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PubMed1993

Simple, inexpensive suction electrode system for the student physiology laboratory.

A versatile, inexpensive, easily constructed suction electrode system is described that can be used for routine exercises by the student on, or for demonstrations of, the electrophysiology of frog sciatic nerve and gastrocnemius and sartorius muscles. A disposable plastic syringe and a disposable pipette with Ag-AgCl wire comprise the suction electrode. Six readily manipulable electrodes are installed in the walls of the Plexiglas preparation bath, and an arbitrary number of additional "free" electrodes can be placed where desired. An optional small chamber, formed from a disposable plastic culture dish and Gootch rubber tubing, provides for "barrier" recording within the larger chamber. Interpretations are given of the electrical responses of nerve and muscle in terms of longitudinal currents along the preparation within the suction electrode tubes.

Animals↗
PubMedDate not supplied

Effect of pneumatic suction ring placement on intraocular pressure in cats.

PURPOSE: To determine the effect of placing a pneumatic suction ring on intraocular pressure (IOP) in the cat and to design an improved method to generate a stable elevation of IOP. METHODS: A pneumatic suction ring was applied to the eye in cats while the IOP was monitored. Three groups of animals (10 per group) were used. A vacuum pressure of 450 mbar was applied in one step to eyes of group 1 (anesthetized) and to group 2 (euthanized) cats. In group 3 (anesthetized) cats, an initial vacuum pressure of 250 mbar was applied, followed by a vacuum of slowly increasing pressure at a rate of 5 mbar/min for a total of 40 min to 450 mbar. RESULTS: After the one-step application of a vacuum (450 mbar) to the eyes of anesthetized cats (group 1), IOP peaked within the first minute from a basal value of 25 +/- 2 mm Hg (mean +/- SD) to 90 +/- 7 mm Hg. It then rapidly decreased to 69 +/- 2 mm Hg 5 min later and continued to decrease to 39 +/- 4 mm Hg 40 min later. This sharp peak and decline of IOP were also observed in eyes of euthanized cats (group 2). The basal IOP of these eyes was 8 +/- 1 mm Hg. It rose to 18 +/- 2 mm Hg immediately after the application of vacuum pressure (450 mbar) and returned to the basal level 5 min later. In contrast, the eyes of group 3 receiving an initial vacuum of 250 mbar followed by a 5 mbar/min vacuum increment exhibited a rapid increase in IOP and a very stable plateau (mean IOP = 62-68 mm Hg), lasting the whole study period (40 min). CONCLUSION: IOP after a one-step application of a vacuum via a pneumatic suction ring is self-adjusting and declines rapidly over time. This decline in IOP can be overcome by a supplementary increment in vacuum pressure.

Animals↗
PubMedDate not supplied

The effects of shallow versus deep endotracheal suctioning on the cytological components of respiratory aspirates in high-risk infants.

BACKGROUND: The harmful effects of mechanical ventilation and suctioning are compounded if endotracheal suctioning (ETS) is inappropriately performed. Deep ETS involves catheter insertion into the endotracheal tube until resistance is met. Shallow ETS may be beneficial in lessening mechanical irritation to the first bronchial layers. However, clinical observation reveals wide variation in the length of the suction catheter for ETS in high-risk infants. OBJECTIVE: The study was conducted to examine the effects of deep and shallow ETS on the cytological components of respiratory aspirates from high-risk infants. METHODS: A cross-over experimental study was performed in 22 high-risk infants with a mean birth weight of 2200 g. Whether deep or shallow ETS was conducted first was determined randomly. The numbers of (1). columnar cells [CC - ciliated (CCC) and nonciliated (NCC)], (2). fresh clustered columnar cells (CLCC), and (3). Curschmann's spirals (CS), a mucus cast residing inside the lower terminal airways, in the respiratory aspirates were compared between the two ETS protocols. RESULTS: No statistical differences were found in the quantities of CC, CLCC and NCC between shallow and deep ETS. However, greater quantities of CLCC were observed in the deep ETS aspirates than in the shallow ETS aspirates. CONCLUSIONS: Detachment of larger amounts of clustered columnar cells from the respiratory epithelium without the guarantee that lung secretions from the lower airways will be removed questions the justification of deep ETS in high-risk infants.

