Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Suction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMedDate not supplied

Flexible endoscopes: structure and function. The suction and biopsy channel.

Flexible endoscopes are complex medical instruments that are easily damaged. To maintain the flexible endoscope in optimum working condition, the user must have a thorough understanding of the structure and function of the instrument. This is the second in a series of articles presenting an in-depth look at the care and handling of the flexible endoscope. The first article discussed the air and water system. This article will focus specifically on the suction and biopsy channel system. The flexible endoscope is constructed of several systems that operate simultaneously to produce a highly technical, yet effective diagnostic and therapeutic medical device. These systems include the air and water system, the suction or operating channel system, the mechanical system, the endoscopic retrograde cholangiopancreatography (ERCP) elevator system, the optical system, and the electrical system. A review of the internal and external structure of the flexible endoscope and the functions of the channel system, including infection control issues, potential problems and evaluation, and prevention of minor problems to avoid expensive repairs, will be addressed.

Biopsy↗
PubMed1993

Intraocular pressure and corneal curvature changes on application of limbal-scleral suction fixation ring in rabbits.

Suction rings are used to stabilize the globe during refractive surgery procedures. This study investigates the changes in ocular pressure and corneal curvature induced by a suction ring on rabbit corneas. A sharp rise in intraocular pressure, to as high as 80 mm Hg, followed by a time-dependent decline was found. The application of this ring also caused astigmatic changes in the cornea. Corneal thickening was also encountered. These findings have implications for possible artifactual changes during photorefractive keratoplasty and raise the possibility of intraocular pressure-induced damage in susceptible individuals.

Animals↗
PubMedDate not supplied

A new controllable suction catheter for blind cannulation of the main stem bronchi.

A new controllable suction catheter is described which was used for blind cannulation of the main stem bronchi. Cannulation of the right main stem bronchus was successful in 24 of 25 attempts (96%). Cannulation of the left main stem bronchus was successful in 22 of 25 attempts (88%). The use of a controllable tip suction catheter increases the rate of successful cannulation of the left main stem bronchus compared to previous reports in the literature.

Bronchi↗
PubMed1985

Effect of chest-tube suction on gas flow through a bronchopleural fistula.

Suction applied to a chest-tube drainage system produces subambient pressure within the chest tube and may increase or decrease the flow of gas passing from the airway through a bronchopleural fistula. Such gas may have participated in gas exchange and contain more CO2 and less O2 than inspired gas. Calculated or measured variables dependent upon exhaled CO2 and O2 will be erroneous unless the fistula gas values are considered. A device easily assembled from standard measuring instruments was used to titrate suction, thereby facilitating fistula closure and allowing more accurate physiologic assessment of gas content.

Adolescent↗
PubMed1999

Effect of endotracheal suctioning on cerebral oxygenation in traumatic brain-injured patients.

OBJECTIVE: In patients with severe head injuries, brain damage occurs not only from the primary trauma but also secondarily from a reduction in cerebral oxygenation as a result of brain swelling, ischemia, and elevated intracranial pressure (ICP). However, routine interventions designed to maintain oxygenation, such as endotracheal suctioning (ETS), also may negatively affect the cerebrovascular status by increasing the ICP. The purpose of this study was to determine whether ETS influences cerebral oxygenation in patients with traumatic brain injury. DESIGN: Descriptive, prospective, with repeated assessments within each patient. SETTING: Ten-bed trauma intensive care unit in a university Level I trauma center. SUBJECTS: Nineteen patients who were 16 yrs or older, had acute head injury, a Glasgow Coma Scale score < or =8; external ventricular drain and arterial pressure devices in place, and were intubated and mechanically ventilated. INTERVENTIONS: ETS protocol consisting of administration of four ventilator-delivered breaths at 135% of the patients' actual tidal volume, 100% F(IO)2, before and after suctioning with a standardized catheter at a 16-L flow rate. MEASUREMENTS AND MAIN RESULTS: This study examined cerebrovascular responses as measured by the traditional measures of ICP and cerebral perfusion pressure, as well as middle cerebral artery velocity and jugular venous oxygen tension that occurred during ETS in head-injured adults. The results of this study show that both ICP and cerebral perfusion pressure are increased during ETS. In the majority of patients (84%), the ICP returned to baseline values within 2 mins. CONCLUSIONS: The increase in jugular venous oxygen tension associated with increases in middle cerebral artery velocity and mean arterial pressure suggests that cerebral oxygen delivery was maintained during ETS. Cerebral changes associated with ETS using the described protocol are consistent with the preservation of cerebral oxygenation.

