Adjustable inspiratory occlusion valve in experimental bronchopleural fistula. A new therapeutic perspective

• Published in: Acta cirurgica brasileira Vol. 30; no. 8; pp. 561 - 567
• Main Authors: Toneloto, Maria Gabriela Cavicchia, Moreira, Marcos Mello, Bustorff-Silva, Joaquim Murray, Souza, Gabriel Franco de, Martins, Luiz Claudio, Dragosavac, Desanka, Falcão, Antonio Luis Eiras
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia 01.08.2015
• Subjects: Animals; Arterial Pressure - physiology; Blood Gas Analysis; Bronchial Fistula - therapy; Capnography; Drainage - instrumentation; Drainage - methods; Fistula; Hemodynamics - physiology; Intubation, Intratracheal - instrumentation; Medical Illustration; Models, Animal; Pleural Diseases - therapy; Reproducibility of Results; Respiration, Artificial; Respiration, Artificial - methods; Respiratory Function Tests - methods; Swine; Therapeutic Occlusion - instrumentation; Therapeutic Occlusion - methods; Treatment Outcome; Ventilators, Mechanical
• ISSN: 0102-8650; 1678-2674; 0102-8650
• DOI: 10.1590/S0102-865020150080000007

To assess the efficacy of an adjustable inspiratory occlusion valve in experimental bronchopleural fistula during mechanical ventilation. We studied six mechanically ventilated pigs in a surgically created, reproducible model of bronchopleural fistula managed with mechanical ventilation and water-sealed thoracic drainage. An adjustable inspiratory occlusion valve was placed between the thoracic drain and the endotracheal tube. Hemodynamic data, capnography and blood gases were recorded before and after the creation of the bronchopleural fistula as well as after every adjustment of the inspiratory occlusion valve. When compared with the standard water-sealed drainage treatment, the use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume and reduced bronchopleural air leak (p<0.001), without hemodynamic compromise when compared with conventional water sealed drainage. The use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume, reduced alveolar leak, in an experimental reproducible model of bronchopleural fistula, without causing any hemodynamic derangements when compared with conventional water sealed drainage.