Body Fluids↗
PubMed1995

Experience with a suction fixation system for stereotactic radiosurgery of intraocular malignancies.

We designed a suction fixation system for the radiosurgical treatment of intraocular malignancies with the Leksell Gamma Knife. Our device consists of a circular suction chamber and an adjustable unit which is fixed to the Leksell stereotactic head frame. All components are made of plastic in order to avoid artifacts in CT or MRI. A permanent suction of 600-800 mbar is provided by a standard vacuum pump, powered by a portable battery. In the Gamma Knife Unit of the Neurosurgical Department at the University of Vienna, we successfully used this device. Up to April 1994 we successfully performed 25 radiosurgical treatments in 12 patients with large or extra-large uveal melanomas and in 1 patient suffering from a choroidal metastasis.

Aged↗
PubMed1984

Comparison of fasting, nasogastric suction and cimetidine in the treatment of acute pancreatitis.

88 unselected patients with acute pancreatitis entered a randomized clinical trial comparing the therapeutic efficacy of fasting alone, nasogastric suction and fasting plus cimetidine. The disease was mild to moderate in all but 3 cases, and cholelithiasis was the main etiological factor. The number of treatment failures and complications, and the clinical outcome were similar in the three groups. However, when compared to fasting alone, nasogastric suction was shown to delay the resumption of bowel activity a mean of 11 h (p less than 0.05), prolong the duration of pain a mean of 20 h (p less than 0.01), increase analgesic needs (pentazocine lactate) a mean of 64 mg (p less than 0.05), and lengthen hospital stay a mean of 2 days (p = NS). In conclusion, cimetidine has no beneficial effects in acute pancreatitis. It is suggested that fasting alone be initially used as the simpler, safer and more economical therapy. Nasogastric suction should be reserved for patients presenting with intestinal ileus, a situation that occurred in 1 out of every 8 cases in the present series.

Acute Disease↗
PubMed1997

Closed versus open endotracheal suctioning in preterm infants: effects on cerebral oxygenation and blood volume.

The aim of our study was to compare, using near-infrared spectroscopy (NIRS), the effects on cerebral intracellular oxygenation and cerebral blood volume (CBV) of closed endotracheal suctioning (CS), which permits continuous ventilation of the patient, with open endotracheal suctioning (OS), which requires disconnection from the ventilator. Eleven preterm infants were studied. Each patient underwent one CS, followed, after 60 min, by one OS, or vice versa, three times during the same day. Modifications in CBV and oxidized cytochrome oxidase (CytO2) were continuously detected by NIRS; arterial oxygen saturation (SaO2) heart rate (HR), transcutaneous carbon dioxide tension and mean arterial blood pressure were simultaneously recorded. Significant reductions in HR and SaO2 were observed following OS; the magnitude and duration of these negative effects of suctioning were significantly reduced with CS. In addition, the decrease in CBV was more pronounced than following CS. No changes in CytO2 concentration were seen.

Blood Volume↗
PubMed1993

Soluble CD14 monocyte antigen in suction blister fluid and serum of patients with psoriasis.

The purpose of this study was to measure soluble CD14 (sCD14) molecules in the skin and in serum of patients with psoriasis. CD14 is a newly discovered cell surface marker on monocytes that is shed after cell activation. The following procedures were used: suction blisters were raised over the abdominal skin of 9 healthy control individuals and 8 patients with psoriasis. Serum of 17 healthy controls and 17 patients with psoriasis was collected. sCD14 was determined in suction blister fluid and serum by the ELISA technique. The clinical status of psoriasis was rated by the psoriasis area and severity index (PASI score). We found that sCD14 levels in suction blisters of healthy skin (1,050 +/- 236 ng/ml, mean +/- SE) were similar to those of nonlesional psoriatic skin (841 +/- 113 ng/ml). By contrast, control serum contained 2,687 +/- 167 ng/ml, but psoriatic serum 4,059 +/- 388 ng/ml sCD14 (p = 0.001, Wilcoxon test). Linear-regression analysis revealed that serum sCD14 levels and the PASI score of patients did not correlate. We conclude that there is an abnormal monocyte stimulation in blood but not in nonlesional skin in psoriasis that is independent from the clinical status expressed by the PASI score.

Adolescent↗
PubMed1990

Histopathologic study of the perilymph-suctioned labyrinth.