Adolescent↗
PubMed1998

Histologic evaluation of endoscopic versus suction biopsies of small intestinal mucosae in children with and without celiac disease.

BACKGROUND: Concern over the adequacy of histologic diagnosis of endoscopic duodenal biopsies in children prompted this comparative study on the histologic quality of endoscopic versus capsule biopsies. We found this problem addressed in only six previous reports. METHODS: Blind examinations of the histologic sections of 48 duodenal biopsies obtained by gastrointestinal endoscopy in children aged 2-18 years were compared to 52 biopsies obtained by the small bowel suction method (from children aged 1-16 years). RESULTS: Although 87.5% of endoscopic biopsies and 94.2% of capsule biopsies were adequate for histologic diagnosis, fragmentation or squashing was seen in 83.3% of endoscopic biopsies and only in 25% of capsule biopsies. CONCLUSIONS: Biopsies obtained by suction are of better quality than those obtained by endoscopy. If endoscopy is preferred for technical reasons, the following conditions should be observed: the patients should be aged over 2 years, and a minimum of four biopsies should be obtained with forceps of a diameter greater than 2 mm. Adequate histologic criteria for diagnosis should include at least one full-thickness mucosal specimen more than 3 mm in length, vertically oriented, and not fragmented. In children under age 2, duodenal or jejunal capsule biopsies are preferred, since the specimens are usually larger and less fragmented. Endoscopy is technically more difficult in the very young patient.

Adolescent↗
PubMedDate not supplied

Methodologic issues associated with secretion weight as a dependent variable in research using closed-system suction catheters.

BACKGROUND: Closed-system suction catheters (CSSC) were designed to eliminate the need to disconnect the patient from the ventilator during endotracheal suctioning (ETS). During data collection on an NIH-funded study, it was noted that moisture accumulated on the inside of the CSSC and sleeve when attached to the patient for 30 minutes. Because CSSC are not disconnected, they present unique methodologic problems related to measurement of secretions as a dependent variable in clinical research. OBJECTIVES: To describe a valid, reliable, and practical method for weighing secretions obtained during ETS using a CSSC; and to determine the change in weight of a CSSC after its attachment for 30 minutes to a mechanically ventilated patient. METHODS: After being weighed, a CSSC and sputum trap were attached to the endotracheal tube of a mechanically ventilated adult and remained attached for 43 minutes (30 minutes to allow positive end expiratory pressure and oxygenation levels to return to normal and 13 minutes to mimic the time frame for the ETS procedure used in another study). No ETS occurred. The CSSC and sputum trap were then removed and reweighed. RESULTS: A convenience sample consisted of 50 adults who were critically ill and mechanically ventilated. Independent variables included tidal volume, pressure support, body temperature, and respiratory rate. The dependent variable was wet weight of the CSSC, determined by subtracting the preprotocol catheter weight from the postprotocol catheter weight. The mean wet weight for all catheters was 0.5142 +/- 0.1215 grams. In a subset of 37 patients, two wet weights (74 paired observations) were determined. The mean wet weight for these catheters was 0.54014 +/- 0.1404 grams. The paired wet weights were statistically different (t = 2.433; df = 36; p = 0.02). Pearson correlation coefficients and beta coefficients were computed. While tidal volume and pressure support were highly correlated (r = 0.678; p = 0.011), there were no other statistically significant associations. CONCLUSIONS: The amount of secretions is a common dependent variable in ETS research. During the time that CSSC are attached to the patient and ventilator, moisture from either the ventilator's humidification system or the patient accumulates in the CSSC. This wet weight is not actually part of the secretions retrieved during ETS and should not be considered in the actual weight of secretions. Further study on the determinants of wet weight is warranted.

Adult↗
PubMed1984

Subcutaneous endoscopy in suction lipectomy.

Subcutaneous photographs of tissues treated by suction lipectomy have been obtained by adapting fiberoptic endoscopy equipment. These photographs document the presence of an intact neurovascular supply to the overlying skin and lend support to the concept of suction lipectomy with the blunt cannula. The technique of subcutaneous endoscopy is described, and additional uses for the method are suggested.

Adipose Tissue↗
PubMed1985

Defatting of flaps by means of suction-assisted lipectomy.

Single-stage debulking of flaps using suction-assisted lipectomy in combination with skin excision is a safe and reliable procedure with results comparable to conventional multistaged surgical techniques. Three representative cases are presented that demonstrate the efficacy of suction-assisted lipectomy as an adjunctive procedure for flap defatting.

