WorldWideScience

Sample records for closed endotracheal suction

  1. The Effects of Endotracheal Suctioning with Manual Hyperventilation on Cerebrovascular Status of Closed Head Injured Patients

    Science.gov (United States)

    1989-02-02

    PERFORMING ORGANIZATION 6b. OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATION AFIT STUDENT AT (if applicable) AFIT/CIA Univ of MDI 6c. ADDRESS (City, State...Medicine, Pediatrics, ICU USAF Regional Hospital RAF Lakenheath, England 1987-Present Graduate Student Air Force Institute of Technology University...open or closed head injury to determine the acute physiologic alterations in cerebrovascular status that occurred during chest physiotherapy (CPT). ICP

  2. Reliability and criterion-related validity testing (construct) of the Endotracheal Suction Assessment Tool (ESAT©).

    Science.gov (United States)

    Davies, Kylie; Bulsara, Max K; Ramelet, Anne-Sylvie; Monterosso, Leanne

    2018-05-01

    To establish criterion-related construct validity and test-retest reliability for the Endotracheal Suction Assessment Tool© (ESAT©). Endotracheal tube suction performed in children can significantly affect clinical stability. Previously identified clinical indicators for endotracheal tube suction were used as criteria when designing the ESAT©. Content validity was reported previously. The final stages of psychometric testing are presented. Observational testing was used to measure construct validity and determine whether the ESAT© could guide "inexperienced" paediatric intensive care nurses' decision-making regarding endotracheal tube suction. Test-retest reliability of the ESAT© was performed at two time points. The researchers and paediatric intensive care nurse "experts" developed 10 hypothetical clinical scenarios with predetermined endotracheal tube suction outcomes. "Experienced" (n = 12) and "inexperienced" (n = 14) paediatric intensive care nurses were presented with the scenarios and the ESAT© guiding decision-making about whether to perform endotracheal tube suction for each scenario. Outcomes were compared with those predetermined by the "experts" (n = 9). Test-retest reliability of the ESAT© was measured at two consecutive time points (4 weeks apart) with "experienced" and "inexperienced" paediatric intensive care nurses using the same scenarios and tool to guide decision-making. No differences were observed between endotracheal tube suction decisions made by "experts" (n = 9), "inexperienced" (n = 14) and "experienced" (n = 12) nurses confirming the tool's construct validity. No differences were observed between groups for endotracheal tube suction decisions at T1 and T2. Criterion-related construct validity and test-retest reliability of the ESAT© were demonstrated. Further testing is recommended to confirm reliability in the clinical setting with the "inexperienced" nurse to guide decision-making related to endotracheal tube

  3. Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants.

    Science.gov (United States)

    Gillies, Donna; Spence, Kaye

    2011-07-06

    Mechanical ventilation is commonly used in Neonatal Intensive Care Units to assist breathing in a variety of conditions. Mechanical ventilation is achieved through the placement of an endotracheal tube (ETT) which is left in-situ. The ETT is suctioned to prevent a build-up of secretions and blockage of the airway. Methods of suctioning the endotracheal tube vary according to institutional practice and the individual clinician performing the task. The depth of suctioning is one of these variables. The catheter may be passed to the tip of the ETT or beyond the tip into the trachea or bronchi to facilitate removal of secretions. However, trauma to the lower airways may result from the suction catheter being passed into the airway beyond the tip of the endotracheal tube. To compare the effectiveness and complications of deep (catheter passed beyond the tip of the ETT) versus shallow (catheter passed to length of ETT only) suctioning of the endotracheal tube in ventilated infants. In this first update the searches were expanded to the Cochrane Central Register of Controlled Trials (The Cochrane Library, March 30), MEDLINE (from January 1966 to May 30 2011), CINAHL (from 1982 to May 30 2011) and EMBASE (1980 to May 2011) using text words and subject headings relevant to endotracheal suctioning. There were no language restrictions. Controlled trials using random or quasi-random allocation of neonates receiving ventilatory support via an endotracheal tube to either deep or shallow endotracheal suctioning. The updated search resulted in 149 potentially relevant references. Two of the studies from this search were identified as potentially relevant. We included one of the potentially relevant studies and the other was excluded because it did not fit the inclusion criteria. One small crossover trial (n = 27) of shallow versus deep suctioning met the criteria for inclusion in this review. The reported outcomes were oxygen saturation and heart rate, during and after suctioning

  4. Effects of shallow and deep endotracheal tube suctioning on cardiovascular indices in patients in intensive care units.

    Science.gov (United States)

    Irajpour, Alireza; Abbasinia, Mohammad; Hoseini, Abbas; Kashefi, Parviz

    2014-07-01

    Clearing the endotracheal tube through suctioning should be done to promote oxygenation. Depth of suctioning is one of the variables in this regard. In shallow suctioning method, the catheter passes to the tip of the endotracheal tube, and in deep suctioning method, it passes beyond the tip into the trachea or brunches. This study aimed to evaluate the effect of shallow and deep suctioning methods on cardiovascular indices in patients hospitalized in the intensive care units (ICUs). In this clinical trial, 74 patients were selected among those who had undergone mechanical ventilation in the ICU of Al-Zahra Hospital, Isfahan, Iran using convenience sampling method. The subjects were randomly allocated to shallow and deep suctioning groups. Heart rate (HR) and blood pressure (BP) were measured immediately before and 1, 2, and 3 min after each suctioning. Number of times of suctioning was also noted in both the groups. Data were analyzed using repeated measures analysis of variance (ANOVA), Chi-square and independent t-tests. HR and BP were significantly increased after suctioning in both the groups (P 0.05). The suctioning count was significantly higher in the shallow suctioning group than in the deep suctioning group. Shallow and deep suctioning were similar in their effects on HR and BP, but shallow suctioning caused further manipulation of patient's trachea than deep suctioning method. Therefore, in order to prevent complications, nurses are recommended to perform the endotracheal tube suctioning by the deep method.

  5. Comparison the Effects of Shallow and Deep Endotracheal Tube Suctioning on Respiratory Rate, Arterial Blood Oxygen Saturation and Number of Suctioning in Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinia

    2014-09-01

    Full Text Available Introduction: Endotracheal tube suctioning is essential for improve oxygenation in the patients undergoing mechanical ventilation. There are two types of shallow and deep endotracheal tube suctioning. This study aimed to evaluate the effect of shallow and deep suctioning methods on respiratory rate (RR, arterial blood oxygen saturation (SpO2 and number of suctioning in patients hospitalized in the intensive care units of Al-Zahra Hospital, Isfahan, Iran. Methods: In this randomized controlled trial, 74 patients who hospitalized in the intensive care units of Isfahan Al-Zahra Hospital were randomly allocated to the shallow and deep suctioning groups. RR and SpO2 were measured immediately before, immediately after, 1 and 3 minute after each suctioning. Number of suctioning was also noted in each groups. Data were analyzed using repeated measures analysis of variance (RMANOVA, chi-square and independent t-tests. Results: RR was significantly increased and SpO2 was significantly decreased after each suctioning in the both groups. However, these changes were not significant between the two groups. The numbers of suctioning was significantly higher in the shallow suctioning group than in the deep suctioning group. Conclusion: Shallow and deep suctioning had a similar effect on RR and SpO2. However, shallow suctioning caused further manipulation of patient’s trachea than deep suctioning method. Therefore, it seems that deep endotracheal tube suctioning method can be used to clean the airway with lesser manipulation of the trachea.

  6. Comparison the effects of shallow and deep endotracheal tube suctioning on respiratory rate, arterial blood oxygen saturation and number of suctioning in patients hospitalized in the intensive care unit: a randomized controlled trial.

