Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “IRRIGATION”

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 91 records · Page 5Linked to original sources
PubMed1997

[Implantation of the Palmaz-Schatz stent in coronary vessels irrigating and non-irrigating necrotic myocardial areas: comparison of acute results and at mid-term].

Recent evidence suggests that higher restenosis rate is observed after coronary angioplasty of an infarct-related artery. Furthermore, angiographic restenosis seems associated with a deterioration of left ventricular function at follow-up. The aim of this study was to assess the acute results and angiographic restenosis following coronary artery stenting of infarct-related (Group 1) and non infarct-related coronary arteries (Group 2). We retrospectively analyzed the results of 381 consecutive patients treated with Palmaz-Schatz coronary stent implantation between May 1992 and January 1996. Stenting of the infarct-related artery was performed in 154 patients (Group 1), while 227 patients (Group 2) received stenting of the non infarct-related artery. Both groups had similar age, gender, clinical conditions and coronary angiographic pattern. There were no significant differences between groups, concerning type of stented coronary vessel (left anterior descending-LAD 52.4% vs non-LAD 47.6%, Group 1, LAD 59.5% vs non-LAD 40.5%, Group 2) and number of stents per patient (1.31 +/- 0.48 in Group 1, 1.18 +/- 0.56 in Group 2) and per coronary vessel (1.17 +/- 0.54 in Group 1, 1.09 +/- 0.46 in Group 2). The procedure was performed using similar maximal inflation pressures in both groups (13.3 +/- 2.9 atm in Group 1, 13.40 +/- 3.17 atm in Group 2). Technical success was achieved in 96.8% of Group 1 and in 96% of Group 2 patients. Acute coronary stenting success and major adverse events (acute myocardial infarction, emergency bypass, death) were similar in both groups of patients. No difference was found in restenosis rate at 6-month angiographic follow-up (Group 1 = 29.8%, Group 2 = 27%). In conclusion, this study indicates that stenting of infarct and non infarct-related coronary arteries has similar success and 6-month restenosis rates.

Coronary Circulation↗
PubMed2001

Biophysics of radiofrequency ablation using an irrigated electrode.

BACKGROUND: Previous reports have proposed that prevention of electrode-endocardial interfacial boiling is the key mechanism by which radiofrequency application using an irrigated electrode yields a larger ablation lesion than a non-irrigated electrode. It has been suggested that maximal myocardial temperature is shifted deep into myocardium during irrigated ablation. PURPOSE: To examine the biophysics of irrigated ablation by correlating electrode and myocardial temperatures with ablation circuit impedance and lesion morphology, and to perform a comparison with non-irrigated ablation modes. To assess the influence of irrigant rate, composition, temperature and blood flow velocity. METHODS: I. Ablation with and without electrode irrigation was performed in vitro utilizing a whole blood-superfused system. Electrode, electrode-endocardial interface, and intramyocardial temperatures were assessed, as were ablation circuit impedance, total delivered energy, and lesion and electrode morphology. Irrigants assessed were room temperature normal saline, iced normal saline, and dextrose. Irrigant flow rates assessed were 20 and 100 cc/min. Blood flow velocities assessed were 0 and 0.26 m/s. II. Finite element simulations of myocardial temperature during irrigated ablation were performed to further elucidate irrigation biophysics and provide a more detailed myocardial temperature profile. Two models were constructed, each utilizing a different core assumption regarding the electrode-tissue boundary: 1. electrode temperature measured in vitro; 2. interfacial temperature measured in vitro. Intramyocardial temperatures predicted by each model were correlated with corresponding temperatures measured in vitro. RESULTS: I. Ablation during electrode irrigation with normal saline was associated with greater ablation energy deposition and larger lesion dimensions than non-irrigated ablation. The mechanism underlying the larger lesion was delay or inhibition of impedance rise; this was associated with attenuation or prevention of electrode coagulum. Irrigation did not prevent interfacial boiling, which occurred during uninterrupted radiofrequency energy deposition and lesion growth. Irrigation using saline at 100 cc/min was associated with no impedance rise regardless of blood flow velocity, whereas during irrigation at 20 cc/min impedance rise was blood flow rate-dependent. Iced saline produced results equivalent to room temperature saline. Irrigation with dextrose was associated with curtailed energy application and relatively small lesions. II. The finite element simulation that used electrode-endocardial interfacial temperature as the core assumption predicted a myocardial temperature profile which correlated significantly better with in vitro than did the simulation which used electrode temperature as the core assumption. Regardless of irrigant and blood flow rates, maximal myocardial temperature was always within 1 mm of the endocardial surface. CONCLUSIONS: Radiofrequency energy application via a saline irrigated electrode resulted in a larger lesion due to attenuation or eradication of electrode coagulum, thus preventing an impedance rise. Irrigation did not prevent interfacial boiling, but boiling did not prevent lesion growth. The site of maximal myocardial temperature during irrigated ablation was relatively superficial, always within 1 mm of the endocardial surface. Irrigation with iced saline was no more effective than with room temperature saline; both were far more effective than dextrose. Higher irrigation rates immunized the electrode from the influence of blood flow. The biophysical effects of blood flow and irrigation were similar.