A small amount of perilymph was suctioned from the scala tympani through the round window membrane of guinea pigs. The animals either were killed immediately after the suctioning or were kept alive for 1 to 3 months. For morphologic study, the conventional celloidin embedding method was employed, and the temporal bones were serially sectioned. Various kinds and degrees of changes in the membranous labyrinth were observed: hydrops, collapse, and rupture. Loss of outer hair cells in the upper turns of the cochlea was noted in the 1- to 3-month recovery specimens. These findings are identical to those found in animals in which artificial perilymph was injected into the subarachnoid space in order to produce experimental perilymphatic fistula. After comparing morphologic changes of the membranous labyrinth following use of each method, we concluded that perilymph suctioning from the round window can be used as an animal model of perilymphatic fistula.

Animals↗
PubMed2001

Haemolysis during cardiopulmonary bypass: how to reduce the free haemoglobin by managing the suctioned blood separately.

During cardiopulmonary bypass (CPB) the collection of the patient's blood from the operating area is of fundamental importance. This blood is collected in the cardiotomy reservoir using field suckers and can be managed in different ways. It can be filtered in the cardiotomy reservoir and redirected to the venous reservoir, then oxygenated and returned to the patient, or it can be managed separately: collected in the cardiotomy reservoir, treated at the end of the operation and only after this, returned to the patient. The aim of this study is to determine in vivo the effect of a separate management of the suction blood from the operative field, using the Avant D903 oxygenator (Dideco, Mirandola, Italy). Twenty-one patients undergoing coronary artery bypass graft surgery with CPB were selected and put into two groups at random. In the control group (n = 10) the suction blood in the cardiotomy reservoir was filtered and immediately redirected into the venous reservoir, oxygenated and returned to the patient. In the study group (n = 11) the suctioned blood was collected in the D903 Avant's (Dideco) cardiotomy reservoir and returned to the patient only after having been washed at the end of the operation, using a Compact Advanced (Dideco), as required. Clinical data demonstrated that while in the study group it was possible to keep the free plasma haemoglobin (FPH) concentrations the same as at the beginning, in the control group there was a significant increase in FPH from 5.0 +/- 3.5 mg/dl (baseline) to 37 +/- 16.7mg/dl (120min after CPB).

Aged↗
PubMed1987

Improving autologous blood harvest: recovery of red cells from sponges and suction.

The efficacy of red cell salvage was assessed under circumstances which simulated blood loss managed with sponges or suction. Expired banked blood was equally divided and processed by either suction, or absorbing the blood on a sponge followed by rinsing the sponge in saline. These two techniques were used to harvest washed, centrifuged erythrocytes. The volume, haematocrit and free haemoglobin concentration of the banked blood and the processed units were measured, and smears from all units were examined microscopically. The red cell mass was calculated as the product of the volume and haematocrit. The red cell mass recovered by suction and from sponges averaged 93% and 87% respectively. Blood lost in sponges can be recovered and used to increase the available autologous blood, thereby reducing the need for donor blood.

Blood Transfusion, Autologous↗
PubMed1995

A pseudoepidemic of Mycobacterium chelonae infection caused by contamination of a fibreoptic bronchoscope suction channel.

An unusual increase in the frequency of isolation of Mycobacterium chelonae subspecies chelonae from specimens of bronchial washings was found between September and December 1992 in National Taiwan University Hospital. During this period, a total of 123 patients underwent fibreoptic bronchoscopy with an Olympus P20. Seventy six patients had bronchial washing for bacteriological study and cytological examination. Acid-fast bacilli were found in 21 patients, in 18 of whom Mycobacterium chelonae were isolated from bronchial washing cultures. Eight patients were treated as mycobacterial infected, because of the presence of unexplained pulmonary lesion, positive acid-fast stain and culture for Mycobacterium chelonae. Diagnosis of lung cancer was delayed in one patient because of the initial negative cytological study and positive bacterial culture. The fibreoptic bronchoscope was disinfected by automated washing machine (EW-20, Olympus) using 2.3% glutaraldehyde according to a standard protocol. From a survey to search for possible sources of contamination, they were identified at the suction channel of four different bronchoscopes. This episode proved to be a pseudoepidemic. The contamination was controlled by extensive suction and rinsing of the channel with 70% alcohol immediately after disinfection by the automated bronchoscope disinfection machine. This study shows that, despite using the disinfection machine, the suction channel could still be contaminated with Mycobacterium chelonae. This may cause diagnostic confusion and unnecessary antimycobacterial treatment.

