How Much PEEP Does High Flow Deliver via Tracheostomy? A Literature Review and Benchtop Experiment.

How Much PEEP Does High Flow Deliver via Tracheostomy? A Literature Review and Benchtop Experiment. Crit Care Res Pract. 2021;2021:6036891 Authors: Thomas M, Joshi R, Cave G Abstract Background: High flow tracheostomy (HFT) is a commonly used weaning and humidification strategy for tracheostomised patients, but little is known as to how much PEEP or mechanical benefit it offers. Patient anatomy and device characteristics differentiate it from high flow nasal cannula and the physiological effects observed. Objectives: (1) To review the available literature on the effects of HFT on airway pressure and indices of gas exchange. (2) To quantify PEEP generated by a HFT  circuit. Methods: A randomised benchtop experiment was conducted, with a size 8 uncuffed Portex tracheostomy connected to an Optiflow™ with Airvo 2™ humidifier system. The tracheostomy tube was partially immersed in water to give rise to a column of water within the inner surface of the tube. An air fluid interface was generated with flows of 40 L/min, 50 L/min, and 60 L/min. The amount of potential PEEP (pPEEP) generated was determined by the distance the water column was pushed downward by the flow delivered. Findings. Overall 40 L/min, 50 L/min, and 60 L/min provided pPEEP of approximately 0.3 cmH2O, 0.5 cmH2O, and 0.9 cmH2O, respectively. There was a statistically significant change in pPEEP with change in flows from...
Source: Critical Care Research and Practice - Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

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