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PubMed2006

Nitrogen removal function of recycling irrigation system.

The purpose of this study was to clarify the nitrogen (N) purification capacity of a paddy field in a recycling irrigation system. Irrigation water was sampled at 12-h intervals during the irrigation period from April to September 2003. In addition, ponded water in a paddy field was collected at three points (inlet, centre and outlet). Total amounts of N were 30.7 kg ha(-1) in inflow and 27.8 kg ha(-1) in outflow. Thus, the net outflow load was -2.9 kg ha(-1). The N removal rate constant when N removal is expressed as a 1st-order kinetic was 0.017-0.024 m d(-1). This value is close to values of wetlands and paddy fields in the literature. We found a good correlation between recycling ratio and N removal effect. These results indicate that the recycling irrigation system accumulates N in the irrigation/drainage system, and thus the paddy field does a good job of water purification by removing N.

Agriculture↗
PubMedDate not supplied

Systemic absorption of gentamicin nasal irrigations.

OBJECTIVE: To determine if gentamicin nasal irrigation is systemically absorbed, and to identify any ototoxic side effects related to its use. DESIGN: Retrospective review of 12 patients treated with gentamicin nasal irrigations (30 cc of 80 mg/L solution used bilaterally twice daily). METHODS: Serum gentamicin levels were assayed after the course treatment. Pure tone audiometry (250-8000 Hz) and distortion product otoacoustic emissions (DP-OAEs) at 7280, 5133, 3640 and 2560 Hz were obtained before and after therapy. RESULTS: Twelve patients (age 4 to 74, mean 43) with chronic rhinosinusitis were treated for 3-15 weeks (mean 7 weeks). All patients had undergone previous endoscopic sinus surgery. Ten patients had pretreatment cultures that grew organisms sensitive to gentamicin (Pseudomonas, Proteus, or methacillin resistant Staphylococcus aureus), and three patients had cystic fibrosis. Ten of 12 patients (83%) had detectable posttreatment levels of gentamicin, with a mean serum level of 0.42 mcg/mL (range 0.3 to 0.7 mcg/mL). Four of 12 patients (33%) had serum gentamicin levels within the normal range for gentamicin trough (0.5 to 2 mcg/mL). Comparison of pre- and posttreatment audiologic data revealed no significant change in PTA or DP-OAE, except for the right ear at 8000 Hz on PTA (p = 0.035) where a mean of 7 dB loss was observed. No patient reported hearing loss or vertigo during treatment. CONCLUSION: Gentamicin nasal irrigation may be systemically absorbed. Although the otologic consequences of this finding are questionable, patients receiving gentamicin nasal irrigations should be counseled regarding this hypothetical possibility.

Absorption↗
PubMed1986

Sorbitol concentrations in plasma in connection with transurethral resection of the prostate using sorbitol solution as an irrigating fluid.

20 patients undergoing transurethral resection of the prostate (TURP) using 5% sorbitol (N = 13) or Cytosol (N = 7) (5% sorbitol and 0.25% acetic acid) as an irrigating fluid were studied. The sorbitol concentration was determined in serum (plasma), as were sodium, prostatic acid phosphatase protein (PAP) and osmolality, as possible indicators of absorption of irrigating fluid. The plasma level of sorbitol immediately postoperatively, the increase in serum PAP and the decrease in serum sodium all reflect the amount of irrigating fluid absorbed during TURP. The three variables are intercorrelated. The plasma osmolality was not significantly changed. The maximum sorbitol concentration immediately postoperatively in any patient was 6.0 g/l (33.5 mmol/l). The mean for the series was 1.2 g/l (6.8 mmol/l). The mean serum PAP increase was 31 micrograms/l. The serum sodium decrease ranged between 0 and 14 mmol/l, mean 5.0 mmol/l. The mean half-life of sorbitol in plasma was short: 35 min, reflecting rapid metabolism. An estimate of the volume of fluid absorbed was made from the plasma sorbitol levels observed. A fluid absorption up to 2.3 l (mean 0.6 l) was found. A marked diuretic effect up to 14.1 ml/min (mean 7.8 ml/min) was observed in some cases when irrigation with sorbitol was combined with intravenous furosemide given postoperatively.

