PURPOSE: To determine if a novel device can successfully extract occlusive materials from the inner lumen of endotracheal tubes (ETT), thereby restoring the native lumen, minimizing the need to exchange the ETT and promote the weaning process. The Hypothesis is that the device is designed to successfully remove secretions that narrow the lumen and suction the ETT lumen, accomplishing these goals.
METHODS: Adult patients in the ICU were routinely ventilated using the AVEA® ventilator (Viasys, CareFusion, San Diego, CA 92130) in the pressure regulated volume control (PRVC) mode. Airway resistance was measured daily by temporarily switching to the Volume AC mode with a square wave flow waveform set at 60 LPM. Resistance of the airway was computed as Raw = Pressure (PIP - Plateau) x liter-1 x seconds. Abnormal airway resistance was defined as a Raw elevated above 10 cmH2O x liter-1 x seconds. Patients for this study were selected with ETT sizes 6.5 to 9.5 French with elevated Raw or respiratory distress believed due to accumulation of intrinsic occlusive material in the ETT. The ETT in each patient had the CAM Rescue Cath™ (Omneotech™ Tavernier, FL 33070) inserted, the built-in balloon manually inflated and the CAM Rescue Cath™ withdrawn, dislodging and extracting secretions.
RESULTS: No patient required an exchange of ETT to restore normal Raw. In patients where a normal caliber suction catheter could not be passed through the ETT, the CAM Rescue Cath™ restored patency as confirmed by flexible fiberoptic bronchoscopy. Similarly, using the CAM Rescue Cath™ in patients with prolonged failure to wean and elevated Raw, the weaning process was enhanced.
CONCLUSIONS: The CAM Rescue Cath™ successfully extracted occlusive biologic materials from the inner lumen of ETTs.
CLINICAL IMPLICATIONS: This device minimizes the exchange of an ETT due to retained secretions and also promotes the weaning process in patients with elevated Raw.
DISCLOSURE: The following authors have nothing to disclose: Herbert Patrick, Marion Principe, Stan Segal
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