    Science.gov (United States)

    Abbasinia, Mohammad; Irajpour, Alireza; Babaii, Atye; Shamali, Mehdi; Vahdatnezhad, Jahanbakhsh

    2014-09-01

    Endotracheal tube suctioning is essential for improve oxygenation in the patients undergoing mechanical ventilation. There are two types of shallow and deep endotracheal tube suctioning. This study aimed to evaluate the effect of shallow and deep suctioning methods on respiratory rate (RR), arterial blood oxygen saturation (SpO2) and number of suctioning in patients hospitalized in the intensive care units of Al-Zahra Hospital, Isfahan, Iran. In this randomized controlled trial, 74 patients who hospitalized in the intensive care units of Isfahan Al-Zahra Hospital were randomly allocated to the shallow and deep suctioning groups. RR and SpO2 were measured immediately before, immediately after, 1 and 3 minute after each suctioning. Number of suctioning was also noted in each groups. Data were analyzed using repeated measures analysis of variance (RMANOVA), chi-square and independent t-tests. RR was significantly increased and SpO2 was significantly decreased after each suctioning in the both groups. However, these changes were not significant between the two groups. The numbers of suctioning was significantly higher in the shallow suctioning group than in the deep suctioning group. Conclusion : Shallow and deep suctioning had a similar effect on RR and SpO2. However, shallow suctioning caused further manipulation of patient's trachea than deep suctioning method. Therefore, it seems that deep endotracheal tube suctioning method can be used to clean the airway with lesser manipulation of the trachea.

  7. COMPARISON OF THE EFFECTIVENESS OF TWO LEVELS OF SUCTION PRESSURE ON OXYGEN SATURATION IN PATIENTS WITH ENDOTRACHEAL TUBE

    Directory of Open Access Journals (Sweden)

    Muhaji

    2017-12-01

    Full Text Available Background: Endotracheal suctioning is one of the common supportive measures in intensive care units (ICU, which may be related to complications such as hypoxia. However, a questionable efficacy is still identified to choose suctioning pressure between 130 mmHg and 140 mmHg that is effective for patients with endotracheal tube. Objective: To compare the effectiveness of 130 mmHg and 140 mmHg suctioning pressure on oxygen saturation in patients with endotracheal tube. Methods: This research used a quasy experimental design with pretest and posttest group. The study was conducted from 31 January to 1 March 2017 in the Hospital of Panti Wilasa Citarum and Hospital of Roemani Muhammadiyah Semarang. There were 30 samples recruited using consecutive sampling, with 15 assigned in the 130 mmHg and 140 mmHg suctioning pressure group. Pulse oximetry was used to measure oxygen saturation. Paired t-test and Independent t-test were used for data analysis. Results: Findings showed that there was a statistically significant effect of 130 and 140 mmHg suctioning pressure on oxygen saturation in patients with ETT with p-value <0.05. There was a significant mean difference of oxygen saturation between 130 mmHg and 140 mmHg suctioning pressure group with p-value 0.004 (<0.05. The mean difference of oxygen saturation between both groups was 13.157. Conclusion: The 140 mmHg suctioning pressure is more effective compared with 130 mmHg suctioning pressure in increasing oxygen saturation in patients with ETT.

  8. Development of standard practice guidelines for open and closed system suctioning.

    Science.gov (United States)

    Özden, Dilek; Görgülü, R Selma

    2012-05-01

    This study was carried out to determine the knowledge and practice of nurses before and after training and the development of standard practice guidelines for open and closed system suctioning methods in patients with endotracheal tubes. Many life-threatening complications can occur when a suctioning procedure is not performed with the correct technique. It has been reported that standard practice guidelines for suctioning are insufficient in clinical practice. Non-participant structured observational study. We assessed a total of 48 nurses who were employed in the cardiovascular surgery intensive care unit of a state hospital in Turkey. We used a questionnaire and nurse observation forms to assess the use of the open and closed system suctioning. There was a significant difference between the mean scores of the answers ('true', 'wrong' and 'I do not know') for the use of open and closed system suctioning before and after training. In addition, all steps of both suctioning procedures were carried out correctly during the third observation. The compliance of the nurses to the standard practice guidelines for open and closed suctioning and their knowledge levels on the subject were increased after training, while the implementation of standards was satisfactory. The development of open and closed system suctioning standard practice guidelines directly contributed to the enhancement of patient safety and the quality of nursing care. It is suggested that, as in other nursing care practices, suctioning should be carried out in accordance with standard practice guidelines, and health institutions should develop their standard practice guidelines and work in accordance with them. © 2012 Blackwell Publishing Ltd.

  9. Differential Effects of Endotracheal Suctioning on Gas Exchanges in Patients with Acute Respiratory Failure under Pressure-Controlled and Volume-Controlled Ventilation

    Directory of Open Access Journals (Sweden)

    Xiao-Wei Liu

    2015-01-01

    Full Text Available This study was conducted to evaluate the effects of open endotracheal suctioning on gas exchange and respiratory mechanics in ARF patients under the modes of PCV or VCV. Ninety-six ARF patients were treated with open endotracheal suctioning and their variations in respiratory mechanics and gas exchange after the suctions were compared. Under PCV mode, compared with the initial level of tidal volume (VT, ARF patients showed 30.0% and 27.8% decrease at 1 min and 10 min, respectively. Furthermore, the initial respiratory system compliance (Crs decreased by 29.6% and 28.5% at 1 min and 10 min, respectively. Under VCV mode, compared with the initial level, 38.6% and 37.5% increase in peak airway pressure (PAP were found at 1 min and 10 min, respectively. Under PCV mode, the initial PaO2 increased by 6.4% and 10.2 % at 3 min and 10 min, respectively, while 18.9% and 30.6% increase of the initial PaO2 were observed under VCV mode. Summarily, endotracheal suctioning may impair gas exchange and decrease lung compliance in ARF patients receiving mechanical ventilation under both PCV and VCV modes, but endotracheal suctioning effects on gas exchange were more severe and longer-lasting under PCV mode than VCV.

  10. Effects of Lavender Inhalant on the Pain during Endotracheal Suctioning in Intensive Care Unit Patients

    Directory of Open Access Journals (Sweden)

    M. Taheri Rezgh Abadi

    2017-09-01

    Full Text Available Aims: Patients undergoing artificial ventilation require tracheal tube suction because of inability to clear their effective airways, which is usually a painful process for the patients. The aim of this study was to investigate the effect of spike lavender’s inhalant on pain during tracheal tube suctioning in ICU intubated patients. Materials & Methods: In this double-blinded randomized clinical trial, 60 intubated patients hospitalized in ICU of Shahid Modarres Hospital of Kashmar City, Iran, in 2017 were selected by available and simple sampling method, and were randomly divided into 2 control and case groups (each 30 individuals. Before the standard suctioning process, the test group patients received inhalant of 2% spike lavender for 5 minutes and the control group received inhalant of distilled water. The level of pain was recorded before and during tracheal tube suctioning. Data were analyzed by SPSS 16 software using independent T, paired T, Fisher and Mann-Whitney U tests. Findings: There was no significant difference in pain score before tracheal tube suction between 2 groups (p>0.05. However, there were significant differences between the level of pain during tracheal tube suctioning and the pain was increased in both groups, but this increase was significantly higher in the control group (p<0.001. Conclusion: Spike lavender’s inhalant is effective on pain reduction during suctioning process of ICU intubated patients.

  11. Longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on endotracheal suctioning knowledge and skills: A randomized controlled trial.

    Science.gov (United States)

    Jansson, Miia M; Syrjälä, Hannu P; Ohtonen, Pasi P; Meriläinen, Merja H; Kyngäs, Helvi A; Ala-Kokko, Tero I

    2017-01-01

    We evaluated the longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on critical care nurses' endotracheal suctioning knowledge and skills. To do this we used an experimental design without other competing intervention. Twenty-four months after simulation education, no significant time and group differences or time × group interactions were identified between the study groups. The need for regularly repeated educational interventions with audiovisual or individualized performance feedback and repeated bedside demonstrations is evident. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Massive aspiration past the tracheal tube cuff caused by closed tracheal suction system.

