{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:52:51Z","timestamp":1777891971705,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,11,17]],"date-time":"2015-11-17T00:00:00Z","timestamp":1447718400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      The reduction of instrumental dead space is a recognized approach to preventing ventilation-induced lung injury in premature infants. However, there are no published data regarding the effectiveness of instrumental dead-space reduction in endotracheal tube (ETT) connectors. We tested the impact of the Y-piece\/ETT connector pairs with reduced instrumental dead space on CO\n                      <jats:sub>2<\/jats:sub>\n                      elimination in a model of the premature neonate lung.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      The standard ETT connector was compared with a low-dead-space ETT connector and with a standard connector equipped with an insert. We compared the setups by measuring the CO\n                      <jats:sub>2<\/jats:sub>\n                      elimination rate in an artificial lung ventilated via the connectors. The lung was connected to a ventilator via a standard circuit, a 2.5-mm ETT, and one of the connectors under investigation. The ventilator was run in volume-controlled continuous mandatory ventilation mode.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The low-dead-space ETT connector\/Y-piece and insert-equipped standard connector\/Y-piece pairs had instrumental dead space reduced by 36 and 67%, respectively. With set tidal volumes (V\n                      <jats:sub>T<\/jats:sub>\n                      ) of 2.5, 5, and 10 mL, in comparison with the standard ETT connector, the low-dead-space connector reduced CO\n                      <jats:sub>2<\/jats:sub>\n                      elimination time by 4.5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05), 4.4% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), and 7.1% (not significant), respectively. The insert-equipped standard connector reduced CO\n                      <jats:sub>2<\/jats:sub>\n                      elimination time by 13.5, 25.1, and 16.1% (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01). The low-dead-space connector increased inspiratory resistance by 17.8% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), 9.6% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05), and 5.0% (not significant); the insert-equipped standard connector increased inspiratory resistance by 9.1, 8.4, and 5.9% (all not significant). The low-dead-space connector decreased expiratory resistance by 6.8% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) and 1.8% (not significant) and increased it by 1.4% (not significant); the insert-equipped standard connector decreased expiratory resistance by 1.5 and 1% and increased it by 1% (all not significant). The low-dead-space connector increased work of breathing by 4.7% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), 3.8% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), and 2.5% (not significant); the insert-equipped standard connector increased it by 0.8% (not significant), 2.5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), and 2.8% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Both methods of instrumental dead-space reduction led to improvements in artificial lung ventilation. Negative effects on resistance and work of breathing appeared minimal. Further testing in vivo should be performed to confirm the lung model results and, if successful, translated into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.04076","type":"journal-article","created":{"date-parts":[[2015,11,17]],"date-time":"2015-11-17T22:10:07Z","timestamp":1447798207000},"page":"155-161","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Reduction of Endotracheal Tube Connector Dead Space Improves Ventilation: A Bench Test on a Model Lung Simulating an Extremely Low Birth Weight Neonate"],"prefix":"10.1177","volume":"61","author":[{"given":"Vadim A","family":"Ivanov","sequence":"first","affiliation":[{"name":"Section of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,11,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","unstructured":"Goldsmith JP Karotkin EH. 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