Jet or intensive care unit ventilator during simulated percutaneous transtracheal ventilation: a lung model study Y.H. Liu, A.L. Wang, A.D. Marchese,

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Jet or intensive care unit ventilator during simulated percutaneous transtracheal ventilation: a lung model study Y.H. Liu, A.L. Wang, A.D. Marchese, R.M. Kacmarek, Y. Jiang British Journal of Anaesthesia Volume 110, Issue 3, Pages 456-462 (March 2013) DOI: 10.1093/bja/aes417 Copyright © 2013 The Author(s) Terms and Conditions

Fig 1 Schematic demonstration of the experimental set up. The catheter was inserted through the trachea wall mimicking the insertion into the transcricothyroid membrane. A flow/pressure sensor was placed at the distal end of the trachea to measure inspiratory and expiratory volume. A one-way PEEP (7.5 or 15 cm H2O) valve or a sealing cap was placed at the proximal end of the trachea and open to ambient pressure. The tracheal tube (TT) adaptor was a regular 7.0 mm tracheal tube adaptor directly connecting to a breathing circuit. A 3 ml syringe was used to bridge the TT adaptor and the 14 G catheter. British Journal of Anaesthesia 2013 110, 456-462DOI: (10.1093/bja/aes417) Copyright © 2013 The Author(s) Terms and Conditions

Fig 2 Comparison of exhaled tidal volume generated with the jet and ICU ventilators at different direction of catheter insertion. Data shown are the average of three breaths at each setting with an I:E ratio of 1:1 and an RR of 10 bpm. Data in (a) and (b) were collected with the jet ventilator at PEEP 15 and 7.5 cm H2O, respectively. Data in (c) and (d) were collected with the ICU ventilator at PEEP 15 and 7.5 cm H2O, respectively. British Journal of Anaesthesia 2013 110, 456-462DOI: (10.1093/bja/aes417) Copyright © 2013 The Author(s) Terms and Conditions

Fig 3 MV generated by the jet and ICU ventilators when the catheter was inserted towards the lung. Data shown are obtained at an I:E ratio of 1:1. Data in (a) and (b) were collected with the jet ventilator at PEEP 15 and 7.5 cm H2O, respectively. Data in (c) and (d) were collected with the ICU ventilator at PEEP 15 and 7.5 cm H2O, respectively. British Journal of Anaesthesia 2013 110, 456-462DOI: (10.1093/bja/aes417) Copyright © 2013 The Author(s) Terms and Conditions

Fig 4 Exhaled tidal volumes generated by the ICU ventilator through a transcricothyroid membrane catheter at an RR of 10 bpm when the catheters was inserted towards the lung. Data in (a) and (b) were collected at PEEP 15 and 7.5 cm H2O, respectively. Data are pooled data obtained at three compliance levels (20, 40, and 60 ml cm H2O−1). British Journal of Anaesthesia 2013 110, 456-462DOI: (10.1093/bja/aes417) Copyright © 2013 The Author(s) Terms and Conditions

Fig 5 Exhaled tidal volumes generated by the jet ventilator with one or two transcricothyroid membrane catheters at an RR of 10 bpm. The primary catheter was inserted perpendicularly to the axis of the artificial trachea. The second (vent) catheter was open to ambient pressure during the entire breathing cycle and was inserted adjacent and parallel to the primary catheter. Data shown are the average of three breaths at each setting. Data in (a) and (b) were collected using a single catheter at PEEP 15 and 7.5 cm H2O, respectively. Data in (c) and (d) were collected using two catheters at PEEP 15 and 7.5 cm H2O, respectively. British Journal of Anaesthesia 2013 110, 456-462DOI: (10.1093/bja/aes417) Copyright © 2013 The Author(s) Terms and Conditions