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PubMed1999

Suction posterior capsulorhexis.

A technique for creating a posterior capsulorhexis during phacoemulsification is presented. It can be used in cases with posterior capsule tears or opacities. The free edge of the capsule is grasped with suction using a 2 mL syringe and a 27 gauge Rycroft cannula introduced via the paracentesis. The edge is then manipulated to produce a continuous curvilinear opening in the posterior capsule. The combination of a closed eye plus the use of a viscoelastic agent in the anterior chamber and capsular bag minimizes the possibility of vitreous prolapse during the maneuver. Occlusion of the cannula tip by the posterior capsule reduces the risk of vitreous aspiration. In-the-bag intraocular lens implantation is readily achieved.

Capsulorhexis↗
PubMed1991

The effect of repeated endotracheal suctioning on arterial blood pressure.

The purpose of this study was to examine the effects of three lung hyperinflation/suction sequences on mean arterial pressure (MAP). The results indicate both lung hyperinflation (LHS) and suction sequences (SS) significantly increased MAP (p = .05) from baseline. There was a mean increase in MAP of 13.72 mm Hg over the three lung hyperinflation/suction sequences. The results showed a significant increase in MAP from baseline between SS1 to LHS2 (3.62 mm Hg), from LHS2 to SS2 (4.36 mm Hg), and from LHS3 to SS3 (2.84 mm Hg) at p = .05. The increase in MAP was cumulative with each successive lung hyperinflation/suction sequence. Consequently, the number of repeated lung hyperinflation/suction episodes should be limited to only those necessary to maintain airway patency.

Adult↗
PubMed1997

Effect of endotracheal suctioning on the intracerebral haemodynamics of patients in fulminant hepatic failure.

Fulminant hepatic failure is a severe impairment of liver function in someone who has had previously normal liver function. The patients presenting to intensive therapy units have generally had a rapid deterioration which requires prompt intervention and treatment. The first part of this paper gives a detailed review of the aetiology, physiology and management of the disease process. Medical and nursing care of these patients is critical; any adverse intervention may affect outcome. A literature review and small study of the intervention of endotracheal suctioning and its effects on intracranial pressure and cerebral perfusion pressure is described.

Acute Disease↗
PubMed1998

Endotracheal suctioning: a literature review.

Endotracheal suctioning (ETS) is a necessary practice carried out in intensive care units. In involves the removal of pulmonary secretions from a patient with an artificial airway in place. All intensive care nurses should be aware when performing this intervention of the potential hazards a patient is exposed to, and should endeavour to prevent or minimize these. This literature review explores the criteria available to indicate a need for ETS and discusses the potential adverse effects of ETS and how these can be avoided during the procedure. The question is raised as to the frequency with which the procedure should be performed. The current dilemma facing nurses is the overwhelming view that ETS should be performed only when indicated as necessary by assessment, to minimize the exposure of the patient to the hazards of ETS, but also recognition that ETS is a necessary procedure to maintain a patent airway and clear secretions. As nurses are accountable for all aspects of their practice, they need to be able to make an informed choice about the frequency with which ETS is performed. It is hoped that this review will increase nurses' awareness of the potential hazards surrounding ETS, and enable them to question their practices regarding their ability to assess individual patient needs and determine the frequency with which ETS should be performed.

Critical Care↗
PubMed2003

Suction technique to improve cement penetration under the tibial component in total knee arthroplasty.

Improving the longevity and reliability of cemented total knee arthroplasty remains an important part of orthopaedic research. This paper examines the recently described method of preparation of the cancellous surface of the tibia using suction cannulae in the proximal tibia and stem recess during pulsatile lavage and component fixation. The technique provides a surface clear of debris, fat, blood and marrow, and prevents backflow of blood. A retrospective analysis of post-operative radiographs shows significant improvement in the penetration of cement into the tibial plateau, and improved cement profile towards the periphery. Techniques of stem cementation are also compared, and it is recommended that for this particular design implant, cement should be applied into the cut stem recess in the tibia rather than to the stem of the implant itself. This technique of preparation of the cut surface of the tibia is a simple and, to-date, complication-free method of reliably providing satisfactory cement penetration during total knee arthroplasty.

Aged↗
PubMed2002

Vacuum-assisted suction drainage versus conventional treatment in the management of poststernotomy osteomyelitis.