Aged↗
PubMed1986

Monitoring fluid absorption during TURP by marking the irrigating solution with ethanol.

Ethanol has been evaluated as a marker of the irrigating fluid during TURP. In nine patients mannitol served as a reference substance (2% ethanol in 5% mannitol) and it could be verified that ethanol enters the body as a result of irrigating fluid absorption. Ethanol is instantly and easily demonstrated in the patient's expired breath with an Alcolmeter. In four healthy volunteers a 500 ml intravenous infusion of the irrigating fluid was given to imitate absorption. These experiments showed that very small amounts gave significant concentrations of ethanol in expired breath and that there was a distinct fall in expired ethanol as soon as the infusion was stopped. Thus marking the irrigating fluid with ethanol is a simple method which may be used to indicate absorption, to follow its course and to tell if preventive steps taken against further absorption are effective.

Absorption↗
PubMed1986

Mannitol concentrations in blood plasma in connection with transurethral resection of the prostate using mannitol solution as an irrigating fluid.

Thirteen patients undergoing transurethral resections of the prostate (TURP) using iso-osmolar 5% mannitol as an irrigating fluid were studied. Mannitol was determined in serum (plasma), as were sodium, prostatic acid phosphatase protein (PAP) and osmolality as probable indicators of absorption of irrigating fluid. The plasma level of mannitol (mean 2.7 g/l = 15 mmol/l) immediately postoperatively, the increase in serum PAP (mean 93 micrograms/l) and the decrease in serum sodium (mean 8.7 mmol/l) all reflect the amount of irrigating fluid absorbed during TURP. The three variables are intercorrelated. The plasma osmolality was unchanged (mean -1 mosmol/kg). A small but constant fraction of mannitol was found in the erythrocytes 2 hours after the operation, amounting to about 3% of the simultaneous plasma concentration. The mean plasma half-life of mannitol was 127 min in the absence of uraemia. In two cases showing a slight increase in serum creatinine the half-lives were prolonged. An estimate of the volume of fluid absorbed was made from the observed plasma mannitol levels. A fluid absorption of up to 3 litres (mean 1.1 l) was found. A strong diuretic effect was observed in some cases when irrigation with mannitol was combined with i.v. furosemide. We conclude that the i.v. diuretic should be withheld until the extent of fluid absorption has been estimated. If the sodium concentration in the serum is largely unchanged immediately postoperatively, diuresis can be induced by an intravenous diuretic.

Absorption↗
PubMed1995

Diuretic effects of irrigating fluids containing mannitol and sorbitol.

We studied urine excretion and plasma electrolytes in 38 rabbits during and after a 60-min intravenous infusion of 150 ml/kg of irrigating fluid containing either 3.3-6% of mannitol, 5% sorbitol, or 2.7% sorbitol and 0.54% mannitol (Cytal). The Osmolality of the solutions ranged between 165 and 350 mosmol/kg. The excreted urine volume, peak flow rate, duration of 80% of peak urine flow and the ratio of urine excreted per volume of infused irrigating fluid varied greatly but in direct proportion to the osmolality of each solution. There were no differences between the irrigating fluids with respect to dilution changes in plasma sodium and chloride concentrations. We conclude that the urine flow after infusion of irrigating fluids is governed primarily by the osmolality of the solution. Mannitol has no superior effect over sorbitol as a diuretic.

Analysis of Variance↗
PubMed1986

Investigation of sloughed corneal epithelial cells collected by non-invasive irrigation of the corneal surface.

