scholarly journals Comparison of closed with open tracheal aspiration system

Critical Care ◽  
2001 ◽  
Vol 5 (Suppl 1) ◽  
pp. P003 ◽  
Author(s):  
A Sanver ◽  
A Topeli ◽  
Y Çetinkaya ◽  
S Kocagöz ◽  
S Ünal
2021 ◽  
pp. 000348942110267
Author(s):  
Amit Narawane ◽  
Christina Rappazzo ◽  
Jean Hawney ◽  
James Eng ◽  
Julina Ongkasuwan

Objectives: Cerebral palsy (CP) in infants can affect global motor function and lead to swallowing difficulties. This study aims to characterize oral and pharyngeal swallowing dynamics in infancy of patients later diagnosed with CP and to determine if swallow study performance in early infancy is associated with later CP severity and characteristics. Methods: This is a retrospective chart review of infants who underwent videofluoroscopic swallow studies (VFSS) between 6/2008 and 10/2018 at a tertiary children’s hospital, and were later diagnosed with CP. Demographic data, CP characteristics and metrics, and VFSS findings were collected and analyzed. Results: There were 66 patients included in this study. The average age at the time of VFSS was 4 months (range: 0.3-12 months), 42% of patients were female, and 50% of patients were born premature. In our sample, 86% of patients presented with oral dysphagia, and 76% with pharyngeal dysphagia. Laryngeal penetration in isolation was seen in 39% of patients, and tracheal aspiration was seen in 38% of patients. Of these tracheal aspiration events, 64% were silent. At the time of VFSS, 58% of patients had a nasogastric tube, 12% had a gastrostomy tube, and 3% had a prior hospitalization for pneumonia. Rates of penetration and aspiration in early infancy did not consistently correlate with prematurity, type of CP (spastic, non-spastic, or mixed), degree of paralysis (quadriplegic, hemiplegic, or diplegic), or severity of Gross Motor Function Classification System (GMFCS) score. Conclusion: While there was not a consistent correlation of swallowing dynamics in infancy with later gross motor categorizations of CP, the results of this retrospective review highlight the essential role of early clinical and videofluoroscopic swallowing evaluations to identify oral and pharyngeal swallowing dysfunction in this patient population.


2021 ◽  
Vol 77 (18) ◽  
pp. 2900
Author(s):  
Ammar F. ELJack ◽  
Gurjaspreet Bhattal ◽  
Jared Christensen ◽  
Srinivasa Potluri ◽  
Zuyue Wang

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Adnan Siddiqui ◽  
Donald Frei ◽  
Albert J Yoo ◽  
Ghita Soulimani ◽  
Hope Buell ◽  
...  

Introduction: A recent meta-analysis of four randomized controlled trials (RCTs) concluded that mechanical thrombectomy using Solitaire for large vessel ischemic stroke was effective with significantly reduced disability. Hypothesis: Our hypothesis was that treatment with the Penumbra Aspiration System and the novel 3D Stent Retriever would demonstrate similar angiographic and functional outcomes compared to use of Solitaire. Methods: The 3D trial was a RCT to compare the safety and effectiveness of the 3D Stent Retriever when used with the Penumbra Aspiration System (3D/PS) compared to the PS alone. Inclusion criteria for the 3D RCT included presentation with NIH Stroke Scale ≥ 8 and refractory to or not eligible for IV rtPA. Analysis compared reperfusion to mTICI 2b or 3 and functional independence (mRS 0-2 at 90 days) in a 3D Trial cohort with ASPECTS 8-10 vs the meta-analysis data reported by Campbell et al ( Stroke 2016). Results: One hundred four (104) of 198 patients met analysis criteria. Baseline ASPECTS (median [IQR]) were similar between the 3D Trial ASPECTS 8-10 cohort (3D/PS, PS, combined: 9 [8,10]) and Campbell group (9 [7,10]). Substantial reperfusion (mTICI 2b or 3) was experienced in 84.6% (44/52) of 3D/PS and 75.0% (39/52) of PS alone cases, similar to the Campbell group (76.6%). When both arms were pooled, results (79.8%) were also similar to Campbell. With regards to functional independence, both 3D cohorts and pooled trial results showed similar rates compared with Campbell (Figure). Conclusions: The novel 3D Stent Retriever + Penumbra System and the Penumbra Aspiration System alone showed similar reperfusion and functional outcomes compared to Solitaire.


