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At least 415 records · Page 23Linked to original sources
PubMed2001

Pediatric adenoidectomy under vision using suction-diathermy ablation.

OBJECTIVES: To compare adenoidectomy using suction-diathermy ablation with adenoidectomy by way of curettage in a pediatric tertiary care setting. STUDY DESIGN: A prospective series of 68 children undergoing adenoidectomy (without tonsillectomy) under vision using a suction-diathermy ablation technique over 2 years was compared with an historical control group of 58 children undergoing adenoidectomy (without tonsillectomy) by way of curettage over 2 years. METHOD: Intraoperative blood loss was recorded and compared. Efficacy in improving nasal symptomatology was compared between the two groups using an ordinal "nasal symptom score" preoperatively and postoperatively. Complications were recorded and compared. Analysis was performed using two-tailed t tests. RESULTS: The two groups were well matched for age, weight, and adenoid size (P > .4). Follow-up ranged from 4 to 48 months. Adenoidectomy using suction-diathermy resulted in significantly less blood loss (P < .001). The technique was no less efficacious in terms of reducing the nasal symptom score than conventional adenoidectomy by way of curettage (P = .07). Complication rates were no different. No recurrences were identified and no instances of nasopharyngeal stenosis were recognized. CONCLUSIONS: Routine use of suction-diathermy ablation for adenoidectomy converts a difficult, often bloody procedure into a surgically precise operation. It is especially applicable to children. It may have additional advantages in aiding the prevention of the spread of the human form of bovine spongiform encephalopathy (variant Creutzfeldt-Jakob disease [CJD]). Compared with other recently introduced techniques for adenoidectomy, it is considerably less expensive.

Adenoidectomy↗
PubMed1985

Suction lipectomy of the neck.

Suction lipectomy of the neck has been advocated in other reports. However, because of skin laxity, a simultaneous face/neck lift has been performed usually. In this series of 49 patients, ages 18 to 73, removal of submandibular fat was performed by suction lipectomy. A simultaneous face/neck lift was not done. In addition, no skin was excised. On the contrary, the apparent excess skin was found to be required for contouring. Approximately one-third of the patients had a simultaneous chin implant. Others had different aesthetic surgical procedures performed during the same operation. The removal of neck fat by suction has proven to be more efficacious than excisional methods of lipectomy. The risks of operation have been found comparable to suction lipectomy performed in other anatomic locations.

Adipose Tissue↗
PubMed1998

Percutaneous suction aspiration and drainage for pyogenic spondylitis.

STUDY DESIGN: Retrospective evaluation of results in 23 cases of early-stage pyogenic spondylitis treated with percutaneous suction aspiration and drainage. OBJECTIVES: To evaluate the efficacy of percutaneous suction aspiration and drainage as a treatment method for early-stage pyogenic spondylitis. SUMMARY OF BACKGROUND DATA: Traditional surgical treatment for pyogenic spondylitis has the disadvantage of increased morbidity caused by the extensive exposure required in the presence of infection. Recently, a few case reports have described minimally invasive treatment for pyogenic spondylitis in which percutaneous suction aspiration was used. However, the efficacy of this new treatment has not yet been evaluated. METHODS: All charts, radiographs, and bacteriologic and histologic findings were reviewed. All 23 patients who received the new treatment were observed clinically and radiographically, to evaluate the efficacy of the treatment. RESULTS: To date, all patients have been observed for more than 2 years. Twenty (87%) of the 23 patients have shown good results according to the evaluation. The causative organism was identified using tissue culturing in 12 (52%) of the 23 patients. The causative organism was Staphylococcus aureus in 8, and Staphylococcus epidermidis, Candida albicans, Pseudomonas aeruginosa, and Propionibacterium acnes in 1 each. Back pain as the major symptom in these patients was relieved within an average of 9.4 days after the operation. However, the patient in whom the spondylitis was caused by Candida albicans has received this new treatment twice without success. CONCLUSIONS: Evaluation of percutaneous suction aspiration with drainage shows that it is an effective treatment for early-stage pyogenic spondylitis.

Back Pain↗
PubMed2002

Intracranial effects of endotracheal suctioning in the acute phase of head injury.