Adipose Tissue↗
PubMed1986

Quantitative analysis of blood and fat in suction lipectomy aspirates.

This study of suction lipectomy aspirates from 15 consecutive patients was undertaken to biochemically quantitate the blood-to-fat ratios of the aspirates. A wide variation in the blood-to-fat ratios (8 to 54 percent) was noted, but the authors failed to demonstrate any relationship between the blood-to-fat ratios and the suction lipectomy operative site. Prophylactic measures to allow treatment of patients in a consistently safe manner include carefully screening of patients to exclude those with bleeding disorders or significant illnesses, perioperative oral iron therapy, infiltrating the operation site with a dilute epinephrine solution, hydrating the patients adequately perioperatively, using smaller-diameter cannulas for the aspiration, minimizing aspiration once the aspirate turns grossly bloody, and limiting the aspirate to a volume of less than 1750 ml for any operative procedure.

Adipose Tissue↗
PubMed1993

Alfentanil administered prior to endotracheal suctioning reduces cerebral perfusion pressure.

The effects of i.v. alfentanil on the intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were prospectively evaluated during endotracheal suctioning of head-injured adults. Seven subjects underwent trials of saline and alfentanil at 15 and 30 micrograms/kg prior to a stereotypic stimulus of endotracheal suctioning. Investigators and medical personnel were blinded with respect to the intravenous substance administered. The ICP, mean arterial pressure (MAP), heart rate (HR), peak and plateau inspiratory pressures, and Glasgow Coma Scores were recorded. By analysis of variance with repeated measures, data demonstrated that the alfentanil trials were associated with a decline in the CPP relative to control. The CPP was significantly reduced (p < 0.05) in the alfentanil dosage trials 5 min after i.v. alfentanil injection. There was no evidence of alteration of chest wall compliance to explain apparent elevations in the ICP or reductions in the MAP. These findings suggest caution in the use of alfentanil in the neurotrauma patient. Potential mechanisms of reduction in cerebral perfusion will require further evaluation. Formal assessment of other synthetic opiates with respect to efficacy and safety in the neurotrauma patient is advised.

Adult↗
PubMed2003

The use of postoperative subcutaneous closed suction drainage after posterior spinal fusion in adolescents with idiopathic scoliosis.

BACKGROUND The purpose of this prospective study was to assess the impact of closed suction drainage on transfusion requirements, frequency of dressing changes, and wound healing following posterior spinal fusion in adolescents with idiopathic scoliosis. METHODS Thirty patients were randomly assigned to one of two groups: drain or no drain. Although the group with drains received more postoperative autologous blood transfusions than the group with no drains (0.88 vs 0.5 unit), the difference was not statistically significant (P = 0.2131). In the undrained group, 58% of the patients had moderate to completely saturated dressings on the second postoperative day compared with only 17% of patients in the drained group. Three of 12 patients in the undrained group demonstrated a wound complication rate compared with no complications in the drained group. CONCLUSION In conclusion, subcutaneous closed suction drainage can improve immediate postoperative wound care without significantly increasing blood loss and transfusion requirements for patients undergoing surgery for idiopathic scoliosis.

Adolescent↗
PubMed2004

Inhaled nitric oxide as an adjunct to suction thrombectomy for pulmonary embolism.

Pulmonary suction thrombectomy can be a successful interventional tool in the treatment of pulmonary thromboembolism. Removal of clot burden typically results in prompt recovery of hemodynamic stability and improved oxygenation. However, in rare cases, clot removal does not sufficiently improve the clinical situation. Herein, two patients with massive pulmonary thromboembolism are presented whose condition improved only after they received nitric oxide as an adjunct to pulmonary suction thrombectomy. The treatment with this inhalable vasodilator was based on the hypothesis that prolonged ischemia had induced microcirculatory vasospasm, persistent after removal of the central clot.

Administration, Inhalation↗
PubMed1990

Treatment of atelectasis of upper lung lobes. Selective bronchial suctioning with J-shaped catheter tip and guide mark.

We developed a technique for blind bronchial suction using a curved-tip catheter with a guide mark, for the treatment of atelectasis of the lower and middle lobes of the lung. Suction of the upper lobe bronchi could not be performed because of the combination of the peculiar anatomy of the upper lobe bronchi with catheter design. We treated successfully two cases of atelectasis of the right upper lobes using a Rusch Metras bronchography catheter with a guide mark which is not readily available. Therefore we devised a J-shape tipped catheter with a guide mark. We have successfully treated 13 episodes of atelectasis of the right upper lobe in 10 patients and one episode in the left upper lobe in one patient with this new catheter.

