Barbara Stankiewicz

A new endotracheal tube for infants--laboratory and clinical assessment: a preliminary study.

Conventional endotracheal pediatric tubes offer high resistance due to their small diameters and relatively high flow during ventilation. Any increase of the diameter of the tube lumen decreases the airway resistance and subsequently, the work of breathing (WOB). We compared ventilation mechanics using a new, cone‐shaped endotracheal tube of our design to the Cole and standard tubes.

Influence of Preterm Birth, BPD and Lung Inhomogeneity on Respiratory System Impedance – Model Studies

The influence of preterm birth, bronchopulmonary dysplasia (BPD) and lung inhomogeneity on respiratory system impedance (RSI) was studied. The simulation of spontaneous breathing in full term newborns (FT), very low birth weight (VLBW) and extremely low birth weight (ELBW) preterm infants was carried out using a developed linear RLC respiratory system model. Besides BPD, four types of lung inhomogeneity: (1) one-lung obstruction (OBSTR), (2) one-lung restriction (RESTR), (3) one-lung obstructive-restrictive disturbance (OBSTR-RESTR I), (4) bilateral obstructive-restrictive disturbance (OBSTR-RESTR II), with obstruction of one lung and restriction of the second, were studied.

The impact of the intubation model upon ventilation parameters

The impact of various shaped endotracheal tubes on ventilation parameters has been preliminary assessed in this study. Two uncuffed pediatric tubes of different designs: a standard tube (cylindrical) and a new tube of smooth cone shape (3, 3.5 and 4 mm ID) have been examined under IPPV mode ventilation and using infant lung model. The total inspiratory flow resistance (Ri), peak inspiratory preassure (PIP) and work of breathing (WOB) have been determined under intubation with the standard and the cone shaped tube, and also for non-intubated infant lung model. The significant reduction of the Ri, PIP and WOB has been received when the standard tube had been changed with the new cone tube. The results have been confirmed in a case clinic study.

Comparison of a standard paediatric tube with a novel tube of unconventional shape

Aim: Two types of uncuffed paediatric tubes of different designs: a standard tube with a constant internal diameter and a new tube of smooth cone shape were assessed in the model study. Material and Method: The tube resistance to air flow was calculated on the basis of measurements, in which pressure/flow characteristics of the tubes of 3, 3.5 and 4 mm in inner (tracheal) diameter were collected. The flow was controlled by PC and ranged from −30 to +30 lpm. It was measured by a flow sensor (Cole Parmer 00139RN, accuracy: 1%), while the drop of pressure along a tube length was measured by a pressure sensor (JUMO dTrans pO2 B40.4385, accuracy: 0,05%). Patient’s resistive work of breathing (RWOB) was received by simulation of spontaneous breathing of an intubated infant. Simple RC-model of lungs and an endotracheal tube was used for simulation. Results: The air flow resistance of the cone shaped tube was about 40% lower than resistance of the standard tube. RWOB of the virtual infant intubated with the cone tube was decreased by about 20%, in comparison to the situation when a standard tube was used. Conclusion: Using the new cone shaped tube can be more beneficial than the standard tube from a patient’s point of view (when his lungs ventilation is still supported but he is able to breath spontaneously) and ventilation efficiency.

Preliminary clinical evaluation of a new differential lung ventilation set-up

Aim: The objective of this study was to access the ability to control and stabilize ventilation of each lung by a newly developed flow/ventilator divider.