1,721,009 research outputs found
The Mucus Slurper: A novel tracheal tube that requires no tracheal tube suctioning : a preliminary report
No full textObjective: The buildup of mucus within the endotracheal tube (ETT) progressively reduces its internal volume. We devised the Mucus Slurper as an integral part of the tracheal tube to aspirate all mucus automatically at its distal tip. Design and setting: In vitro, and in vivo studies in sheep at the National Institutes of Health, NHLBI, PCCMB. Subjects: Six sheep, sedated, paralyzed, and mechanically ventilated Interventions: We evaluated the Mucus Slurper in vitro, and we evaluated its efficacy and safety in three healthy sheep during 24 h on volume-controlled mechanical ventilation in comparison to three sheep managed with open tracheal tube suctioning. Measurements and results: In vitro: with the Mucus Slurper connected to a source of vacuum of 450-500 mmHg the total volume of a single suction lasting 0.1, 0.2, and 0.3 s was, respectively, 75.4 ± 7.9, 114.5 ± 4.6, and 143.4 ± 8.7 ml; with the measured vacuum within the lumen of the Mucus Slurper ring of 37 cmH2O. In vivo: during mechanical ventilation we aspirated through the Mucus Slurper 13.4 ± 3.3 cc mucus/24 h. During the course of single aspiration the Mucus Slurper never affected the level of applied PEEP. The tracheal tube was free of tracheal secretions in the Mucus Slurper group while thin secretions were found within the ETT in the control group. Conclusion: The Mucus Slurper is a novel device designed to keep the tracheal tube and proximal trachea free of mucus. In studies in sheep lasting 24 h the Mucus Slurper was safe and prevented all mucus accumulation within the ETT
New developments on benzophenones in the photoinitiated polymerization: 2,4,6-trialkylbenzophenones
No full textOropharyngeal decontamination with antiseptics to prevent ventilator-associated pneumonia : rethinking the benefits of povidone-iodine
No full textThe effect of different temperature and amount of fluid on the intravescical pressure measurements
No full textContinuous lateral rotation therapy to prevent ventilator-associated pneumonia : the neglected effects of gravity on pathogenesis of ventilator-associated pneumonia
No full textA 72-hour study to test the efficacy and safety of the "Mucus Slurper" in mechanically ventilated sheep
No full textOBJECTIVE: In patients intubated with endotracheal tubes (ETTs), suctioning is routinely performed to remove mucus from within the ETT and trachea. The Mucus Slurper is a novel ETT with built-in suction ports arranged radially at its tip. We evaluated the safety and efficacy of the Mucus Slurper, compared with conventional tracheal suction, to prevent airway obstruction in sheep with the ETT and trachea oriented below horizontal. DESIGN: Prospective randomized animal study. SETTING: Animal research facility at the National Institutes of Health. SUBJECTS: Twelve healthy sheep. INTERVENTIONS: Sheep were randomized to be intubated with either the Mucus Slurper (study group) or a Hi-Lo Tracheal Tube (Mallinckrodt, St. Louis, MO) (control group) and mechanically ventilated for 72 hrs. In the study group, automatic, timed tracheal aspiration lasted 0.3 secs, was repeated every 2 mins, and was synchronized with the early expiratory phase. In the control group, tracheal suction was performed every 6 hrs or as required. MEASUREMENTS AND MAIN RESULTS: In the control group, tracheal secretions accumulated progressively within the ETT and the trachea. In the study group, all mucus that reached the tip of the Mucus Slurper was aspirated, keeping the lumen of the ETT, and proximal trachea, free from secretions. In the study group, expiratory water trap protein concentration, a crude index to measure mucus drainage through the ETT, was consistently less than the control group (p < .001). At autopsy, no macroscopic injury to the tracheal mucosa was found in either group. In the study group, the respiratory circuit was less colonized than in the control group. There were no statistically significant differences between the two groups in bacterial colonization of the lungs/bronchi. CONCLUSIONS: The Mucus Slurper, combined with orientation of the trachea below horizontal, prevents accumulation of secretions within the lumen of the ETT and trachea, without need for conventional tracheal suctioning
Antimicrobial-coated endotracheal tubes : an experimental study
No full textObjective: Antibiotic-resistant bacterial biofilm may quickly form on endotracheal tubes ( ETTs) and can enter the lungs, potentially causing pneumonia. In an attempt to prevent bacterial colonization, we developed and tested in an in-vitro study and animal study several antibacterial-coated ETTs ( silver sulfadiazine with and without carbon in polyurethane, silver sulfadiazine and chlorhexidine with and without carbon in polyurethane, silver-platinum with and without carbon in polyurethane, in polyurethane, and rose bengal for UV light). Design, setting, animals, interventions: After preliminary silver sulfadiazine in ( SSD-ETT) was selected among the coatings to be challenged every 24 h with 10(4)-10(6) Pseudomonas aeruginosa/ml and evaluated at 6 h, 24 h, and 72 h with standard microbiological studies, scanning electron microscopy, and confocal scanning microscopy. Subsequently, eight sheep were randomized to receive either a SSD-ETT or a standard ETT ( St-ETT). After 24 h of mechanical ventilation, standard microbiological studies were performed together with scanning electron microscopy and confocal microscopy. Measurements and results: In the in-vitro study SSD-ETT remained bacteria-free for up to 72 h, whereas St-ETT showed heavy P. aeruginosa growth and biofilm formation ( p < 0.01). In sheep, the SSD-ETT group showed no bacterial growth in the ETT, ventilator tubing, and lower respiratory tract, while heavy colonization was found in the St-ETT ( p < 0.01), ventilator tubing ( p = 0.03), and lower respiratory tract ( p < 0.01). Conclusion: This study describes several effective and durable antibacterial coatings for ETTs. Particularly, SSD-ETT showed prevention against P. aeruginosa biofilm formation in a 72-h in-vitro study and lower respiratory tract colonization in sheep mechanically ventilated for 24 h
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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