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At least 19 recordsLinked to original sources
PubMed2000

Tissue temperatures and lesion size during irrigated tip catheter radiofrequency ablation: an in vitro comparison of temperature-controlled irrigated tip ablation, power-controlled irrigated tip ablation, and standard temperature-controlled ablation.

The limited success rate of radiofrequency catheter ablation in patients with ventricular tachycardias related to structural heart disease may be increased by enlarging the lesion size. Irrigated tip catheter ablation is a new method for enlarging the size of the lesion. It was introduced in the power-controlled mode with high power and high infusion rate, and is associated with an increased risk of crater formation, which is related to high tissue temperatures. The present study explored the tissue temperatures during temperature-controlled irrigated tip ablation, comparing it with standard temperature-controlled ablation and power-controlled irrigated tip ablation. In vitro strips of porcine left ventricular myocardium were ablated. Temperature-controlled irrigated tip ablation at target temperatures 60 degrees C, 70 degrees C, and 80 degrees C with infusion of 1 mL saline/min were compared with standard temperature-controlled ablation at 70 degrees C and power-controlled irrigated tip ablation at 40 W, and infusion of 20 mL/min. Lesion size and tissue temperatures were significantly higher during all modes of irrigated tip ablation compared with standard temperature-controlled ablation (P < 0.05). Lesion volume correlated positively with tissue temperature (r = 0.87). The maximum recorded tissue temperature was always 1 mm from the ablation electrode and was 67 +/- 4 degrees C for standard ablation and 93 +/- 6 degrees C, 99 +/- 6 degrees C, and 115 +/- 13 degrees C for temperature-controlled irrigated tip ablation at 60 degrees C, 70 degrees C, and 80 degrees C, respectively, and 112 +/- 12 degrees C for power-controlled irrigated tip ablation, which for irrigated tip ablation was significantly higher than tip temperature (P < 0.0001). Crater formation only occurred at tissue temperatures > 100 degrees C. We conclude that irrigated tip catheter ablation increases lesion size and tissue temperatures compared with standard ablation in the temperature-controlled mode at the same or higher target temperatures and in the power-controlled mode. Furthermore, tissue temperature and delivered power are the best indicators of lesion volume during temperature-controlled ablation.

Animals↗
PubMed2001

Linear ablation using an irrigated electrode electrophysiologic and histologic lesion evolution comparison with ablation utilizing a non-irrigated electrode.

OBJECTIVES: To characterize the electrophysiologic and histologic sequelae of linear atrial ablation utilizing an irrigated electrode. To compare "irrigated" lesions with lesions deployed using the same electrode in a non-irrigated mode. BACKGROUND: Previous reports of radiofrequency catheter ablation using an irrigated electrode have emphasized its favorable effect on lesion depth. We hypothesized that electrode irrigation would also benefit linear ablation of smooth atrial myocardium, a relatively superficial target. METHODS: In healthy pigs, lesions were deployed in the right and left atria. Acutely, lesions resulting from ablation using an irrigated electrode, with radiofrequency energy titration guided by electrogram amplitude reduction, were compared to lesions using the same electrode without irrigation, with energy titration guided by electrode thermometry. Irrigated lesions were also assessed serially. RESULTS: Acutely, irrigated lesions formed complete conduction barriers and were uncomplicated. In contrast, non-irrigated lesions formed complete conduction barriers but were frequently complicated, exhibiting endocardial charring, barotrauma, and pericardial damage. The rate and pattern of histologic evolution of irrigated lesions were uniform throughout each lesion; right and left atrial lesions healed similarly. During healing, 90 % of lesions remained complete conduction barriers and 10 % manifested single discrete conduction gaps where viable appearing myocytes bridged the lesion. CONCLUSIONS: Complete, uncomplicated linear lesions could be reliably deployed in either atrium with an irrigated electrode. Not all lesions remained complete barriers to conduction during their histologic evolution. Lesions deployed with the same electrode in a non-irrigated mode were complete but frequently complicated.

Animals↗
PubMed2000

Nurses' knowledge of wound irrigation and pressures generated during simulated wound irrigation.