Animals↗
PubMed2001

Effectiveness of oxidative potential water as a root canal irrigant.

AIM: The aim of this study was to evaluate the effectiveness of oxidative potential water (OPW) as an irrigant, based on its ability to remove the smear layer and/or debris from instrumented root canals. METHODOLOGY: One hundred and twenty root canals from extracted human maxillary incisors were instrumented using a conventional step-back technique with irrigation from sodium hypochlorite (NaOCl) or oxidative potential water (OPW). After instrumentation, the canals were irrigated by syringe or ultrasound using 15% EDTA or OPW as an irrigant. The volume of each irrigant used for syringe irrigation was 10, 20, and 30 mL, respectively, whilst the duration for ultrasonic irrigation was 1, 3, and 5 min, respectively. After irrigation, each root was split longitudinally in two with cutting pliers, and the specimens were prepared for SEM observation. The presence of debris and smear layer on each canal wall was assessed using a three-point scale for each parameter. RESULTS: Smear layer was effectively removed with EDTA both introduced via syringe and via ultrasonic irrigation. A similar effect was observed with OPW via syringe irrigation following instrumentation with 5% NaOCl. The canal walls in any of these cases showed open and patent dentinal tubules following smear layer removal. Some specimens irrigated with EDTA exhibited the effect of demineralization on the dentine resulting in funnelling of tubule orifices. Syringe irrigation was more effective in smear layer removal, except for ultrasonic irrigation with 15% EDTA, whilst ultrasonic irrigation was more effective in debris removal including the use of OPW as irrigant following instrumentation with 5% NaOCl. Neither syringe nor ultrasonic irrigation with OPW following instrumentation with OPW removed smear layer or debris effectively. CONCLUSIONS: The most effective irrigation technique for smear removal was 15% EDTA irrigation by means of syringe following instrumentation with 5% NaOCl solution. However, the most effective irrigation technique for debris removal was ultrasonic irrigation regardless of irrigant used. OPW irrigation by means of syringe following instrumentation with 5% NaOCl showed a similar effect to that of 15% EDTA irrigation for removal of smear layer and debris.

Anti-Infective Agents, Local↗
PubMed1996

The use of ethanol as a marker to detect and quantify the absorption of irrigation fluid during transurethral resection of the prostate.