This paper reports the development of a non-contact corneal irrigation chamber (NC-CIC) which enables non-invasive collection of epithelial cells from the corneal surface of human subjects. Cells were viewed by fluorescence microscopy following vital staining with acridine orange (AO). Staining characteristics revealed two corneal epithelial cell types: cells with (i) green and (ii) orange-red cytoplasmic staining. The green cytoplasmic stain appeared to indicate a more viable cell. Multi-cell aggregates were regularly collected from the corneal epithelial surface. Groups of up to seven epithelial cells were obtained. Quantitative studies of corneal epithelial cell sloughing, using isotonic NaCl (305 mOsm/kg) and isotonic "basic tear solution" (BTS, 305 mOsm/kg) as irrigating solutions, involving hourly irrigations between 8 a.m. and 4 p.m. were conducted. Consistently higher cell counts were obtained with NaCl. Using BTS, data scatter was reduced sufficiently to reveal significant differences in sloughing rate as a function of time of day. Instillation of one drop of 0.5% proparacaine caused a significant, but gradual, increase in epithelial cell sloughing rate over a period of hours, as indicated by subsequent BTS irrigations of the cornea. Since the NC-CIC technique is able to discriminate these effects, it may be an appropriate system for in vivo studies of the relationship between corneal epithelial cell mitosis and sloughing.

Anesthesia, Local↗
PubMed1986

Mediastinal infection following open-heart surgery. Treatment with retrosternal irrigation.

A consecutive series of 1083 patients undergoing open-heart surgery was prospectively observed for infectious complications. Postoperative mediastinitis developed in 15 cases (1.4%). Surgical management of the mediastinal complication consisted of careful debridement of the sternal wound and the anterior mediastinum, followed by continuous retrosternal irrigation with an antiseptic or antibiotic solution after sternal refixation. The mean duration of mediastinal irrigation was 12.7 days. This treatment was successful in 13 of the 15 patients. In 2 of the 13, however, secondary refixation became necessary to stabilize the fragmented sternum. Repeated refixation with mediastinal irrigation was effective in one of these patients. The other underwent removal of the fragmented sternum followed by muscle plasty, but died unexpectedly of aortic dissection when signs of infection were subsiding. Two patients (13%) treated with closed chest irrigation died of recalcitrant mediastinal infection.

Aged↗
PubMed1978

Bladder irrigation in patients with indwelling catheters.

The effect of intermittent bladder irrigation on the bacterial counts in urine samples was studied in patients with indwelling catheter and pre-existing urinary tract infection. Four different irrigating solutions were used. Irrigation with saline or 0.25% acetic acid had no effect on the urinary bacterial count. The bacterial counts were effectively reduced during intermittent irrigation both with 0.02% chlorhexidine and with 0.25% silver nitrate. Silver nitrate gave the greatest reduction of bacterial counts but chlorhexidine is preferable due to fewer side effects and greater convenience.

Acetates↗
PubMed2004

Effectiveness of the head-shaking method combined with cisternal irrigation with urokinase in preventing cerebral vasospasm after subarachnoid hemorrhage.

OBJECT: The head-shaking method combined with cisternal irrigation has been proposed to be effective in preventing cerebral vasospasm after subarachnoid hemorrhage (SAH) by facilitating rapid washout of the clot from the subarachnoid space. This study was conducted to evaluate the effectiveness of this method. METHODS: The inclusion criteria included the following: 1) Fisher Grade 3 SAH on admission computerized tomography (CT) scans; 2) aneurysm secured within 48 hours of SAH onset; and 3) no focal deficit and ability to obey commands within 24 hours postsurgery. Two hundred thirty patients treated between 1994 and 2002 fulfilled the criteria. Because only one machine was available and it required I month of maintenance every other month, 114 patients underwent irrigation combined with the head-shaking method (head-shaking group), whereas the remaining 116 patients received cisternal irrigation alone (control group). There were no significant differences in sex, age, site of aneurysm, or preoperative grade between the two groups. The incidence of symptomatic vasospasm with or without infarction, cerebral infarction on CT scans, and permanent ischemic neurological deficit was 25.7, 17.7, and 8.8%, respectively, in the control group and 15.2, 4.5, and 2.7% in the head-shaking group. The difference was statistically significant for symptomatic vasospasm, cerebral infarction, and permanent ischemic neurological deficit (p < 0.05). In a multivariate backward stepwise logistic regression analysis, absence of head shaking was the only variable that was predictive of permanent ischemic neurological deficit (p = 0.061). The outcomes evaluated using the modified Rankin Scale were better in the head-shaking group (p = 0.051). CONCLUSIONS: The head-shaking method significantly reduced the incidence of symptomatic vasospasm, cerebral infarction, and permanent ischemic neurological deficit and improved the clinical outcomes in patients who underwent cisternal irrigation therapy after aneurysmal SAH.