OBJECTIVE: Our objective was to describe nurses' knowledge of wound irrigation and their ability to produce appropriate irrigation pressures established by the US Agency for Healthcare Research and Quality (AHRQ) during simulated procedures. SUBJECTS AND SETTING: A convenience sample of 28 registered nurses and licensed practical nurses from a university medical center in the Northwest United States comprised the subjects. METHODS: Participants were asked to complete a demographic data sheet and a questionnaire related to wound irrigation and to perform 2 simulated wound irrigations. The questionnaire developed for the study contained 9 questions about general knowledge of wound irrigation and 9 questions about wound irrigation technique. A device to measure the pressures generated by the participants during simulated wound irrigation was developed and calibrated using a transducer calibrated by the National Institute of Science and Technology. RESULTS: Participants' scores were high on items querying general knowledge of wound irrigation but lower on questions relating to irrigation technique. Thirteen participants achieved irrigation pressures within the guidelines established by the AHRQ, 14 fell below the guidelines, and 1 produced pressures exceeding the guidelines. CONCLUSION: The majority of nurses participating in this small study had some difficulty answering questions relating to wound irrigation technique. In addition, performance on simulated irrigation showed that the majority were not able to generate pressures in the recommended range. Nursing professionals and educators should be aware of these knowledge and performance issues and incorporate educational content and experiences in nursing programs designed to aid nurses in improving wound irrigation practice.

Academic Medical Centers↗
PubMed2003

The effects of irrigation fluid volume and irrigation time on fluid electrolyte balance and hemodynamics in percutaneous nephrolithotripsy.

OBJECTIVE: to determine fluid-electrolyte and hemodynamics changes and complications associated with irrigation fluid volume and time in percutaneous nephrolithotripsy in that 0.9% NaCl was used as irrigant. METHODS: Standard anaesthetic procedures were performed to 6 women and 16 men. Mean arterial pressure, heart rate, central venous pressure, Na+, K+, osmolality, haemoglobin, haematocrit were recorded before, during and after irrigation every 10 minutes. Creatinine and blood urea nitrogen were determined before and after irrigation. Moreover, the operation and irrigation times, irrigation fluid volume, total fluid output versus input, blood transfusions and complications were recorded. RESULTS: Mean arterial pressure, heart rate, central venous pressure, Na+, K+, osmolality did not change significantly during and after irrigation and no relationship was observed between those with irrigation volume and time. Creatinine and blood urea nitrogen values during and after irrigation did not change significantly versus those before irrigation. Although no blood transfusion was needed for any case during the procedure, it was necessary for two cases after the procedure. One case with pneumothorax that developed during procedure was treated by inserting a thoracic tube. CONCLUSION: There were no significant changes in fluid-electrolyte balance and hemodynamics related to both irrigation fluid volume and irrigation time when 0.9% NaCl was used in PNL.

Adult↗
PubMed1990

[A scanning electron microscope study comparing the cleansing effect of the irrigating solutions and irrigating systems].

The purpose of this study was to compare the effect of various irrigating solutions and irrigating debris and the smear layer from the walls of instrumented root canals. 20 single-rooted teeth were biomechanically instrumented to size 40 K-file using sterile saline. And then the teeth were divided into 4 groups and 5 teeth in each group. Groups were irrigated as follows: Group 1: Teeth were irrigated with 20 ml of sterile saline. Group 2: Teeth were irrigated with 10 ml of 3% H2O2 and 10 ml of 2.5% NaOCl using the syringe. Group 3: Teeth were irrigated with 10 ml of 3% H2O2 and 10 ml of 2.5% NaOCl using the ENAC. Group 4: Teleth were irrigated with 10 ml of 17% EDTA and 10 ml of 2.5% NaOCl using the Endo-mate. All specimens were viewed at the cervical, middle, and apical thirds of the root canals for evaluation of the cleaning effect with the scanning electron microscope. The results were as follows: 1. The Endo-mate with EDTA and NaOCl solutions was the most efficient in cleaning the cervical and middle thirds of the root canal. 2. There was no difference between the irrigating solutions and irrigating systems in the cleaning effect at the apical third of the root canal.

Edetic Acid↗
PubMed1992

Clinical effectiveness of subgingival irrigation with a pulsated jet irrigator versus syringe.