During transurethral resection of the prostate (TURP), the irrigation fluid is often absorbed by the circulatory system and/or the region around prostate occasionally resulting in severe signs and symptoms. Instant detection and qualification of absorption of irrigation fluid have not been possible earlier. A method involving tagging of the irrigation fluid with ethanol for detection and quantification of absorbed irrigation fluid by measurement of ethanol in expired breath (EB) has been developed. The validity of measuring EB ethanol to detect and quantify absorption of irrigation fluid was studied in 13 patients undergoing TURP. The EB ethanol was compared with three other methods: I. Isotope tagging of the irrigation fluid and detection of absorbed fluid using a scintillation detector placed over large blood vessels. 2. Measuring changes in serum-sodium every 10 min. 3. Regular interval monitoring (RIM) of the difference between volume used for irrigation and volume recovered from patients every 10 min. The method of measuring EB ethanol was found to be highly valid. The possibility of detecting absorption and the incidence of absorption using EB ethanol in the clinical routine was studied in 192 patients undergoing TURP. Half of them absorbed irrigation fluid, 25% absorbed more than 400 ml. The proportion of patients absorbing irrigation fluid was the same for both experienced and inexperienced resectionists. Clinical assessment of absorption of irrigation fluid was performed by the resectionists and the supervising nurses in 118 patients undergoing TURP. Prerequisites for massive absorption were found by the resectionist in 8/9 patients. The resectionist falsely indicated absorption in 22 patients. The nurses correctly indicated 3/9 patients and falsely indicated 4 patients. To investigate the method measuring EB ethanol to detect absorption of irrigation fluid during general anaesthesia, 20 patients underwent TURP and EB ethanol was compared with the RIM method. There was a good correlation between the methods. Elevated pressure in the bladder and the prostatic fossa is a prerequisite for absorption of irrigation fluid. Detection and quantification of absorbed irrigation fluid by EB ethanol was used for comparing 102 patients operated on with and without a pressure warning device alarming at 1.5 kPa in the bladder. using the device reduced both the volume of absorbed irrigation fluid, and the number of patients absorbing irrigation fluid. Both ethanol per se and haemodilution by absorbed irrigation fluid may have impacts on the coagulation system. To investigate the influence of absorption of ethanol tagged mannitol on bleeding time, measurements were performed before and after TURP in 57 patients. No difference in bleeding time was found among patients who absorbed irrigation fluid as compared with those who did not. In conclusion, measurement of ethanol in EB for detection and quantification of absorbed irrigation fluid is a highly valid method when compared with three other methods. Absorption of irrigation fluid was found in 50% of the patients undergoing TURP. Clinical assessments of absorption of irrigation fluid are unreliable. EB ethanol can be used in patients during general anaesthesia. Using a pressure warning device decreases the volume of absorbed irrigation fluid, as well as the number of patients absorbing it. Absorption of ethanol tagged mannitol as irrigation fluid has no influence on bleeding time.

Absorption↗
PubMed2000

Effect of irrigation on the efficacy of insecticides for controlling two species of mole crickets (Orthoptera: Gryllotalpidae) on golf courses.

Effects of irrigation regimen, quantity, and timing on the efficacy of three insecticides for controlling nymphs of the southern mole cricket, Scapteriscus borellii Giglio-Tos, and the tawny mole cricket, Scapteriscus vicinus Scudder, were studied on golf courses in 1997, 1998, and 1999. Two irrigation regimen tests using two rates of bifenthrin and lambda-cyhalothrin produced inconclusive results. Mole cricket damage ratings after the applications of bifenthrin (60 g [AI]/ha) and lambda-cyhalothrin (76 g [AI]/ha) were not significantly different among the four irrigation regimens (non-irrigation, irrigation before treatment, irrigation after treatment, and irrigation before and after treatment). Mole cricket damage rating after the application of bifenthrin (120 g [AI]/ha) under irrigation before and after irrigation was significantly better than those under other irrigation regimens at 14 and 21 d after treatment (DAT). Different irrigation quantity and irrigation timing (after insecticide treatment) did not significantly affect the performance of imidacloprid (434 g [AI]/ha) in the 1998 tests. However, the results from the 1999 test indicated that mole cricket damage ratings from the imidacloprid-treated plots were significantly different between 2 and 0.5 cm irrigation water after treatment at 21 and 28 DAT. Application of bifenthrin at a rate of 120 g (AI)/ha with 0.5 cm of irrigation water after treatment resulted in significantly lower mole cricket damage ratings than those of 1.0 and 2.0 cm of irrigation water after treatment at 30 DAT only in the 1998 test. Bifenthrin with irrigation at 1 h after insecticide treatment provided better mole cricket control than that of irrigation at 5 min after treatment at 30 DAT only in the 1998 test. Mole cricket damage ratings after application of bifenthrin were not significantly different between either irrigation quantity treatment or irrigation timing treatment in the 1999 tests. Possible effects of application timing, environmental conditions, irrigation practice, and insecticide physical properties on the results are discussed.

Agriculture↗
PubMed2001

Comparison of irrigated electrode designs for radiofrequency ablation of myocardium.