    Science.gov (United States)

    Dave, Mital H; Frotzler, Angela; Madjdpour, Caveh; Koepfer, Nelly; Weiss, Markus

    2011-01-01

    Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. High-volume low pressure tube cuffs of 7.5 mm internal diameter (ID) were placed in a 22 mm ID artificial trachea connected to a test lung. Positive pressure ventilation (PPV) with 15 cm H₂O peak inspiratory pressure and 5 cm H₂O positive end-expiratory pressure (PEEP) was used. A closed tracheal suction system (CTSS) catheter (size 14Fr) was attached to the tracheal tube and suction was performed for 5, 10, 15, or 20 seconds under 200 or 300 cm H₂O suction pressures. Amount of fluid (mL) aspirated along the tube cuff and the airway pressure changes were recorded for each suction procedure. Fluid aspiration during different suction conditions was compared using Kruskal-Wallis and Mann-Whitney test (Bonferroni correction [α = .01]). During 10, 15, and 20 seconds suction, airway pressure consistently dropped down to -8 to -13 cm H₂O (P aspiration was never observed under PPV + PEEP but occurred always during suctioning. Aspiration along the tube cuff was higher with -300 cm H₂O than with -200 cm H₂O suction pressure (P aspiration of fluid occurs along the tracheal tube cuff during suction with the closed tracheal suction system. © SAGE Publications 2011.

  13. Closed suction drainage using Lichtenstein technique in preventing wound complications following inguinal hernioplasty: brief report

    Directory of Open Access Journals (Sweden)

    Hamid Reza Hemmati

    2015-03-01

    Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00. Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.

  14. Pilot Study Comparing Closed Versus Open Tracheal Suctioning in Postoperative Neonates and Infants With Complex Congenital Heart Disease.

    Science.gov (United States)

    Tume, Lyvonne N; Baines, Paul B; Guerrero, Rafael; Hurley, Margaret A; Johnson, Robert; Kalantre, Atul; Ramaraj, Ram; Ritson, Paul C; Walsh, Laura; Arnold, Philip D

    2017-07-01

    To determine the hemodynamic effect of tracheal suction method in the first 36 hours after high-risk infant heart surgery on the PICU and to compare open and closed suctioning techniques. Pilot randomized crossover study. Single PICU in United Kingdom. Infants undergoing surgical palliation with Norwood Sano, modified Blalock-Taussig shunt, or pulmonary artery banding in the first 36 hours postoperatively. Infants were randomized to receive open or closed (in-line) tracheal suctioning either for their first or second study tracheal suction in the first 36 hours postoperatively. Twenty-four infants were enrolled over 18 months, 11 after modified Blalock-Taussig shunt, seven after Norwood Sano, and six after pulmonary artery banding. Thirteen patients received the open suction method first followed by the closed suction method second, and 11 patients received the closed suction method first followed by the open suction method second in the first 36 hours after their surgery. There were statistically significant larger changes in heart rate (p = 0.002), systolic blood pressure (p = 0.022), diastolic blood pressure (p = 0.009), mean blood pressure (p = 0.007), and arterial saturation (p = 0.040) using the open suction method, compared with closed suctioning, although none were clinically significant (defined as requiring any intervention). There were no clinically significant differences between closed and open tracheal suction methods; however, there were statistically significant greater changes in some hemodynamic variables with open tracheal suctioning, suggesting that closed technique may be safer in children with more precarious physiology.

  15. Efectos de la contención en hipoxia percutánea posterior a la aspiración endotraqueal en neonatos Effects of containment on percutaneous hipoxia after endotracheal suctioning in neonates

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    Bertha Cecilia Salazar González

    2007-03-01

    Full Text Available Objetivo: Verificar la efectividad de la contención en el tiempo de recuperación de la hipoxia percutánea de neonatos prematuros con Síndrome de Dificultad Respiratoria, posterior a la aspiración con y sin bolsa de oxígeno pre-aspiración. La contención es una técnica que limita los movimientos del neonato simulando el ambiente uterino y se propone como ayuda para inducir la relajación en los prematuros. Material y métodos: Se diseñó un estudio de mediciones repetidas con un grupo; cada neonato fue su propio control. Se estudiaron 30 neonatos nacidos entre la semana 26 y 36 de gestación en una Unidad de Cuidados Intensivos Neonatal de un Hospital de Seguridad Social de Monterrey, de agosto a diciembre de 2002. Se observaron cuatro procedimientos de aspiración endotraqueal: dos sin contención y dos con contención. Resultados: El peso al nacer de los neonatos osciló entre .790 y 3.275 Kg. De acuerdo con el expediente, 25 de ellos (83.30% presentaron Síndrome de Dificultad Respiratoria moderado. La prueba de análisis de varianza, F(3,87= 7.77, p Objective: The purpose was to verify the effectiveness of containment using pre-suction oxygen bag versus non pre-suction oxygen bag on recovery time of percutaneous hipoxia values after endotracheal suctioning of premature infants with respiratory distress syndrome. Containment is proposed as an aid to induce relaxation in premature babies; it is a technique that limits a neonate’s movements resembling the uterus environment. Material and methods: A crossover design with one group was used, each neonate serve as its own control. This study was conducted in 30 neonates who had been born between 26 and 36 weeks gestational age, in a Neonatal Intensive Care Unit of a Social Security’s Hospital in Monterrey. Each neonate was observed during four suction procedures: two without containment and two with containment. Results: The neonate’s weight ranged from .790 to 3.275Kg., according to

  16. Systematic review and meta-analysis of closed suction drainage versus non-drainage in primary hip arthroplasty.

    LENUS (Irish Health Repository)

    Kelly, Enda G

    2014-03-01

    The routine use of drains in surgery has been dogmatically instituted in some disciplines. Orthopaedic surgery is one such sub-speciality. The use of postoperative closed suction drainage in total hip arthroplasty (THA) has become increasingly controversial with multiple randomised control trials performed to assess the benefit to outcome in THA. The hypothesis of this systematic review is that closed suction drainage does not infer a benefit and increase transfusion requirements of primary total hip arthroplasty patients. A systematic review and meta-analysis was conducted adhering to the PRISMA guidelines. A search of the available literature was performed on PubMed, Cochrane Central Registry of Controlled Trials, MEDLINE (OVID) and EMBASE using a combination of MeSH terms and Boolean operators. All data analysis was performed using the Cochrane Collaboration\\'s Review Manager 5.1. Sixteen studies (n=2705) were included in the analysis. Post-operative closed suction drainage was found to increase total blood loss and blood transfusion requirements (p<0.05). Surgical site infection demonstrated no significant difference between the two groups (p=0.82). No significant difference in haematoma formation between groups (p=0.19) was elicited. The routine use of closed suction drainage systems post primary hip arthroplasty is not supported by this meta-analysis. However, the heterogeneity between studies does limit the accuracy of the meta-analysis.

  17. The use of IV-tubing as a closed-suction drainage system during neurosurgical cases in Tanzania.

    Science.gov (United States)

    Bonfield, Christopher M; Shabani, Hamisi K; Kanumba, Emmanuel S; Ellegala, Dilantha B; Nicholas, Joyce

    2013-01-01

    Commercial closed-suctions drainage systems are commonly used in the United States and many other countries for use in neurosurgical cases. However, in Tanzania and other developing nations with fewer resources, these are not available. This report explores another option for a closed-system drainage system utilizing inexpensive supplies found commonly in hospitals around the world. Sterile IV-tubing is cut, inserted into the wound, and brought out through an adjacent puncture incision. For suction, an empty plastic bottle can be attached to the tubing. The IV-tubing closed-suction drainage system was applied in both cranial and spinal neurosurgical procedures, including as subdural, subgaleal, epidural, and suprafacial drains. It maintained suction and was an adequate substitute when commercial drains are unavailable. This report illustrates how sterile IV-tubing can be adapted for use as a closed-drainage system. It utilizes inexpensive supplies commonly found in many hospitals throughout the world and can be applied to both cranial and spinal neurosurgical procedures.

