Nikowski1, A Rogalski1 1Centre of Excellence ARTOG, Institute of Biocybernetics and
Nikowski1, A Rogalski1 1Centre of Excellence ARTOG, Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland; 2Department of Anaesthesiology and Intensive Care, Warsaw Medical University, Warsaw, Poland Critical Care 2006, 10(Suppl 1):P50 (doi:10.1186/cc4397) Aim To assess in vitro the usefulness of three paediatric uncuffed endotracheal tubes of various shapes: a standard (one-diameter) tube, a Cole tube and the newly designed cone tube, use of which is not associated with an increased risk of periglottic trauma. Methods The flow (0?0 lpm) resistance (RETT) was measured across the length of each tube and repeated for similar tubes of internal diameters 3, 3.5 and 4 mm. The imposed work of breathing (WOBI), necessary to overcome the tube resistance, the patient’s resistive work of breathing (RWOB) and the pressure ime product (PTP) were determined from the computer simulation of a spontaneous breathing, intubated infant. Results The resistance of the 3.5 mm ID cone tube to 10 lpm air flow was 44 and 6 lower when compared with the resistance offered by the standard and the Cole tubes, respectively. The WOBI necessary to overcome the cone tube resistance was approximately 44 and 6 lower than with using the standard and the Cole tubes, respectively. The RWOB PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/27797473 and PTP of the virtual infant intubated with the cone and with the Cole tubes were similar; however, the values of both parameters decreased by 18 and 8 , respectively, in comparison with the situation when a standard tube was used. Conclusion Replacement of a standard endotracheal tube with the cone or Cole tubes resulted in a significant decrease of RETT, WOBI, RWOB and PTP. Acknowledgement The study has been supported by the Foundation for Polish RG1662 site Science.Results Forty-four patients in the study group and 41 patients in the placebo group were analysed. Factors such as gender, weight, smoking habit, chronic pre-existing diseases and prevalence of COPD were distributed equally in both groups. Three patients died in the rhDNAse group versus eight in the placebo group. The median duration of ventilation was 140 hours (CI 120?00 hours) in the rhDNAse and 324 hours (CI 178?42 hours) in the placebo group. Discussion This interim analysis suggests that rhDNAse may have the potential to reduce the duration of ventilation in adult nonsurgical intensive care patients. This confirms results obtained in paediatric patients [2]. Data from surgical patients will be presented as soon as the PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25636517 interim analysis in that group is completed. References 1. Fuchs et al.: N Engl J Med 1994, 331:637-642. 2. Riethmueller J, et al.: Pediatr Pulmonol 2005, 41:61-66.P52 The efficacy of intratracheal rhDNase therapy in the treatment of severe hypercapnoeic respiratory acidosis in ventilated children with status asthmaticus and bronchiolitisM McDougall, S Colhurst, S Tibby, A Durward, I Murdoch Guy’s and St Thomas NHS Trust, London, UK Critical Care 2006, 10(Suppl 1):P52 (doi:10.1186/cc4399) Objective Successful rescue therapy with intratracheal recombinant (rh) DNAse has been documented in case reports of severe status asthmaticus with life-threatening mucus plugging [1]. Benefit may occur via its mucolytic properties or enhancement of mucociliary transport. The aim of this study was to report the efficacy of rhDNAse in terms of CO2 clearance in a cohort of ventilated children with severe airflow obstruction secondary to either status asthmaticus or viral bronchiolitis.