. Grimmer, J. Fredrik affil: Department of Bioengineering, University of Utah, Salt Lake City Utah, U.S.A sug: subj: Computer-Aided Design Respiration, Artificial Methods Intubation, Intratracheal Equipment and Supplies Software Endoscopes Human Bronchoscopy Equipment Design Validation Studies Comparative Studies Evaluation Research Multicenter Studies ab: Objectives/hypothesis: Observed complications during rigid bronchoscopy, including hypercarbia and hypoxemia, prompted us to assess how well rigid bronchoscopes serve as an airway device. We performed computer-aided design flow analysis of pediatric rigid bronchoscopes to gain insight into flow dynamics.Study Design: We made accurate three-dimensional computer models of pediatric rigid bronchoscopes and endotracheal tubes. SOLIDWORKS (Dassault Systemes, Vélizy-Villacoublay, France) flow analysis software was used to analyze fluid dynamics during pressure-controlled and volume-controlled ventilation.Methods: Flow analysis was performed on rigid bronchoscopes and similar outer diameter endotracheal tubes comparing resistance, flow, and turbulence during two ventilation modalities and in common surgical scenarios.Results: Increased turbulent flow was observed in bronchoscopes compared to more laminar flow in endotracheal tubes of similar outer diameter. Flow analysis displayed higher resistances in all pediatric bronchoscope sizes except one (3.0 bronchoscope) compared to similar-sized endotracheal tubes. Loss of adequate ventilation was observed if the bronchoscope was not assembled correctly or if increased peak inspiratory pressures were needed. Anesthesia flow to the patient was reduced by 63% during telescope insertion.Conclusions: Flow analysis illustrates increased turbulent flow and increased airflow resistance in all but one size of pediatric bronchoscopes compared to endotracheal tubes. This increased turbulence and resistance, along with the unanticipated gas distal exit pattern, may contribute to the documented hypercarbia and hypoxemia during procedures. These findings may explain why hypoxemia and hypercarbia are commonly observed during rigid bronchoscopy, especially when positive pressure ventilation is needed.Level Of Evidence: NA Laryngoscope, 126:1940-1945, 2016. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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