Adult↗
PubMed1985

Pulsatile irrigation in orthopedics.

A brief history of the use of irrigation fluids in the management of traumatic and surgical wounds is presented. The development of irrigation fluid as a debridement technique and some of the problems in controlling the fluid dynamic parameters are described. Orthopedics requires varied applications of irrigation devices, and a machine has been developed which combines irrigation lavage or pulsatile debridement technique with the rapid suction removal of effluent. The applications, technique, and precautions in using a Rapid Suction Removal System are described.

Anti-Bacterial Agents↗
PubMedDate not supplied

Wound irrigation in musculoskeletal injury.

Wound irrigation to remove debris and lessen bacterial contamination is an essential component of open fracture care. However, considerable practice variation exists in the details of technique. Volume is an important factor; increased volume improves wound cleansing to a point, but the optimal volume is unknown. High-pressure flow has been shown to remove more bacteria and debris and to lower the rate of wound infection compared with low-pressure irrigation, although recent in vitro and animal studies suggest that it may also damage bone. Pulsatile flow has not been demonstrated to increase efficacy. Antiseptic additives can kill bacteria in the wound, but host-tissue toxicities limit their use. Animal and clinical studies of the use of antiseptics in contaminated wounds have yielded conflicting outcomes. Antibiotic irrigation has been effective in experimental studies in some types of animal wounds, but human clinical data are unconvincing due to poor study design. There are few animal or clinical studies of musculoskeletal wounds. Detergent irrigation aims to remove, rather than kill, bacteria and has shown promise in animal models of the complex contaminated musculoskeletal wound.

Animals↗
PubMed1989

Surgical antibiotic irrigations.

Instillation of antibiotic solutions into surgical wound sites seems empirically attractive since relatively high concentrations of antibacterial agents can be applied directly to the probable site of infection. However, systemic effects provided by antibiotic assimilated from sites of application are responsible for much of the activity and toxicity of antibiotic irrigations. The most appropriate drugs and dosages for use as prophylactic antibiotic irrigations have not been determined. Most controlled trials conducted in recent years have utilized various cephalosporins in concentrations of 1 to 4 g/L. In some of these trials, surgical irrigation has been found as effective as prophylactic intravenous antibiotics, which are the proven and accepted standard. Reported cases of toxicity associated with antibiotic irrigations are few in number, excepting neomycin, which has caused postoperative respiratory depression/apnea, permanent deafness, and renal failure.

Anti-Bacterial Agents↗
PubMed1975

[The effect of irrigation on the oxygen tension in the healthy rat gingiva].

The temperature of the rat's gingiva was 30.4 +/- 0.3 degrees C. before, and 37.1 +/- 0.2 degrees C. after irrigation. After irrigation, the oxygen tension in the gingiva of the rats was by 40% higher than its original value. When pure oxygen was inhaled, the tension increased by 120% before irrigation, and by 126% after irrigation.

Animals↗
PubMed2000

Outpatient penile aspiration and epinephrine irrigation for young patients with sickle cell anemia and prolonged priapism.