OBJECTIVE: The purpose of our study was to compare vacuum-assisted suction drainage (VASD) to conventional wound management, in the treatment of poststernotomy osteomyelitis (SOM). METHODS: We included a total of 42 patients that developed poststernotomy osteomyelitis and required open wound management, between 1998 and 2000, in this study. Twenty of these patients were treated by VASD and the other 22 by conventional wound management. The patients were well comparable with regards to age, presenting postoperative day, infecting organism and risk factors for osteomyelitis. This was a retrospective study. RESULTS: The patients treated by VASD had a significantly reduced treatment duration (mean 17.2+/-5.8 vs. 22.9+/-10.8 days, P=0.009) and total hospital stay (mean 27.2+/-6.5 vs. 33.0+/-11.0 days, P=0.03). Perioperative mortality was similar, with one early death in each group. CONCLUSION: We conclude from our experience in the treatment of 42 patients with poststernotomy osteomyelitis that VASD shortened wound healing and hospital stay and thus proved to be an excellent alternative to conventional open management of these wounds.

Aged↗
PubMed2003

The closed tracheal suction catheter: 24 hour or 48 hour change?

Closed suction catheters (CSC) for removal of bronchial secretions in intubated patients have been used in intensive care units (ICU) for many years. Manufacturers still recommend daily changes of the catheter in order to reduce the incidence of ventilator associated pneumonia (VAP). There is, however, a lack of clinical evidence to support this recommendation. The objective of this study was therefore to compare the incidence of VAP in patients who receive either 24 hourly or 48 hourly changes of the CSC. Eligible patients were randomised to one of the two groups to receive either a 24 hourly change (n = 53) or a 48 hourly change (n = 48) of the CSC. Sputum specimens were sent second daily for quantitative culture. Chest x-rays (CXR) and white blood cell counts were attended daily. A VAP was diagnosed according to previously established criteria. A second set of modified criteria were also used to conduct a further analysis of the results. Of the 158 patients randomised, 101 completed the study. These patients had a mean age of 65 years and a mean APACHE II score of 28.2 in the first 24 hours of the study. The average duration in the trial was 10 days. The two groups were comparable in terms of demographic features. There were no reported cases of VAP in either group using the criteria originally selected in the study design. Using a modified criteria to diagnose VAP there were 10 (19%) patients with VAP in the 24 hour group and 13 (27%) in the 48 hour group. The incidence of VAP between the two groups was not statistically different (p = 0.35). To conclude, there was no difference in the incidence of VAP between the two groups studied. Based on previous studies conducted by Quirke and Kollef and the experience of our study we have changed our clinical practice to a 48 hour change of the CSC. We would, however, suggest further study or a meta-analysis of the available literature before a recommendation is made.

Aged↗
PubMed1996

Prevention of microbial contamination of the dental unit caused by suction into the turbine drive air lines.

OBJECTIVE: To determine whether a specially designed antisuction device can prevent the bacterial contamination of the drive air lines of the dental turbine that is caused by suction when the turbine is stopped. STUDY DESIGN: A dental unit with and without the antisuction device and three different types of sterilized handpieces were used in the tests. Each turbine was operated in air, then submerged into a bacterial suspension of E. coli and enterococci for 3 seconds, removed, and stopped. This procedure was repeated 10 times. Possible bacterial contamination of the drive air lines was examined by submersing the head of a sterilized handpiece with the turbine running into a nutrient broth for 30 seconds. The broth was incubated at 35 degrees C up to 2 days. RESULTS: After use of the conventional dental unit, bacterial growth of drive air lines was found in 10 of 150 broth samples. After the installation of the antisuction device no bacterial growth was found in any of the 138 samples. The difference in the contamination frequencies is statistically significant (p = 0.011, Fisher's two-sided exact test). CONCLUSIONS: The drive air lines of the turbine in the dental unit may become contaminated despite the sterilization of handpieces. The antisuction device installed into the dental unit was found to prevent the contamination. With the exception of possibly immunocompromised patients, the transmission of microbes by exhaust air may be too small to cause infections. However, transmission of oral material between patients should be prevented in dental practice.

Air↗
PubMed1980

Suction tube noise and myringotomy.

The possibility of a noice-induced hearing loss occurring as a result of a high level of sucker-tip noise in myringotomy for seromucinous otitis media is discussed. A group of twenty-four ears is investigated and the noise levels generated by the suction tube are measured at operation by means of a probe microphone lowered into the external auditory meatus. The conclusions reached are that, although the sound levels attained are at times quite high, they are not of sufficient amplitude, nor are they present for a sufficient length of time, to produce a sensori-neural hearing loss.

Child↗
PubMed2005

The ProSeal laryngeal mask airway and the laryngeal tube Suction for ventilation in gynaecological patients undergoing laparoscopic surgery.

