Effects of continuous, expiratory, reverse, and bi-directional tracheal gas insufflation in conjunction with a flow relief valve on delivered tidal volume, total positive end-expiratory pressure, and carbon dioxide elimination: a bench study.

Our data from an artificial lung model support that continuous bi-TGI minimizes the change in total-PEEP seen during other TGI modalities. The flow relief valve compensated for the extra gas volume delivered by the TGI catheter, thereby eliminating the need to make ventilator adjustments. Used in combination with a flow relief valve, bi-TGI appears to offer unique advantages by providing a simpler method to deliver TGI. Further testing is indicated to determine if similar benefits occur in the clinical setting