Bronchi↗
PubMed1991

Environmental contamination during tracheal suction. A comparison of disposable conventional catheters with a multiple-use closed system device.

The extent of airborne environmental bacterial contamination which occurs following tracheal suction has been investigated in patients undergoing intermittent positive pressure ventilation in the intensive therapy unit. Two methods of performing suction, one using a conventional open technique and one using a closed system (Stericath), have been compared. Significantly lower levels of environmental contamination were observed when the closed system was used.

Air Microbiology↗
PubMed1993

The level of neuromuscular block needed to suppress diaphragmatic movement during tracheal suction in patients with raised intracranial pressure: a study with vecuronium and atracurium.

The effects of tracheobronchial suction before and after neuromuscular blockade with vecuronium (0.12 mg.kg-1; ED95 x 2; group A) and atracurium (0.4 mg.kg-1; ED95 x 2; group B) on intracranial pressure were studied in 18 neurosurgical patients with a Glasgow Coma Scale < 7. Despite adequate sedation, moderate to severe diaphragmatic movements (bucking and coughing) in response to carinal stimulation with significant increases in intracranial pressure (A: 18 SD 7 to 24 SD 8 mmHg; B: 19 SD 7 to 27 SD 5 mmHg) and subsequent decreases in cerebral perfusion pressure (group A: 69 SD 11 to 63 SD 8 mmHg; group B: 63 SD 11 to 59 SD 17 mmHg) could be observed without muscle relaxation. After a bolus dose of vecuronium or atracurium, profound neuromuscular paralysis quantified by the post-tetanic count, was observed after an onset time of 253 SD 72 s (vecuronium) and 159 SD 54 s (atracurium). Slight diaphragmatic movements could be elicited in only two patients in group A and in two patients in group B during tracheal suction; intracranial pressure (group A: 20 SD 8 to 20 SD 8 mmHg; group B: 19 SD 7 to 19 SD 7 mmHg) and cerebral perfusion pressure (group A: 65 SD 13 to 65 SD 13 mmHg; group B: 66 SD 12 to 65 SD 11 mmHg) remained unchanged. When coordinating respiratory therapy in neurosurgical intensive care patients, profound neuromuscular block, quantified by a post-tetanic count of at least 5 for vecuronium and 1 for atracurium, it is necessary to rule out any impact of diaphragmatic movement on intracranial pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Comparison of brush before biopsy, suction cytology, brush after biopsy and endoscopic biopsy in the diagnosis of carcinoma oesophagus.

A study was conducted on 40 patients of carcinoma oesophagus to compare the diagnostic yield of brush biopsy, suction cytology, brush after biopsy and endoscopic biopsy. The positive yield with brush before biopsy was 87.5%, with suction cytology 90%, with brush after biopsy 100% and with endoscopic biopsy 90%. Difference in the yield of brush after biopsy compared to other modalities was statistically insignificant (P > 0.05). However, the quantitative yield of the material was significantly high (P < 0.05) in the brush after biopsy compared to brush before biopsy. Of these three cytological modalities brush after biopsy appears to be the cytological technique of choice to be used as an adjunct to endoscopic biopsy.

Biopsy↗
PubMed2006

Advanced suction detection for an axial flow pump.

An automatic detection system for ventricular collapse was developed and tested in a first clinical trial as part of a physiological speed control concept for axial flow pumps. From this clinical experience, and based on the acquired data during this trial, an optimization of the developed system was performed. An already-existing database of 784 individual cases was extended. For harmonization of this database an additional 412 snap files were extracted from continuous data recordings and classified manually using a standardized procedure. The already-developed and clinically tested algorithms were supplemented by one additional indicator derived from a preexisting criterion. One threshold value was replaced by application of a numerically optimized nonlinear characteristic curve dependent on heart rate. Finally, in a multidimensional optimization process of the entire suction detection system, 7 individual indicators were adjusted by using 17 independent threshold values. The optimization criteria were applied using a three-level hierarchical system. Within the final database consisting of 1196 snap shots the overall amount of maldetections could be reduced to 23 cases including 5 false positive events (0.42%) and 18 false negative decisions (1.5%). By application of the clinical experience from the first clinical trial of a physiologic control system it became possible to optimize the sensitivity and specificity of the suction detection system to unprecedented accuracy.

Algorithms↗