  18. In Vitro Evaluation of Evacuated Blood Collection Tubes as a Closed-Suction Surgical Drain Reservoir.

    Science.gov (United States)

    Heiser, Brian; Okrasinski, E B; Murray, Rebecca; McCord, Kelly

    The initial negative pressures of evacuated blood collection tubes (EBCT) and their in vitro performance as a rigid closed-suction surgical drain (CSSD) reservoir has not been evaluated in the scientific literature despite being described in both human and veterinary texts and journals. The initial negative pressures of EBCT sized 3, 6, 10, and 15 mL were measured and the stability of the system monitored. The pressure-to-volume curve as either air or water was added and maximal filling volumes were measured. Evacuated blood collection tubes beyond the manufacture's expiration date were evaluated for initial negative pressures and maximal filling volumes. Initial negative pressure ranged from -214 mm Hg to -528 mm Hg for EBCT within the manufacturer's expiration date. Different pressure-to-volume curves were found for air versus water. Optimal negative pressures of CSSD are debated in the literature. Drain purpose and type of exudates are factors that should be considered when deciding which EBCT size to implement. Evacuated blood collection tubes have a range of negative pressures and pressure-to-volume curves similar to previously evaluated CSSD rigid reservoirs. Proper drain management and using EBCT within labeled expiration date are important to ensure that expected negative pressures are generated.

  19. Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems.

    Science.gov (United States)

    Li, Ya-Chi; Lin, Hui-Ling; Liao, Fang-Chun; Wang, Sing-Siang; Chang, Hsiu-Chu; Hsu, Hung-Fu; Chen, Sue-Hsien; Wan, Gwo-Hwa

    2018-01-01

    Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems. The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study. The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia. Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system. ClinicalTrials.gov PRS / NCT03359148.

  20. PERBEDAAN PARAMETER KARDIOPULMONAL SETELAH TINDAKAN OPEN SUCTION

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    Muhamat Nofiyanto

    2013-12-01

    Full Text Available Background: Endotracheal suctioning is often performed by nurses and beneficial for critically ill patients. Suctioning is essential for removing secretions, maintaining airway patency and prevent unexpected complications. Open suctioning is performed by disconnecting patients with the ventilator. Suctioning not only removed secretions in the airway but also oxygen. Suctioning must be done correctly, safely, effectively and efficiently to prevent unexpected events in critically ill patients. Objective: This study aimed to determine differences on cardiopulmonary parameters after open suction in critically ill patients Methods: The study design was comparatif cross sectional analytic approach, using one group pre test and post test. The sample of the research amounted to 34 people, using purposive sampling technique. Catheter size 14 Fr on ETT number 7 mm used in this research to performed endotracheal suctioning. Cardiopulmonary parameters (Heart rate/ HR, respiratory rate/RR, oxygen saturation/SpO2, systolic blood pressure/ SBP and diastolic blood pressure/DBP measured by pulse oxymeter and bedside monitor before suction and immediately thereafter. Results: The results showed increase average heart rate 6.412 (from 106.62 into 113.03, Respiratory rate has increased 4.971 (from 20.62 into 25.59, SpO2 decreased 1.68 (from 99.09 into 97.41, and systolic blood pressure increased 5.71 (from 118.29 into 124.00 after performed open suction. The results of paired t-test statistical analysis (for RR, HR obtained a < 0.05 (0.000, whereas Wilcoxon statistical analysis (for SpO2, SBP obtained a < 0.05 (0.000 and 0.001. So it can be said that the difference cardiopulmonary parameters was statistically significant after perfomed open suction in critically ill patients.

  1. Comparison between autologous blood transfusion drainage and closed-suction drainage/no drainage in total knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Hong, Kun-Hao; Pan, Jian-Ke; Yang, Wei-Yi; Luo, Ming-Hui; Xu, Shu-Chai; Liu, Jun

    2016-08-01

    Autologous blood transfusion (ABT) drainage system is a new unwashed salvaged blood retransfusion system for total knee replacement (TKA). However, whether to use ABT drainage, closed-suction (CS) drainage or no drainage in TKA surgery remains controversial. This is the first meta-analysis to assess the clinical efficiency, safety and potential advantages regarding the use of ABT drains compared with closed-suction/no drainage. PubMed, Embase, and the Cochrane Library were comprehensively searched in March 2015. Fifteen randomized controlled trials (RCTs) were identified and pooled for statistical analysis. The primary outcome evaluated was homologous blood transfusion rate. The secondary outcomes were post-operative haemoglobin on days 3-5, length of hospital stay and wound infections after TKA surgery. The pooled data included 1,721 patients and showed that patients in the ABT drainage group might benefit from lower blood transfusion rates (16.59 % and 37.47 %, OR: 0.28 [0.14, 0.55]; 13.05 % and 16.91 %, OR: 0.73 [0.47,1.13], respectively). Autologous blood transfusion drainage and closed-suction drainage/no drainage have similar clinical efficacy and safety with regard to post-operative haemoglobin on days 3-5, length of hospital stay and wound infections. Autologous blood transfusion drainage offers a safe and efficient alternative to CS/no drainage with a lower blood transfusion rate. Future large-volume high-quality RCTs with extensive follow-up will affirm and update this system review.

  2. Pediatric cuffed endotracheal tubes

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    Neerja Bhardwaj

    2013-01-01

    Full Text Available Endotracheal intubation in children is usually performed utilizing uncuffed endotracheal tubes for conduct of anesthesia as well as for prolonged ventilation in critical care units. However, uncuffed tubes may require multiple changes to avoid excessive air leak, with subsequent environmental pollution making the technique uneconomical. In addition, monitoring of ventilatory parameters, exhaled volumes, and end-expiratory gases may be unreliable. All these problems can be avoided by use of cuffed endotracheal tubes. Besides, cuffed endotracheal tubes may be of advantage in special situations like laparoscopic surgery and in surgical conditions at risk of aspiration. Magnetic resonance imaging (MRI scans in children have found the narrowest portion of larynx at rima glottides. Cuffed endotracheal tubes, therefore, will form a complete seal with low cuff pressure of <15 cm H 2 O without any increase in airway complications. Till recently, the use of cuffed endotracheal tubes was limited by variations in the tube design marketed by different manufacturers. The introduction of a new cuffed endotracheal tube in the market with improved tracheal sealing characteristics may encourage increased safe use of these tubes in clinical practice. A literature search using search words "cuffed endotracheal tube" and "children" from 1980 to January 2012 in PUBMED was conducted. Based on the search, the advantages and potential benefits of cuffed ETT are reviewed in this article.

  3. Closed suction drain with bulb

    Science.gov (United States)

    ... of gloves. Put a new bandage around the drain tube site. Use surgical tape to hold it down ... small amount of redness is normal). There is drainage from the skin around the tube site. There is more tenderness and swelling at ...

  4. Obstruction of endotracheal tube with relevant respiratory acidosis during pediatric cardiac surgery

    NARCIS (Netherlands)

    Morei, N.M.; Mungroop, H. E.; Michielon, Guido; Scheeren, Thomas

    2014-01-01

    We describe a case of pediatric cardiac surgery in a 21- days old baby, in whom a nasal endotracheal tube (ETT) was inserted. At the end of surgery both ventilatory pressures and end-tidal CO2 increased suggesting airway obstruction. Suctioning of the ETT lumen did not relieve the problem, only ETT

  5. Endotracheal and upper airways suctioning: changes in newborns’ physiological parameters Aspiración del tubo endotraqueal y de las vías aéreas superiores: alteraciones en los parámetros fisiológicos en recién nacidos Aspiração do tubo orotraqueal e de vias aéreas superiores: alterações nos parâmetros fisiológicos em recém-nascidos

    Directory of Open Access Journals (Sweden)