BACKGROUND AND OBJECTIVE: ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum. METHODS: Fifty patients undergoing elective gynaecological laparoscopic surgery were randomized to two groups of 25 each. After induction of general anaesthesia, devices were inserted, correct placement was verified, airway leak pressure was measured, and a gastric tube was inserted. Ease of insertion, quality of airway seal, risk of gastric insufflation and patient comfort were investigated. RESULTS: There were no differences in patient characteristics data for both groups. First-time insertion success rates were comparable for both groups: 92%--first attempt, 8%--second attempt for PLMA and LTS. Time until delivery of the first tidal volume for PLMA and LTS was 23.2 +/- 6.1 and 23.5 +/- 6.6s, airway leak pressure was 45.4 +/- 4.9 cmH2O and 45.6 +/- 6.7 cmH2O with cuff pressures adjusted to 60 cmH2O. No gastric insufflation, gas loss or signs of regurgitation were detected. Placement of a gastric tube was successful in all patients. Patients were questioned for sore throat and dysphagia after removal of devices. Sore throat was stated in 1%/0% (PLMA) and 8%/4% (LTS) after 6/24 h, dysphagia in 4%/4% (PLMA) and 12%/4% (LTS). CONCLUSIONS: Both devices provide a secure airway even under conditions of elevated intra-abdominal pressure. In this pilot study, no differences concerning handling or quality of airway seal were detected between PLMA and LTS.

Adult↗
PubMed1999

Normal saline instillation with endotracheal suctioning: primum non nocere (first do no harm).

Normal saline instillation, in conjunction with endotracheal suctioning, is purported to be beneficial in removing thick and tenacious secretions for patients receiving mechanical ventilation. Guidelines for this routine procedure are inconsistent and its efficacy is unsupported by research-based evidence. This discussion paper highlights that the procedure produces no physiological benefits for the patient and, indeed, may have detrimental effects on the patient's psychological wellbeing. It is proposed that after 25 years of inconsistent practice in trying to remove thick and tenacious secretions, it is time to focus on techniques to prevent thick and tenacious secretions.

Humans↗
PubMed2000

Suction blister grafting for stable vitiligo using pulsed erbium:YAG laser ablation for recipient site.

BACKGROUND: Suction blister grafting was performed via a modified simple technique using a 20-mL syringe to create the donor graft and pulsed erbium:YAG laser ablation of the recipient site. METHODS: Two patients with stable vitiligo and one with postinflammatory depigmentation were studied. RESULTS: The grafts took well in all three patients and pigmentation was retained at 20 weeks. No complications occurred. CONCLUSIONS: The erbium:YAG laser is an ideal tool for creating graft recipient sites, given its precision in terms of width and depth of ablation. A 20-mL syringe can be used to create a blister of adequate size.

Adult↗
PubMed2004

Peritoneal needle suction for intestinal perforation in the preterm neonate.

UNLABELLED: A few years ago, most intestinal perforations in the premature newborn appeared within the clinical context of necrotising enterocolitis (NEC). Since then, we have observed an increase in the number of isolated perforations appearing outside typical NEC. The fact that the perforations are more often isolated, and the healing capabilities of the premature intestine, led us to propose peritoneal needle suction (PNS) alone as first treatment for intestinal perforations in the premature neonate. MATERIALS AND METHOD: The charts of 6 consecutive premature infants presenting with intestinal perforations treated initially by PNS alone were reviewed. RESULTS: The patients' median birth weight was 1030 g, with a median gestational age of 27 weeks. In 5 out of 6 infants (83 %), PNS achieved complete exsufflation without recurrence of the pneumoperitoneum and complete intestinal healing, allowing complete enteral feeding 30 to 71 days after perforation. One infant with recurrent pneumoperitoneum after 3 PNS and peritoneal drainage was operated. All infants survived. CONCLUSION: We believe that for early perforations of the premature neonate, the poor diffusion of the infection and the frequent capacity of the perforation to close and subsequently heal without scars, favour a minimally invasive management using PNS.

Humans↗
PubMed2004

Subcutaneous emphysema of the hand caused by the suction drain -- a case report.

Subcutaneous emphysema of the hand can be related to non-infectious causes and most commonly high-pressure injection injuries. Surgical emphysema of the hand is rare. We report a case of surgical emphysema of the dorsum of the hand following the excision of a dorsal wrist ganglion when the inserted suction drain did not work properly, accompanied by the inadvertent compression of the patient's body. Conservative management was adequate; oedema and emphysema subsided in several days.

Adult↗
PubMed1984

Pneumothorax due to endotracheal tube suction.

Traumatic pneumothoraces in ventilated premature infants are mostly related to high applied airway pressures. We report five cases of pneumothorax after endotracheal tube suctioning that illustrate two different mechanisms by which this may occur. Following suggested preventive measures, such complications have not recurred.

Female↗