Aged↗
PubMed2004

The effects of remifentanil on endotracheal suctioning-induced increases in intracranial pressure in head-injured patients.

In patients with severe traumatic brain injury, bronchotracheal toilet may be accompanied by deleterious variations in intracranial pressure (ICP). To avoid these effects, IV opioids have been proposed. Twenty mechanically-ventilated patients received 3 ascending IV doses of remifentanil: dose 1 (1 microg/kg bolus, 0.25 microg/kg/min infusion); dose 2 (2 microg/kg bolus, 0.5 microg/kg/min infusion); and dose 3: (4 microg/kg bolus, 1 microg/kg/min infusion). Endotracheal suction was performed 20 min after the beginning of infusion to assess coughing. Heart rate, ICP, mean arterial blood pressure (MAP), cerebral perfusion pressure (CPP), middle cerebral artery mean flow velocity (V(MCA)), and bispectral index were monitored throughout the 30-min study period. Twelve, 15, and 19 patients receiving dose 1, 2, and 3, respectively, required vasopressors to maintain CPP >60 mm Hg. Suctioning resulted in coughing in 16, 15, and 5 patients receiving dose 1, 2, and 3, respectively. An increase in ICP, without change in V(MCA), corresponded to the reduction in MAP consistent with the preservation of autoregulation. Remifentanil used as a continuous infusion in head-injured patients is not an effective drug to block responses to suctioning.

Adult↗
PubMed2005

Suction diathermy adenoid ablation.

Adenoidectomy is a surgical procedure frequently carried out in otolaryngological practice, traditionally undertaken blindly with curettage using an adenotome following palpation of the adenoid bed. While a number of alternative methods have been described for surgical removal of the adenoid pad (power-assisted/microdebrider, transnasal adenoid ablation, suction coagulation and liquefaction/aspiration) none has become the definitive procedure. Suction diathermy adenoidectomy has been known and used for some time; it has gained in popularity over recent years and is established as an alternative to conventional curettage, particularly in children. We describe several techniques which improve the view of the surgical field while performing suction diathermy adenoid ablation.

Adenoidectomy↗
PubMed1995

Suction drain management of salivary fistulas.

Salivary fistulas remain an unpleasant complication of upper aerodigestive tract surgery. To avoid a disastrous outcome such as carotid rupture, clinicians "medialize" (i.e., incise the skin flap in the anterior aspect of the neck and insert a Penrose drain) to divert fistula fluid from the carotid sheath and then perform laborious wound care. Meanwhile, patients endure the unpleasant odor, discomfort due to the wound dressing, occasional secondary surgical procedures, a lengthened hospital stay, and increased financial costs. In an effort to mitigate these problems, suction drains that had been placed at the time of the original surgical procedure were used as an alternative management technique. Out of a population of 118 reviewable patients who underwent standard or extended variations of supraglottic laryngectomy, partial laryngopharyngectomy, near-total laryngectomy, or total laryngectomy between 1988 and 1992, 16 patients appropriate for inclusion in this study developed postsurgical fistulas. Eight of these patients were treated with traditional medialization procedures, and the other 8 patients were treated with suction drainage. Comparison of the two groups revealed no significant difference with respect to complications or time to fistula closure. The advantages of simplified postsurgical care, less patient discomfort, reduced time demands on the clinician, and cost containment were noted for the group treated with suction drainage.

Aged↗
PubMedDate not supplied

Tracheostomy care: tracheal suctioning and humidification.

Tracheostomy care is a complex nursing activity and has many potential complications. However, aspects of tracheostomy care appear to be carried out without uniformity and with some confusion as to correct techniques, especially outside the ear, nose and throat and intensive care environments. Some aspects of the literature appear contradictory, leaving nurses to make individual judgments about correct procedures. It is the nurse who is accountable for the care given; therefore, with the wealth of evidence available, it is important that the nurse is adequately trained and fully competent in the care of a patient with a tracheostomy. This article discusses particular aspects of tracheostomy care: assessment; tracheal suctioning; suction pressure; suction catheters; and humidity.