    Andréa Lopes Barbosa

    2011-12-01

    Full Text Available This study investigated which physiological parameters change when endotracheal and upper airway suctioning is performed immediately before, immediately after and five minutes after this procedure is performed in newborns hospitalized in a Neonatal Intensive Care Unit (NICU. This is a quantitative and longitudinal study, before and after type, performed in the NICU of a public institution in the city of Fortaleza, CE, Brazil. The sample was composed of 104 newborns using oxigenotherapy and who needed endotracheal and upper airway suctioning. The results showed significant alterations in respiratory and heart rates (pSe objetivó investigar cuales son los parámetros fisiológicos que se alteran en la ejecución de la aspiración del tubo endotraqueal (TOT y de las vías aéreas superiores (VAS, comparándolos inmediatamente antes, inmediatamente después y cinco minutos después de la realización del referido procedimiento. Se trata de un estudio cuantitativo, longitudinal, del tipo antes y después, realizado en una Unidad de Terapia Intensiva Neonatal (UTIN de una institución pública en Fortaleza, CE, Brasil. La muestra constó de 104 recién nacidos que usaban oxigenoterapia, y que necesitaron de aspiración del tubo endotraqueal y de las vías aéreas superiores. Los resultados mostraron, alteraciones significativas (pObjetivou-se investigar quais são os parâmetros fisiológicos que se alteram na execução da aspiração do tubo orotraqueal (TOT e das vias aéreas superiores (VAS, comparando-os imediatamente antes, imediatamente depois e cinco minutos após a realização do referido procedimento. Trata-se de estudo quantitativo, longitudinal, do tipo antes e depois, realizado em Unidade de Terapia Intensiva Neonatal (Utin de uma instituição pública em Fortaleza, CE, Brasil. A amostra constou de 104 recém-nascidos em uso de oxigenoterapia, e que necessitaram de aspiração do tubo orotraqueal e das vias aéreas superiores. Os

  6. Hydroponic Feed With Suction

    Science.gov (United States)

    Cox, William M.; Brown, Christopher S.; Dreschel, Thomas W.

    1994-01-01

    Placing nutrient solution under suction increases growth. Foam plug seals growing stem of plant, making it possible to maintain suction in nutrient liquid around roots. Jar wrapped in black tape to keep out light. Potential use in terrestrial applications in arid climates or in labor-intensive agricultural situations.

  7. Cuffed endotracheal tubes in paediatrics

    African Journals Online (AJOL)

    cuffed endotracheal tubes (CETTs) in children who are younger than eight years old. Most paediatric ... the smallest functional part of the infant airway, because the ... During the 2003 severe acute respiratory syndrome (SARS) outbreak in ...

  8. Blind Naso-Endotracheal Intubation

    African Journals Online (AJOL)

    Difficult endotracheal intubation techniques include, use of fiberoptic bronchoscope, intubating laryngeal mask airway, tracheostomy, blind nasotracheal and retrograde intubation. According to the Difficult Airway Society guidelines, intubating with the aid of a fiberoptic scope has taken its place as the standard adjuvant for.

  9. Dynamic behaviour of suction caissons

    Energy Technology Data Exchange (ETDEWEB)

    Liingaard, M.

    2006-12-15

    Offshore wind energy is a promising source of energy in the near future, and is rapidly becoming competitive with other power generating technologies. The continuous improvement in wind turbine technology means that the wind turbines have increased tremendously in both size and performance during the last 25 years. In order to reduce the costs, the overall weight of the wind turbine components is minimized, which means that the wind turbine structures become more flexible and thus more sensitive to dynamic excitation. Since the first resonance frequency of the modern offshore wind turbines is close to the excitation frequencies of the rotor system, it is of outmost importance to be able to evaluate the resonance frequencies of the wind turbine structure accurately as the wind turbines increase in size. In order to achieve reliable responses of the wind turbine structure during working loads it is necessary to account for the possibilities of dynamic effects of the soil-structure interaction. The aim of this thesis is to evaluate the dynamic soil-structure interaction of foundations for offshore wind turbines, with the intention that the dynamic properties of the foundation can be properly included in a composite structure-foundation system. The work has been focused on one particular foundation type; the suction caisson. The frequency dependent stiffness (impedance) of the suction caisson has been investigated by means of a three-dimensional coupled Boundary Element/Finite Element model, where the soil is simplified as a homogenous linear viscoelastic material. The dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequencydependent coefficients corresponding to the different degrees of freedom. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been carried out for different combinations of the

  10. Dynamic stiffness of suction caissons

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars

    The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear...... viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three...

  11. Installation process of suction anchors in Gulf of Guinea clay : Centrifuge modelling

    OpenAIRE

    THOREL, Luc; GARNIER, Jacques; RAULT, Gérard; DENDANI, Hédi; COLLIAT, JL

    2010-01-01

    The preparation process of a deepwater Gulf of Guinea clay for modelling of 24 m long suction anchors at a scale of 1/100 in the LCPC centrifuge, the clay characteristics and the installation phase (self-weight and suction) are presented. Two types of caissons have been tested in each tub : one with stiffeners and the other without stiffener. The embedment ratio is close to the suction caisson's slenderness of 3. An analysis of the forces of suction and soil friction shows, as expected, hi...

  12. Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia.

    Science.gov (United States)

    Caruso, Pedro; Denari, Silvia; Ruiz, Soraia A L; Demarzo, Sergio E; Deheinzelin, Daniel

    2009-01-01

    To compare the incidence of ventilator-associated pneumonia (VAP) with or without isotonic saline instillation before tracheal suctioning. As a secondary objective, we compared the incidence of endotracheal tube occlusion and atelectasis. Randomized clinical trial. The study was conducted in a medical surgical intensive care unit of an oncologic hospital. We selected consecutive patients needing mechanical ventilation for >72 hrs. Patients were allocated into two groups: a saline group that received instillation of 8 mL of saline before tracheal suctioning and a control group which did not. VAP was diagnosed based on clinical suspicion and confirmed by bronchoalveolar lavage quantitative culture. The incidence of atelectasis on daily chest radiography and endotracheal tube occlusions were recorded. The sample size was calculated to a power of 80% and a type I error probability of 5%. One hundred thirty patients were assigned to the saline group and 132 to the control group. The baseline demographic variables were similar between groups. The rate of clinically suspected VAP was similar in both groups. The incidence of microbiological proven VAP was significantly lower in the saline group (23.5% x 10.8%; p = 0.008) (incidence density/1.000 days of ventilation 21.22 x 9.62; p < 0.01). Using the Kaplan-Meier curve analysis, the proportion of patients remaining without VAP was higher in the saline group (p = 0.02, log-rank test). The relative risk reduction of VAP in the saline instillation group was 54% (95% confidence interval, 18%-74%) and the number needed to treat was eight (95% confidence interval, 5-27). The incidence of atelectases and endotracheal tube occlusion were similar between groups. Instillation of isotonic saline before tracheal suctioning decreases the incidence of microbiological proven VAP.

  13. Dynamic Behaviour of Suction Caissons

    DEFF Research Database (Denmark)

    Liingaard, Morten

    to the excitation frequencies of the rotor system, it is of outmost importance to be able to evaluate the resonance frequencies of the wind turbine structure accurately as the wind turbines increase in size. In order to achieve reliable responses of the wind turbine structure during working loads it is necessary...... in a composite structure-foundation system. The work has been focused on one particular foundation type; the suction caisson. The frequency dependent stiffness (impedance) of the suction caisson has been investigated by means of a three-dimensional coupled Boundary Element/Finite Element model, where the soil...

  14. Necessity of suction drains in gynecomastia surgery.

    Science.gov (United States)

    Keskin, Mustafa; Sutcu, Mustafa; Cigsar, Bulent; Karacaoglan, Naci

    2014-05-01

    The aim of gynecomastia surgery is to restore a normal chest contour with minimal signs of breast surgery. The authors examine the rate of complications in gynecomastia surgery when no closed-suction drains are placed. One hundred thirty-eight consecutive male patients who underwent gynecomastia surgery without drains were retrospectively analyzed to determine whether the absence of drains adversely affected patient outcomes. Patients were managed by ultrasonic-assisted liposuction both with and without the pull-through technique. The mean age of the patients was 29 years, and the mean volume of breast tissue aspirated was 350 mL per beast. Pull-through was needed in 23 cases. There was only 1 postoperative hematoma. These results are comparable with previously published data for gynecomastia surgery in which drains were placed, suggesting that the absence of drains does not adversely affect postoperative recovery. Routine closed-suction drainage after gynecomastia surgery is unnecessary, and it may be appropriate to omit drains after gynecomastia surgery.