BACKGROUND: Previous reports have demonstrated that radiofrequency energy delivered to myocardium via an irrigated electrode results in a more voluminous ablation lesion than a non-irrigated electrode. Different irrigated electrode designs have been utilized; no direct comparisons have been reported. PURPOSE: To compare different irrigated electrode designs. METHODS: Three irrigation electrode designs were compared to a control (non-irrigated electrode) group: 1. internal; 2. showerhead; 3. sheath. For each electrode, prior to ablation Doppler echocardiographic assessment of the irrigant flow along the electrode outer surface was performed. Ablation was performed in vitro utilizing a whole blood-superfused system. Electrode, electrode-endocardial interface, and intramyocardial temperatures were assessed, as were ablation circuit impedance, total delivered energy, and lesion and electrode morphology. Room temperature normal saline was utilized as the irrigating fluid, delivered at 20 cc/min. Electrode-endocardial interfacial blood flow was assessed at rates of 0 and 0.26 m/s. RESULTS: Irrigant was contained within the internal electrode design and therefore the electrode outer surface manifested no significant flow during irrigation. Irrigant spread primarily radially away from the showerhead electrode design, yielding relatively high electrode outer surface flow at the irrigation holes, but low elsewhere. Irrigant traveled in parallel to and enveloped the electrode outer surface of the sheath electrode design, yielding relatively moderate but uniform flow. Ablation via each of the irrigated electrodes yielded greater ablation energy deposition and larger lesion dimensions than the non-irrigated electrode. Irrigation did not necessarily prevent interfacial boiling, which could occur during uninterrupted radiofrequency energy deposition and lesion growth. The results for the 3 irrigation designs were incongruent. The duration of radiofrequency energy application via the internal electrode design was significantly shorter than the other designs, curtailed by impedance rise. This yielded the smallest total radiofrequency energy deposition and smallest ablation lesion volume. Relative to this, duration using the showerhead design was significantly longer, associated with greater total energy deposition and larger lesion volume. The sheath design permitted the longest duration, associated with the largest total energy deposition and lesion volume. CONCLUSIONS: Although each of the irrigated electrode designs yielded larger lesions than the non-irrigated electrode, they were not comparable. Ablation duration and lesion size were directly correlated with flow along the electrode outer surface.

Animals↗
PubMed2007

Dynamic recording of irrigating fluid distribution in root canals using thermal image analysis.

AIM: To investigate the influence of the size and the depth of insertion of irrigating needles, and the diameter of the master apical file on flow distribution during fluid irrigation in root canals. METHODOLOGY: Stepback canal instrumentation was employed on seven extracted human single canal teeth. The size of the master apical files ranged from sizes 25, 30, 35, 40, 45, 50 to size 80 within the seven teeth, respectively. A thermal imaging system (ThermaCAM; National Instruments Co., Austin, TX, USA) was used to record the dynamic fluid distribution following root canal preparation. The dynamic fluid distribution was analysed during irrigation by insertion of different irrigating needle tips (23, 25 and 27 gauge) at various depths (3, 6 and 9 mm) from the root apex. The whole process of irrigation was recorded by a video camera and analysed by two observers separately. The success of the irrigation process was defined when the irrigant was able to flow into to the apical region immediately after injection. RESULTS: The aqueous irrigant was flushed into the apical region when a size 27 gauge irrigating needle was placed into a size 30 canal at a point 3 mm from the apical stop. When the same needle tip was placed 6 mm from the root canal apex, successful irrigation was achieved only in the canals prepared to size 50 or larger. When a size 25 gauge irrigating needle was placed 3 mm from the working length, the canal size had to be no <45 to allow for successful irrigation. When a size 23 gauge needle was placed at the same position, the canal needed to be prepared to size 50 to allow thorough irrigation of the apex. At 9 mm from the apical stop, none of the irrigating needles could achieve successful irrigation of any canal size. CONCLUSION: The flow distribution of root canal irrigation can be affected adversely by large diameter irrigating needles, by greater distances between the needle tip and the apical stop, and by narrow root canals.

Dental Pulp Cavity↗
PubMed2006

Inhibition of post-meningitic cochlear injury with cerebrospinal fluid irrigation.