In patients with head injury, endotracheal suctioning (ETS) is a potentially dangerous procedure, because it can increase intracranial pressure (ICP). The purpose of this prospective nonrandomized study was to evaluate the impact of ETS on intracranial dynamics in the acute phase of head injury. Seventeen patients with severe head injury (Glasgow Coma Score < or = 8, range 4-8), sedated and mechanically ventilated, were studied during the first week after trauma. Single-pass ETS maneuver (with a 16-French catheter, negative pressure of 100 mm Hg, and duration of less than 30 seconds) was performed 60 seconds after the FiO2 was increased to 100%. After ETS, FiO2 was maintained at 100% for another 30 seconds. Before and after ETS, arterial blood gases and jugular oxygen saturation (S(j)O2), ICP, and mean arterial pressure (MAP) were measured and cerebral perfusion pressure (CPP) was calculated. A total of 131 ETS episodes, which consisted of repeated assessment of each patient, were analyzed. Six patients in 20 cases coughed and/or moved during ETS because of inadequate sedation. After ETS, ICP increased from 20 +/- 12 to 22 +/- 13 mm Hg in well-sedated patients and from 15 +/- 9 to 28 +/- 9 mm Hg in patients who coughed and/or moved (mean change, 2 +/- 6 versus 13 +/- 6 mm Hg, P <.0001). CPP and S(j)O2 increased in well-sedated patients (from 78 +/- 16 to 83 +/- 19 mm Hg, and from 71 +/- 10 to 73 +/- 13%, respectively) and decreased in patients who reacted to ETS (from 79 +/- 14 to 72 +/- 14 mm Hg and from 69 +/- 7 to 66 +/- 9%, respectively), and the differences were significant (mean change, CPP: 5 +/- 14 versus -7 +/- 15 mm Hg, P =.003; (S(j)O2) 2 +/- 5 vs. -3 +/- 5%, P <.0001). In well-sedated patients, endotracheal suctioning caused an increase in ICP, CPP, and S j O 2 without evidence of ischemia. In contrast, in patients who coughed or moved in response to suctioning, there was a slight and significant decrease in CPP and S(j)O2. In the case of patients with head injuries who coughed or moved during endotracheal suctioning, we strongly suggest deepening the level of sedation before completing the procedure to reduce the risk of adverse effects.

Acute Disease↗
PubMed2003

Mechanical insufflation-exsufflation vs. tracheal suctioning via tracheostomy tubes for patients with amyotrophic lateral sclerosis: a pilot study.

OBJECTIVE: To compare the effects of mechanical insufflation-exsufflation vs. suctioning via tracheostomy tubes on respiratory variables for six amyotrophic lateral sclerosis patients. DESIGN: In this prospective crossover study, six consecutive patients with amyotrophic lateral sclerosis who required continuous mechanical ventilation via tracheostomy tubes and developed chest infections underwent measurement of pulse oxyhemoglobin saturation (SpO2), peak inspiratory pressure (PIP), mean airway pressure (Pawm), and work of breathing performed by the ventilator (WOBv) at baseline and 5 and 30 min after tracheal suctioning and 5 min after mechanical insufflation-exsufflation. RESULTS: The baseline values were 93.50 +/- 2.26% for SpO2 in ambient air, 18.50 +/- 4.23 cm H2O for PIP, 4.67 +/- 1.37 cm H2O for Pawm, and 1.03 +/- 0.25 J/liters for WOBv. Only WOBv changed significantly, decreasing after tracheal suctioning (P < 0.05), whereas all variables improved significantly after mechanical insufflation-exsufflation. CONCLUSION: For ventilator-dependent patients with amyotrophic lateral sclerosis, mechanical insufflation-exsufflation via a tracheostomy tube with an inflated cuff may be more effective in eliminating airway secretions than conventional tracheal suctioning.

Amyotrophic Lateral Sclerosis↗
PubMed2007

Suctioning prevents emboli during insertion of acetabular components without holes.

