{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:46:44Z","timestamp":1789616804276,"version":"build-2803163510"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2010,4,26]],"date-time":"2010-04-26T00:00:00Z","timestamp":1272240000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2010,4,26]],"date-time":"2010-04-26T00:00:00Z","timestamp":1272240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Dead space negatively influences carbon dioxide (CO<jats:sub>2<\/jats:sub>) elimination, particularly at high respiratory rates (RR) used at low tidal volume ventilation in acute respiratory distress syndrome (ARDS). Aspiration of dead space (ASPIDS), a known method for dead space reduction, comprises two mechanisms activated during late expiration: aspiration of gas from the tip of the tracheal tube and gas injection through the inspiratory line - circuit flushing. The objective was to study the efficiency of circuit flushing alone and of ASPIDS at wide combinations of RR and tidal volume (V<jats:sub>T<\/jats:sub>) in anaesthetized pigs. The hypothesis was tested that circuit flushing and ASPIDS are particularly efficient at high RR.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>In Part 1 of the study, RR and V<jats:sub>T<\/jats:sub> were, with a computer-controlled ventilator, modified for one breath at a time without changing minute ventilation. Proximal dead space in a y-piece and ventilator tubing (VD<jats:sub>aw, prox<\/jats:sub>) was measured. In part two, changes in CO<jats:sub>2<\/jats:sub> partial pressure (PaCO<jats:sub>2<\/jats:sub>) during prolonged periods of circuit flushing and ASPIDS were studied at RR 20, 40 and 60 minutes<jats:sup>-1<\/jats:sup>.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>In Part 1, VD<jats:sub>aw, prox<\/jats:sub> was 7.6 \u00b1 0.5% of V<jats:sub>T<\/jats:sub> at RR 10 minutes<jats:sup>-1<\/jats:sup> and 16 \u00b1 2.5% at RR 60 minutes<jats:sup>-1<\/jats:sup>. In Part 2, circuit flushing reduced PaCO<jats:sub>2<\/jats:sub> by 20% at RR 40 minutes<jats:sup>-1<\/jats:sup> and by 26% at RR 60 minutes<jats:sup>-1<\/jats:sup>. ASPIDS reduced PaCO<jats:sub>2<\/jats:sub> by 33% at RR 40 minutes<jats:sup>-1<\/jats:sup> and by 41% at RR 60 minutes<jats:sup>-1<\/jats:sup>.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>At high RR, re-breathing of CO<jats:sub>2<\/jats:sub> from the y-piece and tubing becomes important. Circuit flushing and ASPIDS, which significantly reduce tubing dead space and PaCO<jats:sub>2<\/jats:sub>, merit further clinical studies.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc8986","type":"journal-article","created":{"date-parts":[[2010,4,27]],"date-time":"2010-04-27T06:14:42Z","timestamp":1272348882000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Re-inspiration of CO2 from ventilator circuit: effects of circuit flushing and aspiration of dead space up to high respiratory rate"],"prefix":"10.1186","volume":"14","author":[{"given":"Edoardo","family":"De Robertis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif","family":"Uttman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Jonson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2010,4,26]]},"reference":[{"key":"8416_CR1","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1056\/NEJM200005043421801","volume":"342","author":"The Acute Respiratory Distress Syndrome Network","year":"2000","unstructured":"The Acute Respiratory Distress Syndrome Network: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.\n                           N Engl J Med 2000, 342: 1301-1308. 10.1056\/NEJM200005043421801","journal-title":"N Engl J Med"},{"key":"8416_CR2","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1183\/09031936.93.03101202","volume":"3","author":"B Jonson","year":"1990","unstructured":"Jonson B, Similowski T, Levy P, Viires N, Pariente R: Expiratory flushing of airways: a method to reduce deadspace ventilation.\n                           Eur Respir J 1990, 3: 1202-1205.","journal-title":"Eur Respir J"},{"key":"8416_CR3","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1136\/thx.49.8.735","volume":"49","author":"JJ Marini","year":"1994","unstructured":"Marini JJ: Tracheal gas insufflation: a useful adjunct to ventilation?\n                           Thorax 1994, 49: 735-737. 10.1136\/thx.49.8.735","journal-title":"Thorax"},{"key":"8416_CR4","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1164\/ajrccm.159.3.9712140","volume":"159","author":"E De Robertis","year":"1999","unstructured":"De Robertis E, Sigurdsson S, Drefeldt B, Jonson B: Aspiration of airway dead space. 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