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Results for “INTUBATION, GASTROINTESTINAL”

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At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Methods to test feeding tube placement in children.

PURPOSE: This replication study examined the extent to which feeding-tube aspirates (pH and enzyme content) are effective predictors of feeding tube location in acutely ill children. STUDY DESIGN AND METHODS: A convenience sample of 56 children was obtained at a metropolitan children's hospital. Approximately 2.5 ml of fluid were withdrawn from children's nasogastric, orogastric, or nasointestinal tubes within 30 minutes of radiographic examination. Fluid was tested for pH and enzymes, and results were compared with radiographic results of tube location. RESULTS: Mean gastric pH was significantly lower than mean intestinal pH. Mean fasting gastric pepsin level was significantly higher than mean fasting intestinal pepsin level. Usual intestinal constituent, trypsin, was significantly higher in the small bowel than in the stomach. Mean fasting trypsin level was 70 microg/ml in the intestine, and only 10 microg/ml in the gastric site. Predictive positive value was >90% for all tests; predictive negative value was < 65%. Colors of the gastric aspirates were distinctly different from those observed in intestinal aspirates. CLINICAL IMPLICATIONS: Methods of aspirating fluid from feeding tubes and testing visually or assaying for aspirate characteristics were found to be adaptable from adults to children. The clinical implications of being able to use a test as simple as pH of feeding aspirates means that nurses can easily test these aspirates in any clinical setting using reliable pH test strips, similar to what was done in this study. These data add evidence that suggests indicators of tube location effective in adults are also effective in children.

Adolescent↗
PubMed1993

Cholinergic regulation of phase II interdigestive pancreatic secretion in humans.

Small fluctuations in cholinergic input may be involved in the regulation of human interdigestive pancreatic secretion. To determine the effects of small changes in cholinergic tone on phase II interdigestive trypsin secretion, we gave cholinergic agonists or antagonists to 17 healthy fasting subjects who underwent gastrointestinal intubation. Duodenal trypsin outputs, gastroduodenal motility, and plasma levels of pancreatic polypeptide (PP) as a marker of cholinergic tone were measured during intravenous infusion of bethanechol (0, 5, or 40 micrograms.kg-1.h-1) or atropine (0, 4, or 16 micrograms.kg-1.h-1) given during phase II alone or in combination based on a 3 x 3 factorial design. Data were evaluated by a response surface analysis of the average log values for the test period (using the average of log values of the control period as a covariate). Bethanechol increased trypsin output (p < 0.05) and plasma concentrations of PP (p < 0.05) within the ranges of spontaneous fluctuations of trypsin output and PP during phase II, but did not disrupt the periodicity of pancreatic secretion or the characteristic cyclical pattern of interdigestive motility and induction of phase III activity. Atropine markedly decreased trypsin output (p < 0.05) and plasma concentrations of PP (p < 0.05) and abolished the cycling of interdigestive pancreatic secretion and motor activity. These data suggest the hypothesis that cholinergic pathways participate in the control of interdigestive pancreatic secretion during phase II, while enzyme secretion during phase III may be regulated by other mechanisms.

Acetylcholine↗
PubMed1998

Neonatal pharyngeal pseudodiverticulum mimicking esophageal atresia.

Pseudodiverticulum of the hypopharynx is an infrequent but potentially serious complication of orogastric or nasogastric tube insertion and endotracheal intubation. We report two cases of injury to the hypopharynx resulting in a pseudodiverticulum of the hypopharynx that was initially diagnosed as esophageal atresia. Both cases were managed successfully by conservative therapy. We also review the literature regarding neonatal pharyngeal pseudodiverticulum.

Diagnosis, Differential↗
PubMed2003

Capnography application in acute and critical care.

The use of capnography has expanded over recent years. Currently, capnography is used in a variety of acute care settings. This article describes what capnography is and how it is used. The normal and abnormal capnogram or waveforms are described to assist in identifying various clinical situations. The multiplicity of clinical indications include detection of pulmonary embolism as well as malpositioned endotracheal/tracheal, gastric, and small bowel tubes. Capnography also provides clinicians with information regarding expiratory breathing patterns and assists in perfusion assessments such as those for cardiopulmonary resuscitation. Finally, case studies are provided to help the reader apply the concepts of capnography to a variety of acute care settings.

Acute Disease↗
PubMed1989

Safe suctioning.

Explore the source record for details and available documents.

Humans↗
PubMed2003

Activated charcoal laryngitis in an intubated patient.

UNLABELLED: Activated charcoal is useful in the management of poisonings, but it is not harmless. We report the case of a patient who developed obstructive laryngitis secondary to aspiration of activated charcoal with a protected airway. CASE: A 2-year-old girl presented acute mental alteration secondary to presumed poisoning. Mechanical ventilation was initiated, and a single dose of activated charcoal was administered. She had an episode of vomiting during the respiratory weaning. Black-tinted tracheal secretions were suctioned through the tube immediately. Pulmonary auscultation and radiologic examination were normal. When she was extubed, she developed obstructive laryngitis. Fiberbronchoscopy was performed and showed edema and a significant amount of charcoal particles on the epiglottis, arytenoids, and arytenoepiglottic folds. Charcoal particles were removed by bronchoscopy successfully. Later evolution was normal, and no symptoms were present when she was discharged at home. COMMENTS: Obstructive laryngitis is a new major complication of activated charcoals use in upper airway. It is remarkable that this complication occurred in a protected airway. Charcoal is not an innocuous agent. This case shows that nasogastric administration of activated charcoals presents a significant degree of risk.

Charcoal↗
PubMed2004

Acute airway obstruction in an infant with Pierre Robin syndrome after palatoplasty.

This report describes a complication of post-operative oedema of the palate, tongue and pharynx after a Perko-revised cleft palate repair, which resulted in a life-threatening airway obstruction in an infant with Pierre Robin syndrome. Although infants experiencing airway problems after Wardill-Kilner, von Langenbeck and Furlow palatoplasty have been described, airway complications in a group of Perko-revised repair children have not been previously reported. We speculate that this complication, which occurred in the absence of a history of previous airway problems, is due to prolonged operating time and excessive pressure exerted on the base of the tongue by the Kilner-Doughty retractor. Acknowledgments of this risk permits to identify those patients prior to surgery so that they can be managed appropriately.

Acute Disease↗