Embolic events can occur when inserting uncemented press-fit acetabular components (cups), especially those without holes. However, there is a paucity of literature regarding prevention of embolic events. We asked whether suctioning in the acetabulum might be as effective as suctioning during femoral insertion. We compared embolic events in 30 hips (27 patients) (Group 1) that had conventional press-fit cup fixation without holes, with 30 hips (27 patients) (Group 2) treated by suctioning from a cannula in the ilium during cup impaction. We evaluated embolic events using transesophageal echocardiography, blood gas (PaO2, PaCO2), and blood pressure preoperatively and 5 minutes after cup placement. Echocardiography showed less severe embolic events in Group 2 (23%) than in Group 1 (100%). The decrease in rate of the PaO2 and the blood pressure from baseline to 5 minutes after cup placement were lower in Group 2 than in Group 1. Our data suggest the suctioning technique is effective to reduce embolic events by cup without holes which may cause intraoperative embolic complications.

Acetabulum↗
PubMed1986

Determination of anaphylatoxin concentrations in suction blisters in patients with psoriasis.

Concentrations of C3a and C4a anaphylatoxins in suction blister fluids were determined by radioimmunoassay in patients with psoriasis and normal controls. Comparison of anaphylatoxin levels between serum samples and blister contents in the same subjects revealed that the levels of both C3a and C4a anaphylatoxins were significantly higher in the former than the latter even in those raised on normal skin, suggesting that the classic complement pathway is activated during suction procedure. Therefore we cannot regard suction blister fluid to be simply representative of undisturbed interstitial tissue fluid as far as the complement system is concerned. There was no difference in anaphylatoxin levels between those from uninvolved skin of psoriatic patients and those from normal controls. However, significantly high anaphylatoxin levels were noted in fluids of suction blisters raised on lesional skin as compared with those produced on uninvolved skin in psoriatic patients.

Adolescent↗
PubMed1979

High capacity suction technique. A method of reducing the aspiration hazard during induction.

A suction booster is described which may be interposed between the endotracheal tube and the main suction system. This allows suction to be instantly ready throughout the intubation procedure, the rate of suction to be increased up to ten-fold, and all solid particles which can pass through the tracheal tube to be removed without the risk of blockage.

Intubation, Intratracheal↗
PubMed1993

Evaluation of three portable suction devices.

Three portable suction devices were evaluated and compared with a wall-mounted vacuum driven suction unit. The Repro-med Res-Q-Vac, the Dräger Sujector 2000 and the Laerdal suction unit were assessed by measuring the time taken to aspirate 140 ml of mock gastric contents. The respective times for each device, expressed as mean and (range) were 7.39 (4.3-10.4), 8.6 (7.8-9.4) and 11.4 (9.4-12.6) s. These compare favourable with the Ohmeda suction unit (7.27 (6.2-8.9)). Each type of device has advantages and disadvantages when factors such as size, power supply and portability are considered, and each will be the most suitable for a particular situation.

Equipment Design↗
PubMed2004

Keratinocytes in the depigmented epidermis of vitiligo are more vulnerable to trauma (suction) than keratinocytes in the normally pigmented epidermis, resulting in their apoptosis.

BACKGROUND: Vitiligo may develop following minor physical trauma. However, in autologous epidermal grafting, depigmentation of the donor (normally pigmented) site from a suction blister is rare, even in cases displaying failure of repigmentation at the recipient (depigmented) site. OBJECTIVES: To examine whether the suction procedure is more likely to damage keratinocytes in the depigmented than in the normally pigmented epidermis of vitiligo, and to determine what kind of damage occurs to the keratinocytes. METHODS: Paired roofs of suction blisters from five patients with generalized vitiligo, five with localized and seven with segmental type, were used for the study. Multiple new lesions developed in two of the five patients with the generalized type. Apoptosis of keratinocytes in the epidermis was determined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-digoxigenin nick end labelling (TUNEL) staining, with immunohistochemistry for Bax and active caspase 3. Expression of Bcl-2, Bax, FLIP and p53, activation of caspases 3, 8 and 9, and cleavage of poly(adenosine diphosphate ribose) polymerase (PARP) in the epidermis were analysed by Western blotting in four patients with each type. RESULTS: Apoptotic keratinocytes, which stained with TUNEL and anti-Bax and antiactive caspase 3 antibodies, were scattered in the blistered epidermis, mainly in the lower portions. The depigmented epidermis displayed significantly more apoptotic keratinocytes than the normally pigmented epidermis. The numerical difference between the paired epidermides was related to the disease activity and not to the type of lesions. The number of apoptotic keratinocytes in the normally pigmented epidermis was as high as that in the depigmented epidermis in the two patients with active generalized type vitiligo. Expression of Bax and p53 in the depigmented epidermis was higher than in the normally pigmented epidermis, whereas expression of FLIP was lower. In addition, the activation of caspases 3, 8 and 9, and cleavage of PARP, were increased in the depigmented compared with the normally pigmented epidermis. The degree of difference in expression and activation was parallel to the results of the TUNEL assay. CONCLUSIONS: The keratinocytes in the depigmented compared with the normally pigmented epidermis of vitiligo may become apoptotic more easily after suction.