  15. Treatment of hypertension following endotracheal intubation

    African Journals Online (AJOL)

    Treatment of hypertension following endotracheal intubation. A study comparing the efficacy of labetalol, practolol and placebo. R. J. MAHARAJ, M. THOMPSON, J. G. BROCK-UTNE,. J. W. DOWNING. R. WI LLlAMSON,. Summary. Labetalol, a new adrenergic receptor antagonist, has both a- and B-blocking properties.

  16. Impedance of flexible suction caissons

    DEFF Research Database (Denmark)

    Liingaard, Morten; Andersen, Lars; Ibsen, Lars Bo

    2007-01-01

    The dynamic response of offshore wind turbines is affected by the properties of the foundation and the subsoil. The aim of this paper is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigations include evaluation of the vertical and cou...

  17. Scaled multiple holes suction tip for microneurosurgery; Technical note

    Directory of Open Access Journals (Sweden)

    Abdolkarim Rahmanian, Associate Professor of Neurosurgery

    2017-12-01

    Conclusion: The new suction tip permits easy and precise adjustment of suction power in microneurosirgical operations. Our scaled 3 and 4-hole suction tip is a simple and useful device for controlling the suction power during the microneurosurgeical procedures.

  18. Suction is kid's play: extremely fast suction in newborn seahorses

    Science.gov (United States)

    Van Wassenbergh, Sam; Roos, Gert; Genbrugge, Annelies; Leysen, Heleen; Aerts, Peter; Adriaens, Dominique; Herrel, Anthony

    2009-01-01

    Ongoing anatomical development typically results in a gradual maturation of the feeding movements from larval to adult fishes. Adult seahorses are known to capture prey by rotating their long-snouted head extremely quickly towards prey, followed by powerful suction. This type of suction is powered by elastic recoil and requires very precise coordination of the movements of the associated feeding structures, making it an all-or-none phenomenon. Here, we show that newborn Hippocampus reidi are able to successfully feed using an extremely rapid and powerful snout rotation combined with a high-volume suction, surpassing that observed in adult seahorses. An inverse dynamic analysis shows that an elastic recoil mechanism is also used to power head rotation in newborn H. reidi. This illustrates how extreme levels of performance in highly complex musculoskeletal systems can be present at birth given a delayed birth and rapid development of functionally important structures. The fact that the head skeleton of newborn seahorses is still largely cartilaginous may not be problematic because the hydrodynamic stress on the rotating snout appeared considerably lower than in adult syngnathids. PMID:19324657

  19. Dynamic stiffness of suction caissons

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars

    This report concerns the dynamic soil-structure interaction of steel suction caissons applied as foundations for offshore wind turbines. An emphasis is put on torsional vibrations and coupled sliding/rocking motion, and the influence of the foundation geometry and the properties of the surrounding...... soil is examined. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency-dependent coefficients corresponding to the different degrees of freedom. The dynamic stiffness coefficients...... for the skirted foundation are evaluated by means of a three-dimensional coupled boundary element/finite element model. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been...

  20. A change in humidification system can eliminate endotracheal tube occlusion.

    Science.gov (United States)

    Doyle, Alex; Joshi, Manasi; Frank, Peter; Craven, Thomas; Moondi, Parvez; Young, Peter

    2011-12-01

    Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion. Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Suction caissons subjected to monotonic combined loading

    OpenAIRE

    Penzes, P.; Jensen, M.R.; Zania, Varvara

    2016-01-01

    Suction caissons are being increasingly used as offshore foundation solutions in shallow and intermediate water depths. The convenient installation method through the application of suction has rendered this type of foundation as an attractive alternative to the more traditional monopile foundation for offshore wind turbines. The combined loading imposed typically to a suction caisson has led to the estimation of their bearing capacity by means of 3D failure envelopes. This study aims to anal...

  2. Impacto do sistema de aspiração traqueal aberto e fechado na incidência de pneumonia associada à ventilação mecânica: revisão de literatura Impact of the open and closed tracheal suctioning system on the incidence of mechanical ventilation associated pneumonia: literature review

    Directory of Open Access Journals (Sweden)

    Fernanda Maia Lopes

    2009-03-01

    Full Text Available A pneumonia é a infecção nosocomial mais comum em unidades de terapia intensiva, sendo a ventilação mecânica um fator fortemente associado ao seu desenvolvimento. O objetivo deste estudo foi descrever o impacto do sistema de aspiração traqueal aberto e fechado na incidência de pneumonia associada à ventilação mecânica. Realizou-se uma pesquisa na base de dados Pubmed para identificar tentativas controladas aleatórias, publicadas no período de 1990 a novembro de 2008. Nove estudos foram incluídos. Dos estudos revisados, sete não observaram redução significante da incidência de pneumonia associada à ventilação mecânica com o uso do sistema fechado comparado ao aberto, sendo que dois destes verificaram que o uso do sistema fechado resulta em incremento nas taxas de colonização sem incrementar sua incidência e um observou que o uso do sistema fechado não incrementa a colonização do trato respiratório e reduz a expansão de infecção resultando em redução nas taxas de sepse. Apenas dois estudos verificaram redução na incidência de pneumonia associada à ventilação mecânica com o uso do sistema fechado, e um destes revelou um risco 3.5 vezes maior de desenvolvimento desta infecção com o sistema aberto. Os resultados sugerem que o impacto do sistema de aspiração traqueal aberto e fechado é semelhante para o desenvolvimento da pneumonia associada à ventilação mecânica, assim a escolha do tipo de sistema de aspiração traqueal deve ser baseada em outros parâmetros. Entretanto, o sistema fechado aumenta o risco de colonização do trato respiratório, mas apresenta como vantagens a manutenção da ventilação mecânica e o menor prejuízo hemodinâmico.Pneumonia is the most common nosocominal infection in intensive care units and mechanical ventilation is a significant factor associated to its development. The objective of this study was to describe the impact of the open and closed tracheal suction

  3. Suction caissons subjected to monotonic combined loading

    DEFF Research Database (Denmark)

    Penzes, P.; Jensen, M.R.; Zania, Varvara

    2016-01-01

    Suction caissons are being increasingly used as offshore foundation solutions in shallow and intermediate water depths. The convenient installation method through the application of suction has rendered this type of foundation as an attractive alternative to the more traditional monopile foundation...... for offshore wind turbines. The combined loading imposed typically to a suction caisson has led to the estimation of their bearing capacity by means of 3D failure envelopes. This study aims to analyse the behaviour of suction caissons for offshore wind turbines subjected to combined loading. Finite element...

  4. Abdominal drainage following cholecystectomy: high, low, or no suction?

    OpenAIRE

    McCormack, T. T.; Abel, P. D.; Collins, C. D.

    1983-01-01

    A prospective trial to assess the effect of suction in an abdominal drain following cholecystectomy was carried out. Three types of closed drainage system were compared: a simple tube drain, a low negative pressure drain, and a high negative pressure drain: 120 consecutive patients undergoing cholecystectomy were randomly allocated to one of the three drainage groups. There was no significant difference in postoperative pyrexia, wound infection, chest infection, or hospital stay. This study f...

