Rohrer's Constant, K2, as a Factor of Determining Inspiratory Resistance of Common Adult Endotracheal Tubes

Abstract

The aim of the study was to calculate the in vitro inspiratory resistance (RETT) of adult endotracheal tubes (ETT), via the end-inspiratory occlusion method, and to apply this method in vivo in order to estimate RETT value in real time. By plotting RETT over inspiratory flow (V) and calculating Rohrer's coefficients of linear and nonlinear resistance, K1 and K2 respectively, we determined the resistive behaviour of each ETT. Peak and plateau pressures were recorded at both proximal and distal sites of the ETT after applying a three-second occlusion under constant flow. Distal pressure was obtained via an intraluminal catheter. RETT was calculated as (Ppeak – Pplateau)/(V;), at both sites. RETT value resulted from the difference Rproximal - Rdistal. Graph RETT over (V;) was plotted and Rohrer's constants were calculated by the method of least squares. For ETTs with inner diameter 9.0, 8.5, 8.0, 7.5, 7.0 and 6.5 mm, K2 was 2.42, 3.05, 4.65, 6.01, 9.17 and 12.80 cmH2O/l/s, respectively. The intraluminal catheter increased RETT No.7.0 by an average of 49%. Finally, ten patients with partially obstructed ETTs were tested and K2 in vivo constants found to be higher than their corresponding in vitro values (P value 0.00012). Therefore, knowing the performing size of an ETT may help the clinicians identify ETT obstruction and deal with weaning problems.