Critical Care↗
PubMed1998

Effects of tracheal suctioning on respiratory resistances in mechanically ventilated patients.

OBJECTIVE: To evaluate the effects of tracheal suctioning (TS) on respiratory resistances in sedated critical care patients receiving mechanical ventilation (MV). SETTING: Surgical ICU of Bichat Hospital, Paris. PATIENTS AND PARTICIPANTS: Thirteen sedated critical care patients receiving MV for various conditions. MEASUREMENTS AND RESULTS: Airway resistances (R1), airway and pulmonary resistances (R2), and intrinsic positive end-expiratory pressure (PEEPint) were measured according to the end-inspiratory and end-expiratory occlusion methods before and after TS. R1 and R2 increased by 49.1% and 46.3%, respectively, 0.5 min after TS (p<0.01) but returned to baseline values at 1 min without any change thereafter. PEEPint decreased progressively following TS to reach a significant level (-13.3%) at 10 min (p<0.05) and was persistently reduced at 30 min (p<0.01). Nine patients received 500 microg of inhaled albuterol before another suctioning procedure. R1 and R2 decreased by 11.5% and 9.9%, respectively, 20 min after inhalation (p<0.05), but the R1 and R2 initial increase following TS did not differ between the two suctioning procedures. CONCLUSIONS: TS evokes only a transient bronchoconstrictor response, but thereafter, does not reduce respiratory resistances below presuctioning values. However, the decrease of PEEPint following TS suggests an increase of expiratory flow. Effective beta2-adrenergic receptor blockade fails to suppress the TS-induced bronchoconstrictor response.

Administration, Inhalation↗
PubMed1987

Suction fixation of the tcPco2 electrode for fetal monitoring.

The fixation ring for suction fixation is made of a soft plastic material and is measuring 24.5 mm in diameter and 5.8 mm in height. The electrode is mounted into the center of the ring and kept in position by the elasticity of the material. A polyethylene catheter is glued into the ring connecting it to the vacuum pump (-20 kPa). The soft plastic material will be deformed by heating, and sterilization should be performed by gamma radiation or by fluid aldehydes. The electrode mounted in the suction ring is attached to the fetal head during vaginal examination without amnioscopy or the use of application tools. The suction fixation technique was evaluated in relation to the glue fixation technique by simultaneous measurements with two electrodes. In adult monitoring no differences in stabilization times and Pco2 values were found. In fetal monitoring a little difference (0.3 kPa) in mean values was found at a cervical dilatation of less than 8 cm, but no difference was found at a cervical dilatation of more than 8 cm. Calibration may be performed by either two-point or one-point calibration. One-point calibration is usually sufficient, but the sensitivity of the electrode should be checked regularly. Electrode sterilization by fluid aldehydes following the calibration does not influence electrode drift. A close correlation was found between the transcutaneous carbon dioxide tension just before delivery and the Pco2 of umbilical artery blood (r = 0.77, n = 64). Stabilization time was short (2.1 min.) and the electrode drift usually low (mean -0.14 kPa or 2.7%) independent of the duration of the monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Gas Monitoring, Transcutaneous↗
PubMed1989

Baroreceptor reflex to neck suction and its modification by diltiazem in man.

The carotid sinus baroreceptor reflex was studied in 15 healthy young men by a variable pressure neck suction chamber. Neck suction produced a reduction in blood pressure and an increase in RR interval, which were augmented by an increase of stimuli. Both responses occurred promptly and were attenuated with time. The reproducibility of the response was examined in 6 subjects. There were no differences in either hypotensive or bradycardiac responses between 2 runs separated by 1 hour, indicating good short-term reproducibility. In a long-term reproducibility study involving 2 runs separated by 2 weeks, hypotensive responses showed similar changes, whereas bradycardiac responses showed a wide variation. Based on this good reproducibility of responses, the effects of diltiazem on baroreflex function were studied in 9 men. Following the administration of diltiazem (20 mg, P.O.), the hypotensive responses to neck suction stimuli were significantly augmented compared to preadministration responses. On the other hand, diltiazem did not have a significant influence on heart rate responses. Thus, the present study shows that the neck chamber method is a feasible approach to studying the influence of given interventions on baroreflex function and demonstrates an enhancement of baroreflex-mediated hypotension by diltiazem.

Adult↗