The optimal management of prolonged priapism for patients with sickle cell anemia (SCA) has not been established. We prospectively studied in an outpatient setting the efficacy and safety of a procedure that employs aspiration of blood from the corpora cavernosa and irrigation with a dilute epinephrine solution under local anesthesia to relieve priapism in young patients with SCA. If hydration and analgesics failed to produce detumescence or if priapism had lasted >4 hours, the protocol was activated in the emergency room or clinic. Fifteen patients with homozygous SCA (Hb SS) were treated on 39 occasions; 10 patients were treated once, 1 patient twice, 2 patients 3 times, 1 patient 6 times, and 1 patient 15 times. Median age of patients at first treatment was 14.3 years (range, 3.9-18.3 years). The procedure was successful in producing immediate detumescence on 37 of 39 occasions (95% efficacy, 95% confidence intervals (CI): 81%-99%). No serious immediate or long-term side effects were observed. None of the patients who demonstrated detumescence required hospitalization. The 2 patients whose priapism persisted after aspiration and irrigation presented with episodes lasting >24 hours. All evaluable patients whose priapism resolved after aspiration and irrigation self-reported normal erectile function at a median of 40 months (range, 3-58 months) after the last procedure. Thus, aspiration of the corpora cavernosa followed by irrigation with dilute epinephrine is effective in producing immediate and sustained detumescence and should be the initial therapy employed for patients with SCA and prolonged priapism. (Blood, 2000; 95:78-82)

Adolescent↗
PubMed1999

Residual antimicrobial activity associated with a chlorhexidine endodontic irrigant used with sodium hypochlorite.

PURPOSE: To evaluate the in vitro efficacy of 2.0% chlorhexidine gluconate (CH) as an endodontic irrigant combined with the traditional irrigant, sodium hypochlorite (SH). MATERIALS AND METHODS: Extracted single-rooted human teeth were instrumented using one of three regimens: CH alone; SH alone until instrumentation with the last file, at which time CH was used as the filing irrigant; or SH alone followed by a single rinse with CH. After instrumentation, each root canal was dried with endodontic paper points, filled with sterile water, and maintained in a water-saturated environment. At 6, 12, 24, 48 and 72 hours after instrumentation, the root canal fluid was absorbed with an endodontic paper point, and the canal was irrigated and refilled with sterile water. The paper points containing root canal fluids were assayed for antimicrobial activity by placing them on agar plates inoculated with Streptococcus mutans, and measuring zones of inhibition after incubation. RESULTS: Comparisons of the results obtained from the three treatment regimens indicated there were no significant differences (P > 0.5) in the relative in vitro antimicrobial activity remaining in the three groups of teeth.

Anti-Infective Agents, Local↗
PubMed2000

[Whole bowel irrigation in infants for acute iron poisoning].

Acute iron poisoning is a major cause of death due to poisoning in children, so knowledge of its presentation and appropriate management are necessary. Whole bowel irrigation, used routinely in preparation for elective surgery and colonoscopy, are safe and effective procedures. In recent years whole bowel irrigation has been used several times in various toxic situations, including acute iron poisoning. We report our successful experience treating acute iron poisoning in a 1-year-old girl using whole bowel irrigation and deferoxamine. The safety and theoretical effectiveness of the procedure, although not proven in controlled clinical studies, suggests the use of whole bowel irrigation as treatment for acute iron poisoning.

Chelating Agents↗
PubMedDate not supplied

[Express method for evaluating the efficiency of bladder droplet irrigation].

The catalase test is proposed for objective and rapid evaluation of the efficiency of droplet irrigation of the bladder after operations on the prostate, bladder, and urethra. Three milliliters of irrigation fluid is collected from the bladder drainage into a tube with 0.5 ml 3% hydrogen peroxide solution. If catalase is present in the lavage fluid (this enzyme is present in erythrocytes, leukocytes, and bacteria), hydrogen peroxide is degraded and oxygen is released. In a positive test gas bubbles and foam appear on the surface of the mixture. Three degrees of positive catalase test are defined. The rate and volume of perfusion are regulated with consideration for the test results; constant irrigation can be replaced by fractionation; negative results of the test allow discontinuation of irrigation. The rapid method was clinically tried in 20 patients with good results.

Catalase↗