Abstract
Loss of a patent airway is a significant cause of prehospital death. Endotracheal intubation is the gold standard of care but has a high rate of failure and complications, making development of new devices vital. We previously showed that tracheal tissue has a unique spectral profile which could be utilized to confirm correct airway device placement. Therefore, the goals of this study were twofold: 1‐ to develop an airway obstruction model and 2‐ use that model to assess how airway compromise affects tissue reflectance. Female swine were anesthetized, intubated, and instrumented. Pigs were allowed to breathe spontaneously and underwent either slow‐ or rapid‐onset obstruction until a real‐time pulse oximeter reading of ≤50%. At baseline, 25%, 50%, 75%, and 100% obstruction, a fiber‐optic reflection probe was inserted into the trachea and esophagus to capture reflectance spectra. Both slow‐ and rapid‐onset obstruction significantly decreased arterial oxygen concentration (sO2) and increased partial pressure of CO2 (pCO2). The presence of the tracheal‐defining spectral profile was confirmed and remained consistent despite changes in sO2 and pCO2. This study validated a model of slow‐ and rapid‐airway obstruction that results in significant hypoxia and hypercapnia. This is valuable for future testing of airway device components that may improve airway management. Additionally, our data support the ability of spectral reflectance to differentiate between tracheal and esophageal tissues in the presence of a clinical condition that decreases oxygen saturation.
Highlights
Trauma is a leading cause of death in the civilian population (Prevention CfDCa, 2017)
Once complete obstruction was achieved, there was no significant difference in sO2 or pressure of CO2 (pCO2) between those that underwent slow- versus rapidobstruction
Given our interest in trauma and battlefield-relevant research, we aimed to develop both a slow- and rapid-onset obstruction, we were able to simulate and compare gradually developing airway compromise, similar to what may occur as the result of tissue swelling, versus that of rapid asphyxia, similar to what may occur as the result of sudden obstruction due to maxillofacial trauma
Summary
Trauma is a leading cause of death in the civilian population (Prevention CfDCa, 2017). Severe consequences occur from lack of a patent airway, making airway compromise a significant cause of trauma-related death in both the civilian and military populations (Evans et al, 2010; Eastridge et al, 2012), it is the second leading cause of potentially survivable death on the battlefield (Eastridge et al, 2012). Endotracheal intubation (ETI) is the gold standard for nonsurgical airway management and is frequently performed in trauma patients in environments ranging from life-threatening prehospital situations such as cardiac arrest or trauma (ambulance, battlefield, etc.) to the emergency and operating rooms. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