  5. Laryngotracheal Injury following Prolonged Endotracheal Intubation

    Directory of Open Access Journals (Sweden)

    J. Mehdizadeh

    2006-07-01

    Full Text Available Background: Prolonged endotracheal intubation is a growing method for supporting ventilation in patients who require intensive care. Despite considerable advancement in endotracheal intubation, this method still has some complications; the most important is laryngo-tracheal injuries. Methods: Over a 2-year period, this retrospective study was conducted on 57 patients with history of prolonged intubation who were referred to the ENT Department of Amir Alam Hospital. For each patient, a complete evaluation including history, physical examination, and direct laryngoscopy and bronchoscopy was done under general anesthesia. Results: Fifty-seven patients (44 male; mean age, 23.014.7 years were studied. Mean intubation period was 15.88 days. The most common presenting symptom was dyspnea (62%. Head trauma was responsible for most cases of intubation (72.4%. The most common types of tracheal and laryngeal lesions were tracheal (56.9% and subglottic (55.2% stenosis, respectively. Mean length of tracheal stenosis was 0.810.83 cm. There was a statistically significant relationship between length of tracheal stenosis and intubation period (P=0.0001 but no relation was observed between tracheal stenosis and age, sex, and etiology of intubation (All P=NS. Among the glottic lesions, inter- arytenoids adhesion was the most common lesion (25.9%. No statistically significant relation was found between glottic and subglottic lesions and age, sex and intubation period (all P=NS. Length of stenosis and intubation period was significantly greater in tracheal/ subglottic lesions than those in glottic/ supraglottic lesions (all P=NS. Conclusion: After prolonged endotracheal intubation, laryngo-tracheal lesions had no relation with patient’s age, sex, and cause of intubation.There was direct relation between length of tracheal stenosis and intubation period. Glottic lesions were more commonly observed in head trauma patients. Lesion length and intubation

  6. Endotracheal ectopic parathyroid adenoma mimicking asthma

    Directory of Open Access Journals (Sweden)

    M. Akif Özgül

    2014-01-01

    Full Text Available Primary benign tumors of the trachea are uncommon. These tumors may cause tracheal occlusion and lead to a misdiagnosis of asthma. Ectopic parathyroid adenoma (EPA can be seen anywhere between the mandibular angle and the mediastinum. The distal part of the trachea is a rare location for EPA, and EPA obstructing the endotracheal lumen has not been reported in the literature. We herein describe a 52-year-old female with a several-year history of asthma treatment who presented with progressive dyspnea. Computed tomography revealed a mass that was obstructing the tracheal lumen. Total mass excision was performed via endobronchial treatment, and pathologic examination revealed EPA.

  7. Laryngeal Chondroma: An Unusual Complication Endotracheal Entubation.

    Science.gov (United States)

    Gökdoğan, Ozan; Koybasioglu, Ahmet; Ileri, Fikret

    2016-06-01

    Laryngeal cartilaginous framework tumors are very rare. Chondroma and chondrosarcoma are the most common types of these tumors. A 27-year-old man with a history of intubation presented with exercise-induced dyspnea. A computed tomography scan of larynx showed a rounded and circumscribed mass without infiltration of the adjacent structures which obstructs 75% of airway. Histopathological investigation of the mass revealed the chondroma of the larynx. The patients' history of intubation trauma with the subsequent progressive onset of clinical symptoms demonstrates the relationship between these 2 entities. Clinicians should consider laryngeal chondroma in the differential diagnosis of dyspnea after endotracheal intubation.

  8. Endotracheal expandable metallic stent placement in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Sawada, S; Tanabe, Y; Fujiwara, Y; Koyama, T; Tanigawa, N; Kobayashi, M; Katsube, Y; Nakamura, H [Tottori Univ. School of Medicine, Yonago (Japan). Dept. of Radiology Research Inst. for Microbial Diseases, Osaka (Japan). Dept. of Radiology

    1991-01-01

    Various types of Gianturco zig-zag wire stent were implanted into the tracheas of 4 dogs to define the suitable characteristics of the endotracheal wire stent in these animals. These stents were constructed of 0.45, and 0.33 mm stainless steel wire. The diameter of the fully expanded stents was 3 cm and their lengths were 2, 3, and 4 cm. The 2 cm stent constructed of 0.33 mm wire showed minimum pathologic changes of the trachea of the dog compared to the other stents, and at the same time had a complete covering of ciliated columnar epithelium over the stent surface. (orig.).

  9. Suction v. conventional curettage in incomplete abortion

    African Journals Online (AJOL)

    Suction v. conventional curettage in incomplete abortion. A randomised controlled trial. D. A. A. VERKUYL, C. A. CROWTHER .Abstract This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients ...

  10. Enhanced effect of suction-cavitation on the ozonation of phenol

    International Nuclear Information System (INIS)

    Wu Zhilin; Franke, Marcus; Ondruschka, Bernd; Zhang, Yongchun; Ren Yanze; Braeutigam, Patrick; Wang, Weimin

    2011-01-01

    800 mL of 1.0 mM phenol-containing aqueous solution was circulated at 20 ° C for 30 min in a suction-reactor, while 3.2 mg min -1 ozone was introduced into the solution under the suction orifice. The removal rates of phenol vary polynomially with the orifice diameter as well as the suction pressure. The rate constant for the zero-order kinetics achieves the highest value at -0.070 MPa by using 5 mm orifice. Although the suction-cavitation alone cannot remove phenol in 30 min, it can considerably enhance the ozonation of phenol. The rate constants for the zero-order kinetics by the simple ozonation and the combined method are 0.018 and 0.028 min -1 , respectively. Furthermore, no ozone was observed in the tail gas during the first 15 min for the ozonation in the suction reactor, and then the concentration of unreacted ozone slowly increased, indicating that the utilization rate of ozone is significantly improved by the suction-cavitation. The increasing input concentration of ozone obviously accelerates the ozonation of phenol, but the total required quantities of ozone are very close by various ozone input concentrations to reach the same degradation rate, indicating the ozonation assisted by the suction-cavitation can be considered as a quantitative reaction.

  11. Does the suction drain diameter matter? Bleeding analysis after total knee replacement comparing different suction drain gauges

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    Full Text Available ABSTRACT OBJECTIVES: To evaluate bleeding and the estimated blood loss in patients who underwent total knee replacement (TKR with different closed suction drains (3.2-mm and 4.8-mm gauge. METHODS: This was a randomized controlled trial with 22 patients who underwent TKR and were divided into two groups: Group I, with 11 patients in whom the 3.2-mm suction drain was used, and Group II, with 11 patients in whom the 4.8-mm suction drain was used. The hematocrit was measured after 24, 48 and 72 h after surgery in order to calculate the estimated blood loss. The drained volume was measured 3, 6, 12, 24, and 48 h after TKR, and thereafter both groups were compared. RESULTS: Regarding the hematocrit, there were no differences between groups in measured periods (24, 48, and 72 h after surgery. The total bleeding measured at the suction drains within 48 h was higher in Group II, with a statistically significant difference (p = 0.005; in the first 24 h, there was major bleeding in Group II (mean 893 mL, with a significant difference (p = 0.004. Between 24 and 48 h, there was no statistically significant difference in both groups (p = 0.710. The total estimated bleeding was higher in Group I, with mean of 463 mL, versus 409 mL in Group II, with no statistical significance (p = 0.394. CONCLUSIONS: Bleeding was higher in the group that used the 4.8 mm gauge suction drain, with no differences in hematocrit and estimated blood loss.

  12. Efficacy of intermittent sub-glottic suctioning in prevention of ventilator-associated pneumonia- A preliminary study of 100 patients

    Directory of Open Access Journals (Sweden)

    M N Vijai

    2016-01-01

    Full Text Available Background and Aims: Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP. Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Methods: Group I (n = 50 patients were intubated with HiLo Evac™ endotracheal (ET tube with facility for sub-glottic suctioning, and Group II (n = 50 patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher′s exact test, as appropriate, to analyse the significance of difference between the two groups. Results: The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021. Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001 and ICU stay (8.33 vs. 6.33; P = 0.001 on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006 with lower incidence of mortality (36% vs. 48%; P = 0.224 in the Group I. Conclusion: Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.

  13. Efficacy of intermittent sub-glottic suctioning in prevention of ventilator-associated pneumonia- A preliminary study of 100 patients.

    Science.gov (United States)

    Vijai, M N; Ravi, Parli R; Setlur, Rangaraj; Vardhan, Harsh

    2016-05-01

    Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP). Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Group I (n = 50) patients were intubated with HiLo Evac™ endotracheal (ET) tube with facility for sub-glottic suctioning, and Group II (n = 50) patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU) stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher's exact test, as appropriate, to analyse the significance of difference between the two groups. The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021). Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001) and ICU stay (8.33 vs. 6.33; P = 0.001) on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006) with lower incidence of mortality (36% vs. 48%; P = 0.224) in the Group I. Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.