Previous studies have shown clinical and microbiological improvement with subgingival irrigation particularly after scaling and root planing. In this study we monitored the effects of saline irrigation on non-treated periodontal pockets. Ten subjects with severe periodontal disease and symmetrical lesions on multirooted teeth were selected. They had not received periodontal treatment or antibiotics for the previous 6 months. Patients were given simplified oral hygiene instructions. Neither scaling nor root planing was provided during the study. Two teeth were randomly selected per quadrant for subgingival irrigation with saline solution. One side was treated with a syringe and the other side with a pulsated jet irrigator with a modified tip, professionally administered. Clinical parameters (pocket depth, plaque index, gingival index, crevicular fluid, bleeding index, attachment level, and subgingival microflora) were evaluated on days 0, 15, 30, 60, and 90. Both subgingival irrigation products induced changes (reductions) in these indices during the study. Significant differences (P less than 0.001) with the oral irrigator were found for the following parameters: microscopy, pocket depth, crevicular fluid, and plaque index. In this study, professionally administered saline irrigation with a pulsated jet irrigator was more effective than syringe treatment with the same solution. Neither treatment resulted in a detectable gain in probing attachment level. Since gain in attachment level is achievable by other techniques, neither of these subgingival irrigation procedures alone can be considered adequate for periodontal therapy.

Adult↗
PubMed1989

[Effect of subgingival plaque control by direct irrigation technique--2. Clinical and microbiological changes after irrigation with acrinol or benzalkonium chloride solution].

The aim of the study was to evaluate the effect of the subgingival plaque control by direct irrigation. Twelve adult patients with periodontal pockets of 4 mm or more received an initial treatment. The patients were followed by irrigation using the device called Pocket Irrigator PT-01 with 0.05% acrinol solution or 0.025% benzalkonium chloride solution. The clinical and microbiological parameters were recorded prior to the irrigation and immediately after, at 1 hour, 1 day and 1 week after the irrigation. The Plaque Index, Gingival Index, gingival crevicular fluid and probing depth were used as clinical parameters. Samples of the subgingival plaque were collected with sterilized paper points from the periodontal pockets. The samples were examined by dark field microscopy with the Petroff-Hauser counting chamber with a magnification of 1,500x. The total number of bacteria and the proportion of the motile rods and spirochetes of the pockets were examined. All clinical parameters showed no significant changes after the irrigation. Intracrevicular irrigation by both acrinol and benzalkonium chloride solution significantly reduced the relative number of bacteria and the percentage of spirochetes/motile rods, when compared to those before the irrigation on day 1, though the differences did not persist on day 7. Thus, only by the single irrigation of the deep pockets with acrinol or benzalkonium chloride, the beneficial effects did not appear to continue clinically and microbiologically for a week.

Acridines↗
PubMed1998

Wound infection rate and irrigation pressure of two potential new wound irrigation devices: the port and the cap.

The objectives of this study were to determine the speed of irrigation and the infection rate of two new irrigation devices. In the clinical portion of this two-part study, 208 patients with traumatic wounds were randomized to one of two new irrigation device groups, the cap/bottle or the port/bag, to determine irrigation times and infection/complication rates. Wounds were irrigated in less than 4 minutes in 97% of patients using a mean of 786 mL. The combined infection/complication rates were: port group, 1 of 99 (1%); cap group, 4 of 108 (4%), P = .356. In part II, 9 male and 8 female medical volunteers were timed in the delivery of 250 mL of saline into a graduated cylinder, using four different irrigation set-ups. Mean time for 250 mL and calculated stream pressures (psi) were: (1) cap/bottle, 12.9 seconds, 1.5 psi; (2) port/bag, 11.2 seconds, 2.0 psi; (3) syringe/catheter, 113.2 seconds, 8.2 psi; and (4) syringe/needle, 175.4 seconds, 7.3 psi (time and psi: P < .05 for all pairwise comparisons except cap versus port). Rapid irrigation and infection rates comparable with standard devices used in wound irrigation suggest that the new devices may prove to be valuable tools in emergent wound care.

Adolescent↗
PubMed1992

Comparison of a subgingivally placed cannula oral irrigator tip with a supragingivally placed standard irrigator tip.