2021 ◽  
pp. 000348942110477
Author(s):  
Michael C. Shih ◽  
Christina Rappazzo ◽  
Caroline Hudson ◽  
Julina Ongkasuwan

Objectives: To evaluate videofluoroscopic swallow study (VFSS) findings in infants with dysphagia and without prior diagnoses, and to characterize the outcomes and any diagnoses that follow. Methods: A chart review of all pediatric patients who received a VFSS at a tertiary children’s hospital from November 2008 to March 2017 was performed. Results: There were 106 infants (57 males and 49 females) with 108 VFSS. VFSS was normal in 18 (16.98%) infants. Regarding airway protection, 50 (47.17%) infants had laryngeal penetration, and 8 (7.55%) had tracheal aspiration; 3 (2.83%, 37.5% of all aspirators) exhibited silent aspiration. Of the 75 infants with minimum 2-year follow-up, 35 (46.67%) had no sequelae of disease and received no diagnoses. The most common diagnoses and pathologic sequelae were gastroesophageal reflux (n = 18, 24.00%), asthma (n = 8, 10.67%), laryngomalacia (n = 6, 8.00%), and tracheomalacia (n = 4, 5.33%), all consistent with United States pediatric data on prevalence. All infants (n = 51) with follow-up for dysphagia had resolution of symptoms within 9 months from VFSS order date. Conclusions: Otherwise healthy infants may show signs of dysphagia and not develop later illness. Parents can thus be counseled on the implications of dysphagia in a previously healthy infant. Our findings provide comparative statistics for future research in pediatric dysphagia.


JAMA ◽  
1972 ◽  
Vol 221 (10) ◽  
pp. 1163 ◽  
Author(s):  
Teruo Matsumoto

Author(s):  
V. Kravets ◽  
◽  
S. Padalko ◽  
V. Gorovenko ◽  
◽  
...  

Introduction. Mixer branches of metallurgical enterprises are an intermediate link between blast furnace and steelmaking workshops. They are equipped with mixers – footer containers for storing cast iron melt. In Ukraine, mixers with a capacity of 1300 or 2500 tons are used. Technological operations are accompanied by emissions of finely dispersed brown smoke and large-dispersed graphite dust into the atmosphere. Problem. Mixer compartments of Ukrainian factories are equipped with aspiration systems that dimity emissions from cast iron pouring and draining units with the help of fume tubes, then emissions pass the dust collector and discharge into the atmosphere through a chimney. The main impact of mixer compartments on the environment is: disorganized emission through an aerodynamic dust lamp, which is not allotted by the aspiration system; organized emission through a smoke pipe of dust not caught by a dust collector; solid waste from gas cleaning and dust hoppers settling on the floor and structures of the mixer compartment from the disorganized ejection that did not come out through the lantern. The main problems are insufficient aspiration (disorganized emission) and low emission purification efficiency (emission through the chimney). A separate problem is the disposal of caught dust. The degree of aspiration in the factories of Ukraine is about 0.7 for the filling unit in the mixer and 0.8 for the drain unit from the mixer at the power of the aspiration system 150-250 thousand tons. This does not meet modern requirements. Results. Cyclones are used as a dust collector in most factories, which completely capture graphite, but are not effective enough for brown smoke. Therefore, it is proposed to use sleeve filters or electro filters. It is also possible to introduce the suppression of brown smoke with nitrogen. The use of nitrogen is possible in accordance with cyclones (for existing systems) or compatible with filters (during reconstruction or new construction). The use of suppression of brown smoke with nitrogen allows to solve the problem of disposal of caught dust, because nitrogen supply leads to enrichment of dust with graphite. The content of graphite increases from 15% to more than 30%, which converts dust from care to commodity product. Keywords: mixer, cast iron pouring, cast iron drainage, dust suppression by nitrogen, aspirational mixer compartment system.


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