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Effects of Closed Endotracheal Suctioning on Systemic and Cerebral Oxygenation and Hemodynamics in Children

Objectives: To evaluate the effects of closed endotracheal tube suctioning on systemic oxygen saturation, cerebral regional oxygen saturation, and somatic regional (renal) oxygen saturation and hemodynamic variables in children. Design: Prospective observational. Setting: A tertiary care PICU. Subjects: Children aged 0-18 years, requiring invasive mechanical ventilation and with an arterial line. Interventions: Closed endotracheal suction. Measurements and Main Results: The study included 19 sedated and intubated children, 0–18 years old. They were enrolled in an ongoing prospective observational study. We used near-infrared spectroscopy for cerebral regional oxygen saturation and somatic regional (renal) oxygen saturation. The timing of each closed endotracheal tube suctioning event was accurately identified from video recordings. We extracted systemic oxygen saturation, cerebral regional oxygen saturation, somatic regional (renal) oxygen saturation, heart rate, and systolic blood pressure and diastolic blood pressure for 5 minutes before and 5 minutes after each event and used these data for analysis. One-minute average values of these variables were used for repeated-measures analysis. We analyzed 287 endotracheal tube suctioning episodes in 19 children. Saline was instilled into the endotracheal tube during 61 episodes. The mean heart rate (107.0 ± 18.7 vs 110.2 ± 10.4; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

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Conclusion Results showed that the incidence of HEs after PSF in AIS can be as high as 31.3%. We did not find any significant risk factors. Although DNPD after PSF is a rare complication and we had none in this series, we suggest that these patients with multiple HEs may be at risk for DNPD as a result of hypotension and potential for cord ischemia. Therefore, all patients after PSF should be monitored in a pediatric intensive care unit–type environment or postanesthesia recovery room initially. If stable for, at least, the initial four hours, then patients should be good candidates for a less intensive environment. ...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
CONCLUSIONS: CFTC performs well compared to stroke volume measurements on a Vigileo monitor. The use of CFTC is highlighted in resource-limited environments and when time limits the use of other methods. CFTc should be validated in a larger study with more operators against a variety of hemodynamic monitors. PMID: 29406045 [PubMed - in process]
Source: The American Journal of the Medical Sciences - Category: General Medicine Authors: Tags: Am J Med Sci Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 316th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Ercast’s Rob Orman from sits down with performance coach Jason Brooks to disc...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Education LITFL review Source Type: blogs
AbstractThe aim of this study was to evaluate the accuracy and precision of non-invasive continuous blood pressure measurement by applanation tonometry (AT) in awake or anaesthetised cardiological intensive care patients. Patients suffering from highly impaired left ventricular function atrial fibrillation or severe aortic valve stenosis were included into the study. Arterial blood pressure was recorded by applanation tonometry (T-Line 400, Tensys Medical®, USA) and an arterial line in awake or anaesthetised patients. Discrepancies in mean (MAP), systolic (SAP), and diastolic (DAP) arterial pressure between the two met...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research
Editor —Arterial transducer infusion sets are associated with complications such as bacterial contamination and accidental arterial injection, potentially leading to bacteraemia, tissue necrosis and limb loss.1 In recognition of reported complications, the NHS England National Patient Safety Agency (NPSA)2 has issued warnings on the risks associated with accidental arterial injection, and the Joint Commission and the World Health Organization (WHO) have stated that injection ports on arterial catheters should be avoided.3 In England, after the 2008 National Awareness Alert, the NPSA required NHS hospitals to take imm...
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research
To help prevent intravascular catheter-related infections, the Centers for Disease Control (CDC) has updated its guidelines on catheter-site dressing regimens. The CDC now advises that for patients aged 18 years and older, “Chlorhexidine-impregnated dressings with an FDA-cleared label that specifies a clinical indication for reducing catheter-related bloodstream infection (CRBSI) or catheter-associated bloodstream infection (CABSI) are recommended to protect the insertion site of short-term, non-tunneled central venous catheters (1A)." Previously, according to its 2011 guidelines, the CDC recommended the use of ...
Source: MDDI - Category: Medical Devices Authors: Tags: Medical Device Business Source Type: news
I'm getting confused about zeroing and transducer placement for arterial line. From my understanding, at least where I'm at, they zero using stopcock close to where the transducer is. Once it is zeroed, we don't need to re-zero but just move the transducer according to pt. Is this true? The following is the question from Hall's book. 20-gauge arterial line connected to a transducer that is located 20 cm below the level of the heart. The system is zeroed at the stopcock located at the... Arterial Line - transducer and zeroing
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums
Condition:   Vascular Access Complication Intervention:   Procedure: Arterial Line Placement Sponsor:   Temple University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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