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PEEP and the Bain circuit

H Y Arandia, P H Byles

    Canadian Anaesthetists' Society Journal
    |September 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Positive end-expiratory pressure (PEEP) can be applied in a Bain circuit with an Emerson PEEP valve during mechanical or manual ventilation. However, PEEP is not feasible during spontaneous breathing due to inspiratory obstruction.

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    Area of Science:

    • Anesthesiology
    • Respiratory Therapy
    • Medical Device Engineering

    Background:

    • The Bain circuit is a non-rebreathing anesthetic breathing system.
    • Positive end-expiratory pressure (PEEP) is crucial for maintaining lung volumes and improving oxygenation.
    • Integrating PEEP into the Bain circuit requires careful consideration of system dynamics.

    Purpose of the Study:

    • To evaluate the feasibility of applying positive end-expiratory pressure (PEEP) within the Bain circuit using an Emerson PEEP valve.
    • To determine the conditions under which PEEP can be safely and effectively used with the Bain circuit.
    • To identify potential limitations and complications associated with PEEP application in this system.

    Main Methods:

    • The study involved applying an Emerson PEEP valve to a Bain circuit under various ventilation modes.

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  • Measurements were taken for tidal volume, gas loss, and system resistance.
  • Testing was conducted during mechanically controlled ventilation, manually controlled ventilation, and spontaneous breathing.

    • Main Results:

    • Varying degrees of PEEP were successfully applied during mechanical and manual ventilation.
    • PEEP application was not feasible during spontaneous breathing due to inspiratory flow obstruction.
    • A measurable loss of tidal volume occurred with increasing PEEP, attributed to gas compression and system leakage, with a maximum loss of 100 ml/min at 15 cm H2O PEEP.
    • Relocating the PEEP valve between the Bain manifold and ventilator hose enabled PEEP during mechanical ventilation without inspiratory obstruction.

    Conclusions:

    • Positive end-expiratory pressure (PEEP) can be applied in the Bain circuit with an Emerson PEEP valve during controlled (mechanical or manual) ventilation.
    • Spontaneous breathing is contraindicated when the PEEP valve is placed between the Bain tubing and manifold due to inspiratory obstruction.
    • Relocation of the PEEP valve allows for PEEP application during mechanical ventilation without compromising inspiratory flow.