Adolescent↗
PubMed1996

Endotracheal suctioning: an example of the problems of relevance and rigour in clinical research.

Endotracheal suctioning is a routine but potentially dangerous procedure. The literature documenting approaches to minimizing the cardiopulmonary complications of endotracheal suctioning is reviewed. Hyperoxygenation, hyperventilation, hyperinflation and the use of adaptors are all evaluated. The effects of endotracheal suctioning on haemodynamics and oxygen transport are also examined. The traditional dualist approach to the respiratory and cardiovascular systems is contrasted with the recent emphasis on oxygen transport by the cardiopulmonary system. The trade-off between the rigour of laboratory studies (which can be well controlled but are difficult to generalize) and the relevance of clinical research (which is more easily generalized but which often lacks internal validity) is discussed. Although research studies have become both more methodologically and conceptually sophisticated, definitive recommendations for a safe and effective suctioning procedure still remain elusive.

Clinical Nursing Research↗
PubMed1982

Design and function of tracheal suction catheters.

Tracheal suction catheters damage the mucosa of the airway, due to both the pull from the vacuum and insertion of the catheter. The pull of the vacuum from a suctioncatheter was measured on a Mettler balance. An open side hole reduced the pull by around 90% and a distance of 1 mm gave a reduction of around 90%. The combination of one side hole and a 1 mm distance gave a 99% reduction of the pull. The difference between one or more side holes was measured. The suction efficacy was higher with a single side hole than with several side holes. On the basis of these measurements and a review of the literature, the principles were outlined for the construction of a suction catheter which provided maximum suction efficacy and caused minimum damage: (1) a moderate to strong vacuum was to be used; (2) the catheter was to have a single hole at the tip and a single side hole placed at the convex side of the angle; (3) both side hole and tip hole should be so constructed that the holes were kept at a distance from the mucosa; and (4) the tip should be angulated.

Catheterization↗
PubMed1983

Passage of albumin from plasma to suction skin blisters.

To study the transvascular passage of albumin from the plasma to the skin interstitium, suction blisters were developed on the abdominal skin of six young, healthy male volunteers. Fifteen minutes after the blisters had been formed and the suction had been stopped, 125I-albumin was injected intravenously and the disappearance of the tracer protein from plasma was compared to its appearance in blister fluid as a function of time for up to 4 h after the injection. There was a linear increase of blister fluid activity with time after injection and the mean accumulation rate of the six subjects was 0.9 +/- 0.4 (SD)%/h. It is suggested that this figure is a representative measure of the leakage of albumin through the skin microvasculature. In previous studies, a ten-fold higher accumulation rate of albumin was found when the protein tracer was administered intravenously before the suction was induced. This difference was probably due to a suction-induced increase of the filtration gradient across the skin vessels. It is concluded that both methods might be used to obtain a comparative measure of the local rate at which albumin passes from plasma to the interstitial fluid of the skin.

Adult↗
PubMed2006

Suction blister epidermal grafting for management of eyelid vitiligo: special considerations.

BACKGROUND: Suction blister epidermal grafting is an established technique for the treatment of resistant and stable vitiligo especially over small and cosmetically important areas like the face. However, certain areas, such as lips and eyelids, require special considerations because of their anatomic peculiarities. PATIENTS AND METHODS: The current study was carried out on six patients of stable eyelid vitiligo, not responding to medical treatment. Suction blister was obtained from the thigh using the suction apparatus and the roof was grafted on to the dermabraded eyelid. Certain precautions were taken during the procedure, which will be highlighted in the current study. RESULTS: Response was excellent in all the patients in 3 to 6 months, with no complications. CONCLUSIONS: If carried out properly, suction blister technique is the procedure of choice for cosmetically important sites like eyelids.

