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The Intubated Lung
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The placement of the endotracheal tube affects many of the defence and gas exchange functions of the lung.
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The tube bypasses the following defence functions;1
- mechanical clearance, i.e. sneeze, gag, cough
- filtering of inspired particles
- Hence in the intubated patient, the mucociliary transport system is the sole remaining mechanical defence mechanism.
The placement of the endotracheal tube physically shifts the conditioning, and heat and moisture recovery functions, further down the airway which would not normally be required to give up heat and moisture.
The Lung at Risk
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References
- Estes R, Meduri G. The Pathogenesis of Ventilator-Associated Pneumonia: 1. Mechanisms of Bacterial Transcolonization and Airway Innoculation. Intensive Care Medicine. 1995; 21:365-383
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