How the Bidi Cath Works
The BiDi Cath has a manual stopcock type valve that replaces the normally closed thumb-controlled valve. This allows two-hand-use to insert the catheter into the ET Tube with the suction on.
When we insert catheters through the secretions with the suction off, secretions are pushed deeper and the secretions around the catheter further obstructs pressure from the ventilator. Therefore, air that gets suctioned is likely from the lungs. Clearing the ET Tube during insertion facilitates the ventilator with maintaining FRC.
Bench testing shows that even with ordinary wall suction, the Bidi Cath extracts more secretions while causing less negative airway pressures than ordinary suction-during-withdrawal method — with the ventilator in CPAP mode.
The effectiveness of Exsalta controlled flow with BiDi Cath may have you questioning the need for hyper oxygenation prior to suctioning. We look forward to your assessment of that.
Best practice methods recommended by the AARC for suctioning are proper, because they are based on using uncontrolled high flow ordinary suction with closed suction catheters. The arrival of controlled flow suction with bidirectional closed suction catheters, it’s a whole new ball game. Additionally, today’s ventilators have advanced leak compensation, demand flow and CPAP mode that helps maintain positive pressures during suctioning. Inserting a catheter into the ET Tube that is extracting air and secretions at ~1 l/min allows a ventilator in a CPAP mode to maintain positive pressure and FRC.
Best practices that include waiting to suction until there is desaturation or the ventilator displays obstruction appear counterproductive to the mission of ventilator liberation. If the airway can be cleared without loss of FRC why wait until the patient is compromised?
When it comes to managing ventilator settings, best practices have evolved along with the technological advances in ventilator features for decades. When it comes to managing the airway, best practices can also evolve along with the Technological advances in suction technology.
See It in Action
Watch our video demonstration to visualize the impact of uncontrolled air extraction and how EXSALTA’s Low Flow Smart Suction allows the ventilator on CPAP maintain positive pressure.
Please note: The ET Tube in the video is without secretions and demonstrates free flow. In actual use, free flow is only active when the catheter is cleared of secretions, and this varies greatly from procedure to procedure.