Blister↗
PubMed1987

Gastric suction in healthy newborn infants. Effects on circulation and developing feeding behaviour.

Gastric emptying of newborn infants is a procedure performed to prevent aspiration of gastric contents. The present investigation was conducted to study the effects of gastric suction on circulatory and behavioural parameters in 21 healthy newborn children (11 cases, 10 controls). A small elevation in mean arterial blood pressure was observed during gastric suction. The incidence of retching was also increased. In all children spontaneous sucking and rooting movements, as well as state of sleep and wakefulness were recorded. In the control group spontaneous sucking and rooting movements started occur 15 min after birth and reached a maximum at 45 and 60 min, respectively. The first hand to mouth movement was observed after a mean of 34 min and the infants found the nipple and started to suckle at about 55 min. This sequence of prefeeding behaviour was disrupted in children who had undergone gastric suction. The physiological side-effects induced by gastric suction are minor, but it seemed to be unpleasant for the child and no clear advantages are gained by the procedure.

Feeding Behavior↗
PubMed1984

Repetitive ramped neck suction: a quantitative test of human baroreceptor function.

Bolus intravenous injection of an alpha-agonist is a widely accepted method used for studying baroreceptor function. However, the method is invasive, multiple baroreceptor regions are stimulated, and there are diverse direct effects of these pharmacologic agents, e.g., direct effects on the carotid sinus region. A recently described noninvasive neck suction technique may be highly specific for assessing the carotid sinus to sinoatrial node baroreflex. We compared neck suction-derived baroslopes with those obtained from the standard, invasive phenylephrine infusion method. These techniques were applied to 15 adult volunteers while awake and during 1.34 and 2% isoflurane anesthesia. The correlation coefficients between the two methods were 0.74 (P = 0.002) in awake subjects and 0.75 (P = 0.001) overall. The neck suction method of repetitive, ramped carotid stimuli yielded results that were qualitatively and quantitatively similar to those of the standard phenylephrine method. The neck suction method is simple, noninvasive, and can be repeated at frequent intervals. This method may be highly specific for determining carotid baroreceptor-cardiac reflex physiology in humans.

Adult↗
PubMed1997

Increase in percutaneous muscle biopsy yield with a suction-enhancement technique.

The percutaneous muscle biopsy technique is used in clinical practice and biomedical research. We developed a new enhanced-suction technique [suction-enhancing nipples (SEN)] and compared it with techniques currently in practice by assessing biopsy yields on anesthetized pigs. We applied the enhanced-suction technique to human subjects participating in a clinical trial. In the pig, there was a mean 91% (1.9-fold) increase in the size of the samples obtained with the 4-mm needle when SEN was used and a mean 507% (fivefold) increase in sample size when the SEN was applied to the 6-mm needles. Nine passes of the 6-mm needle with SEN obtained from five consecutive human subjects yielded a mean individual sample size of 109.4 mg or 219.4 mg per needle pass when using the double-sample technique. Adequate tissue samples for histomorphometric and other analyses were obtained in all samples obtained. The percutaneous muscle biopsy performed with enhanced suction using inexpensive, readily available nipples enhances tissue yield two- to fivefold.

Aged↗
PubMed1994

Suction attachment for stereotactic radiosurgery of intraocular malignancies.

We designed a suction attachment for the radiosurgical treatment of intraocular malignancies with the Leksell gamma unit (Gamma Knife). Our device consists of a circular suction chamber and an adjustable unit to be fixed to the Leksell stereotactic head frame. All components are made of plastic materials in order to avoid artifacts in CT or MRT imaging. A permanent suction of 600-800 mbar is provided by a standard vacuum pump, powered by a portable battery. Suction times up to 40 min were well tolerated in all cases. We successfully used this device, performing 17 radiosurgical treatments in 8 patients with large or extra-large uveal melanomas and one patient suffering from a choroidal metastasis.

Aged↗