This study compared the depth of irrigation of periodontal pockets achieved by a cannula subgingival irrigator tip and a standard oral irrigator tip. They were tested on periodontally involved teeth recommended for extraction from 17 patients. Before extraction, reference grooves were made circumferentially in each study tooth at the level of the gingival margin. In one group of 5 patients (29 teeth), a cannula was inserted halfway into the pocket at the facial, mesiofacial, distofacial, lingual, mesiolingual and distolingual surfaces and the surface irrigated for 5 s at 5 psi with a solution of plaque-staining dye from an oral irrigator. A 2nd group of 7 patients (29 teeth) was tested similarly with a standard irrigating tip at 80 psi. A 3rd (control) group of 5 patients (26 teeth) rinsed with the dye solution. Teeth were then extracted. The distance on each tooth from the reference notch to the apical extent of the stained plaque, and also to the coronal limit of the connective tissue attachment, was measured at 4 sites (mesial, distal, buccal, lingual) under a dissecting microscope to determine the extent of dye penetration. Mean linear penetration for the control group was only 0.1 mm. Irrigation with the cannula tip penetrated farther into both the medium (3.5-6 mm) and the deep (greater than 6 mm) periodontal pockets (p less than 0.01) than did irrigation with the standard tip.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheterization↗
PubMed1992

Irrigation or no irrigation after transurethral prostatectomy?

Urologists remain divided as to the need for routine irrigation following transurethral prostatectomy (TURP). This randomised prospective study compared a policy of irrigation with that of no irrigation in a consecutive group of 200 patients undergoing TURP. In the irrigation group, a mean of 15 litres of irrigating fluid was used in each patient and one-third of patients required at least one bladder washout. In the no irrigation group, although two-thirds of the patients required at least one bladder washout, only one-third required more than one washout. No significant difference in blood loss, electrolyte balance, infection rate or recovery was seen in the 2 groups. This study led to a local change in practice, converting from a policy of routine irrigation to one of no irrigation.

Humans↗
PubMed1985

Antimicrobial irrigation of deep pockets to supplement oral hygiene instruction and root debridement. I. Bi-weekly irrigation.

64 sites with probing pocket depth greater than or equal to 6 mm from 11 patients were treated with plaque control instruction and one episode of root planning. Subsequently, selected sites in each patient were irrigated with either chlorhexidine, tetracycline, saline or served as non-irrigated control sites. Irrigation immediately followed instrumentation, and was repeated every 2 weeks for 24 weeks. Healing was monitored at 8, 16, and 24 weeks clinically and at 7, 15, and 23 weeks with subgingival washings for determination of % as well as total number of spirochetes. The following changes were apparent from comparing pooled site means at 24 weeks with pretreatment data: (1) bleeding sites decreased from 62 of 64 sites initially to 22 of 64 at 24 weeks; (2) spirochetes decreased from 34% to 2%; (3) probing pocket depths decreased from 7.6 to 4.7 mm; (4) probing attachment levels showed a gain of 1.2 mm. The improvement of the chlorhexidine and tetracycline irrigated sites was similar to that of the saline irrigated and non-irrigated control sites. Thus, biweekly chlorhexidine, tetracycline or saline irrigation of deep pockets did not appear to augment the effects of non-surgical periodontal therapy.

Adult↗
PubMed2001

Dispersal of adult European corn borer (Lepidoptera: Crambidae) within and proximal to irrigated and non-irrigated corn.

The European corn borer, Ostrinia nubilalis (Hübner), causes economic damage to corn, Zea mays L., throughout the Corn Belt. Because this insect has become the primary target of Bacillus thuringiensis Berliner (Bt) transgenic corn, current efforts addressing the management of O. nubilalis resistance to Bt corn require information on adult European corn borer dispersal and factors affecting its dispersal. In 1998 we conducted mark-release-recapture, release-recapture, and caged-mating studies to directly measure and compare local dispersal patterns of O. nubilalis adults within and proximal to irrigated and non-irrigated cornfields. Releases of marked adults were made corresponding to the first and second flight of O. nubilalis in eastern Nebraska. Adult dispersal was significantly different between irrigated and non-irrigated cornfields. Released adults tended to remain in and near irrigated cornfields, but dispersed out of and away from non-irrigated cornfields. When released at the edge of the cornfield, neither male nor unmated female O. nubilalis displayed an initial tendency to move out of irrigated corn and into the mixed smooth bromegrass (Bromus inermis Leyss) and broadleaf-weed field edge. Mating efficiency in a late-season cornfield was not significantly different than in dense foxtail (Setaria spp.). Generally, we found that adult O. nubilalis dispersal may vary depending on variables such as action-site availability and agronomic practices and their interaction with O. nubilalis life history.

