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The alveoli tend to collapse in patients with ARDS. Endotracheal aspiration may increase alveolar collapse by decreasing the end-expiratory lung volume. The hypothesis is that closed endotracheal aspiration led to less end-expiratory volume loss when compared to open endotracheal aspiration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Open Suction | Other | Endotracheal aspiration will perform after the patient disconnect from mechanical ventilation |
|
| Closed Suction | Other | Endotracheal aspiration will perform without disconnection from mechanical ventilation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endotracheal aspiration | Procedure | Clearance of endotracheal secretions via a catheter. |
|
| Measure | Description | Time Frame |
|---|---|---|
| End expiratory lung volume (EELV) | End expiratory lung impedance (EELI) will be measured wit electric impedance tomography. Change in EELI representative of change in EELV. | One minute before suctioning, 1, 10, 20, 30 minutes after suctioning |
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Inclusion Criteria:
Mechanically ventilated due to ARDS
Exclusion Criteria:
Hemodynamically unstable Air leaks syndrome (pneumothorax) Higher level of FiO2 (>60%) Chronic obstructive pulmonary disease
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Health Sciences Turkey, Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Intensive Care Unit | Izmir | 35110 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37211764 | Derived | Yildirim S, Saygili SM, Sunecli O, Kirakli C. Comparison of the effects of open and closed aspiration on end-expiratory lung volume in acute respiratory distress syndrome. Korean J Anesthesiol. 2024 Feb;77(1):115-121. doi: 10.4097/kja.23194. Epub 2023 May 22. |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
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This is a crossover study and suction procedure was made in a random order with 60 minutes wash out period between two suction maneuvers. Patients were randomized after intubation; randomization was made with sealed envelopes.
All patients mechanically ventilated with lung protective ventilation strategy. Before the suctioning the patients ventilated with 100% of oxygen for 60 seconds. In open suction, the patient was disconnected from mechanical ventilator, the aspiration catheter advanced until resistance met after that the catheter withdraw 1 cm before aspiration. During endotracheal suctioning a negative pressure applied two times for 5 seconds. The negative pressure was set 150 mmHg. All suctioning maneuvers performed by intensivists.
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