OBJECTIVE: Labyrinthitis ossificans, the pathologic ossification of the otic capsule associated with profound deafness and loss of vestibular function occurs frequently as a sequella of bacterial meningitis and subsequent purulent labyrinthitis. Experimentally, in Streptococcus pneumoniae meningitis, it has been shown that a vigorous inflammatory response to teichoic acids in the bacterial cell wall contributes to cochlear damage and subsequent fibrosis and ossification. The hypothesis of this study is that a dilution of concentration of inflammatory mediators through cerebrospinal fluid (CSF) irrigation will lead to a reduction in both inner ear pathology and permanent hearing loss. STUDY DESIGN AND SETTING: Auditory brainstem response testing was used to determine baseline hearing thresholds in 20 Mongolian gerbils (12 irrigated, 8 sham irrigated animals) at 32 kHz, 16 kHz, 8 kHz, and 4 kHz frequencies. Their thresholds at 14 days and 120 days post-procedure were also obtained. Streptococcus pneumoniae meningitis was induced in both groups of animals by intrathecal (i.t.) injection of bacteria. Both groups received penicillin treatment. Forty-eight hours after inoculation, both groups were implanted with i.t. inflow and outflow catheters. The irrigated group was infused continuously with artificial CSF over 36 hr at a rate of 70 muL/hr and the outflow sampled. The tubing in the sham irrigated group was clamped (without sampling). They were sacrificed at 120 days post-procedure and histomorphometric analysis carried out. The concentration of interleukin 1beta (IL-1beta) for the CSF samples from the irrigated group were compared to samples collected from an additional control group of 8 non-irrigated meningitic gerbils. IL-1beta was chosen to study because it is a potent pro-inflammatory cytokines in bacterial meningitis that is unaffected by the neurosurgical trauma of the experimental protocol. RESULTS: Twenty animals survived the meningitis (6 irrigation, 6 sham irrigation, 8 non-irrigation meningitic controls). At Days 14 and 120 post-infection, the irrigated animals manifested significantly less hearing loss with a mean loss of 28.82 dB compared to the sham irrigation group mean loss of 40.76 dB (P < 0.03). The degree of hearing loss in both groups was frequency-dependent with greater loss at higher frequencies (mean loss = 22.4 dB at 32 kHz, 23.0 dB at 16 kHz, 18.6 dB at 8 kHz, and 12.5 dB at 4 kHz). Histomorphometric analysis demonstrated a marked reduction in degeneration of the spiral ligament, spiral ganglion cells, and stria vascularis in experimental animals as compared to controls. Immunohistochemistry showed a significant reduction in IL-beta1 concentrations in the irrigated animals compared to the non-irrigated, infected controls (P < 0.03). CONCLUSIONS: Irrigation of CSF resulted in a significant reduction in post-meningitic cochlear injury when compared to controls. This model for continuous cerebrospinal fluid irrigation provides a means to evaluate the effects of a dilution of inflammatory mediators on hearing loss and labyrinthitis ossificans after bacterial meningitis. SIGNIFICANCE: Despite advances in the prevention of meningitis and improved antibiotic treatment, bacterial meningitis continues to have significant associated morbidity. This study provides insight into some of the mechanisms responsible for post-meningitic hearing loss and labyrinthitis ossificans and presents a novel approach to reduce these complications.

Animals↗
PubMed2005

Colostomy irrigation: results of 25 cases with particular reference to quality of life.

AIMS AND OBJECTIVES: The aim of this study was to document our results with colostomy irrigation with particular emphasis on the possible contribution of irrigation on quality of life. BACKGROUND: Colostomy irrigation is a useful method of achieving faecal continence in selected conditions, and may improve quality of life. When successful, irrigation offers a regular, predictable elimination pattern and only a small covering is needed for security between irrigations. METHODS: The digestive disease quality of life questionnaire-15 (DDQ-15) and Short Form-36 were used to analyse quality of life before and 12 months after stomatherapy in a series of 25 irrigating patients with permanent end colostomies. During the same time period, 10 similar patients with left-end colostomies who also received counselling but did not consent to colostomy irrigation were also analysed for comparison. RESULTS: Colostomy irrigation was found to be effective for achieving faecal continence in selected patients with end colostomies with no complications or significant side-effects, The digestive disease quality of life questionnaire-15 score improved significantly in both groups after stomatherapy (P < 0.0001 and P = 0.009 in the irrigating and non-irrigating groups respectively). The poststomatherapy digestive disease quality of life questionnaire-15 score of the irrigating group was also significantly higher than that of the non-irrigating group (P = 0.039). Although none of the poststomatherapy item scales of Short Form-36 differed significantly between the two groups, stomatherapy with CI resulted in significant improvements in role limitation due to physical problems, social functioning, role limitation due to emotional problems, general mental health, vitality and bodily pain (P < 0.05 for all comparisons). On the contrary, the non-irrigating patient group showed significant improvements only in social functioning and general mental health. CONCLUSION: Our findings suggest that colostomy irrigation can be a useful method of achieving faecal continence in selected conditions, it is safe, and it may help improve many aspects of quality of life. RELEVANCE TO CLINICAL PRACTICE: Colostomy irrigation is free from complications and significant side-effects, and it may serve as a useful adjunct to conventional stomatherapy. Therefore, the enterostomal therapy nurse should assess the appropriateness of routine irrigation as a method of stoma management for patients with left-end colostomy.

Activities of Daily Living↗