Agriculture↗
PubMed1995

The choice of irrigant during hand instrumentation and ultrasonic irrigation of the root canal: a scanning electron microscope study.

The purpose of this study was to investigate the use of 4 per cent sodium hypochlorite and 15 per cent EDTAC, either alone or in conjunction, as irrigants during hand instrumentation and ultrasonic irrigation of the root canal. Thirty-six extracted human teeth, each with a single, straight root 21-25 mm long were hand-instrumented through a clinical access cavity to file size 40. One millilitre of the test irrigant was used after each instrument size. Canal debridement was completed with an intermittent flush irrigation technique with one or both of the test irrigants activated by ultrasound at a medium effective power output. The specimens were sectioned longitudinally, viewed in a scanning electron microscope and scored for the presence or absence of debris and smear layer at levels less than 1 mm, 5 mm, and 10 mm from the apical seat. Under the conditions of this experiment the most effective regime was irrigation with 1 mL EDTAC after each instrument size, followed by two 30 second exposures to ultrasound+EDTAC then four 30 second exposures to ultrasound + 4 per cent sodium hypochlorite. The specimens in this group were free from retained pulp tissue and superficial smear layer, had the lowest debris scores at the < 1 mm and 5 mm levels, and the lowest total debris score. All of the techniques tested produced smear-free canals at the 10 mm level.

Dental Pulp↗
PubMed1985

Effects of intraocular irrigating solutions on the corneal endothelium after in vivo anterior chamber irrigation.

We used wide-field specular microscopy and corneal pachymetry to evaluate the effect of anterior chamber irrigation with BSS and BSS Plus on the corneal endothelium of cats. Endothelial changes were quantitated by computerized morphometric analysis of individual cells. After short-term (15 and 30 minutes) and long-term (one and two hours) irrigation, endothelial cell density remained unchanged. Corneal thickness increased significantly in the BSS group after one hour of irrigation. BSS Plus caused minimal changes in endothelial morphologic characteristics regardless of the irrigation time. By comparison, BSS caused a significant increase in the coefficient of variation of cell area (polymegethism) and a decrease in the percentage of hexagonal cells (pleomorphism). These changes were more prominent after prolonged irrigation. The morphologic changes caused by BSS irrigation are indicative of a stressed endothelial monolayer that may be more susceptible to additional surgical trauma.

Acetates↗
PubMed1985

Antimicrobial irrigation of deep pockets to supplement non-surgical periodontal therapy. II. Daily irrigation.

106 sites with probing pocket depths 7 mm or greater from 14 patients were treated with plaque control instruction and 1 episode of root planing. Sites in each patient were either irrigated with 2% chlorhexidine or left as non-irrigated controls. Irrigation immediately followed root planing and was repeated daily, by the patient, for 24 weeks. Clinical measurements were made at 12 and 24 weeks, as were gingival washings for determining the number and % of spirochetes. Results at 24 weeks demonstrated that bleeding scores decreased from 91% to 9%; the % of spirochetes dropped from approximately 9% to less than 1%; probing pocket depths decreased from 7.5 to 4.5 mm, and probing attachment levels gained 1.1 to 1.4 mm. The chlorhexidine irrigated experimental group and the non-irrigated control group did not differ significantly in any of the studied parameters. Thus, daily patient-administered chlorhexidine irrigation of deep pockets did not augment the effects of non-surgical periodontal therapy.

Adult↗
PubMed1997

Efficacy of sinus irrigation versus sinus irrigation followed by functional endoscopic sinus surgery.

Sinus irrigation is the traditional treatment for chronic maxillary sinusitis. Functional endoscopic sinus surgery (FESS) restores aeration and allows secretions to be removed from an infected sinus. This study compares the efficacy of sinus irrigation with that of sinus irrigation followed by FESS in 89 patients. We measured the effects by way of sinus radiographs, nasendoscopic findings, and patient complaints. When we analyzed the data in terms of intent to treat, we found significantly favorable results for sinus irrigation followed by FESS at the end point, though only for loss of smell and purulent rhinitis. Treatment consisting of sinus irrigation alone prevented surgery in 58% of all patients for 1 year. Both treatment methods were combined with a 10-day course of loracarbef, which might have contributed to the outcome. We conclude that a good option for treatment of chronic maxillary sinusitis seems to be sinus irrigation in combination with a broad-spectrum antibiotic followed by FESS.

Adult↗