  14. Dynamic lateral response of suction caissons

    DEFF Research Database (Denmark)

    Latini, Chiara; Zania, Varvara

    2017-01-01

    Deeper water installations of offshore wind turbines may be supported by jacket structures. This study investigates the dynamic response of suction caissons for jackets by analysing 3D finite element models in the frequency domain. The numerical modelling was firstly validated by analytical...... solutions for pile foundations. Groups of crucial dimensionless parameters related to the soil profile and the foundation geometry are identified and their effects on the response of suction caissons are studied. Static stiffness coefficients are presented in a form of mathematical formulas obtained...... by fitting the numerical results, pertaining foundations with different slenderness ratios and embedded in different soil profiles. Sensitivity of the dynamic impedances of suction caissons on the skirt length was showed in this study. Moreover, the results for the suction caissons indicated that the overall...

  15. Accidental transection of flexometallic endotracheal tube during partial maxillectomy

    Directory of Open Access Journals (Sweden)

    Sushma D Ladi

    2011-01-01

    Full Text Available We report a rare case of an 18-year-old female patient in whom accidental sectioning of flexometallic endotracheal tube occurred during partial maxillectomy for mass lesion under general anaesthesia. She was managed successfully by tracheostomy.

  16. Warming Endotracheal Tube in Blind Nasotracheal Intubation throughout Maxillofacial Surgeries

    Directory of Open Access Journals (Sweden)

    Hamzeh Hosseinzadeh

    2013-12-01

    Conclusion: In conclusion, our study showed that using an endotracheal tube softened by warm water could reduce the incidence and severity of epistaxis during blind nasotracheal intubation; however it could not facilitate blind nasotracheal intubation.

  17. Functional morphology of the feeding apparatus, feeding constraints, and suction performance in the nurse shark Ginglymostoma cirratum.

    Science.gov (United States)

    Motta, Philip J; Hueter, Robert E; Tricas, Timothy C; Summers, Adam P; Huber, Daniel R; Lowry, Dayv; Mara, Kyle R; Matott, Michael P; Whitenack, Lisa B; Wintzer, Alpa P

    2008-09-01

    The nurse shark, Ginglymostoma cirratum, is an obligate suction feeder that preys on benthic invertebrates and fish. Its cranial morphology exhibits a suite of structural and functional modifications that facilitate this mode of prey capture. During suction-feeding, subambient pressure is generated by the ventral expansion of the hyoid apparatus and the floor of its buccopharyngeal cavity. As in suction-feeding bony fishes, the nurse shark exhibits expansive, compressive, and recovery kinematic phases that produce posterior-directed water flow through the buccopharyngeal cavity. However, there is generally neither a preparatory phase nor cranial elevation. Suction is generated by the rapid depression of the buccopharyngeal floor by the coracoarcualis, coracohyoideus, and coracobranchiales muscles. Because the hyoid arch of G. cirratum is loosely connected to the mandible, contraction of the rectus cervicis muscle group can greatly depress the floor of the buccopharyngeal cavity below the depressed mandible, resulting in large volumetric expansion. Suction pressures in the nurse shark vary greatly, but include the greatest subambient pressures reported for an aquatic-feeding vertebrate. Maximum suction pressure does not appear to be related to shark size, but is correlated with the rate of buccopharyngeal expansion. As in suction-feeding bony fishes, suction in the nurse shark is only effective within approximately 3 cm in front of the mouth. The foraging behavior of this shark is most likely constrained to ambushing or stalking due to the exponential decay of effective suction in front of the mouth. Prey capture may be facilitated by foraging within reef confines and close to the substrate, which can enhance the effective suction distance, or by foraging at night when it can more closely approach prey.

  18. Sudden endotracheal tube block in a patient of Achalasia Cardia

    Directory of Open Access Journals (Sweden)

    Ajit Gupta

    2012-01-01

    Full Text Available Endotracheal tube block due to various mechanical causes such as mucous, blood clot, denture, and ampoules have been reported. A patient of achalasia cardia with chronic passive aspiration pneumonitis developed mucoid mass in the respiratory passage which dislodged during the surgical procedure. The episode occurred almost an hour after induction of anesthesia and the dislodged mucoid mass blocked the lumen of endotracheal tube, leading to hypoxia and impending cardiac arrest. However, the patient was salvaged by replacing the tube.

  19. Reduction of the suction losses through reed valves in hermetic reciprocating compressors using a magnet coil

    Science.gov (United States)

    Hopfgartner, J.; Posch, S.; Zuber, B.; Almbauer, R.; Krischan, K.; Stangl, S.

    2017-08-01

    Reed valves are widely used in hermetic reciprocating compressors and are responsible for a large part of the thermodynamic losses. Especially, the suction valve, which is opened nearly during the whole suction stroke, has a big potential for improvement. Usually, suction valves are opened only by vacuum created by the moving piston and should be closed before the compression stroke starts to avoid a reversed mass-flow through the valve. Therefore, the valves are prestressed, which results on the other hand in a higher flow resistance. In this work, a suction valve is investigated, which is not closed by the preload of the valve but by an electromagnetic coil located in the suction muffler neck. Shortly before the piston reaches its bottom dead centre, voltage is applied to the coil and a magnetic force is generated which pulls the valve shut. Thereby, the flow resistance through the valve can be reduced by changing the preload on the reed valve because it is no longer needed to close the valve. The investigation of this adapted valve and the electromagnetic coil is firstly done by numerical simulations including fluid structure interactions of the reed valves of a reciprocating compressor and secondly by experiments made on a calorimeter test bench.

  20. Absence of suction feeding ichthyosaurs and its implications for triassic mesopelagic paleoecology.

    Directory of Open Access Journals (Sweden)

    Ryosuke Motani

    Full Text Available Mesozoic marine reptiles and modern marine mammals are often considered ecological analogs, but the extent of their similarity is largely unknown. Particularly important is the presence/absence of deep-diving suction feeders among Mesozoic marine reptiles because this would indicate the establishment of mesopelagic cephalopod and fish communities in the Mesozoic. A recent study suggested that diverse suction feeders, resembling the extant beaked whales, evolved among ichthyosaurs in the Triassic. However, this hypothesis has not been tested quantitatively. We examined four osteological features of jawed vertebrates that are closely linked to the mechanism of suction feeding, namely hyoid corpus ossification/calcification, hyobranchial apparatus robustness, mandibular bluntness, and mandibular pressure concentration index. Measurements were taken from 18 species of Triassic and Early Jurassic ichthyosaurs, including the presumed suction feeders. Statistical comparisons with extant sharks and marine mammals of known diets suggest that ichthyosaurian hyobranchial bones are significantly more slender than in suction-feeding sharks or cetaceans but similar to those of ram-feeding sharks. Most importantly, an ossified hyoid corpus to which hyoid retractor muscles attach is unknown in all but one ichthyosaur, whereas a strong integration of the ossified corpus and cornua of the hyobranchial apparatus has been identified in the literature as an important feature of suction feeders. Also, ichthyosaurian mandibles do not narrow rapidly to allow high suction pressure concentration within the oral cavity, unlike in beaked whales or sperm whales. In conclusion, it is most likely that Triassic and Early Jurassic ichthyosaurs were 'ram-feeders', without any beaked-whale-like suction feeder among them. When combined with the inferred inability for dim-light vision in relevant Triassic ichthyosaurs, the fossil record of ichthyosaurs does not suggest the

  1. Absence of suction feeding ichthyosaurs and its implications for triassic mesopelagic paleoecology.

    Science.gov (United States)

    Motani, Ryosuke; Ji, Cheng; Tomita, Taketeru; Kelley, Neil; Maxwell, Erin; Jiang, Da-yong; Sander, Paul Martin

    2013-01-01

    Mesozoic marine reptiles and modern marine mammals are often considered ecological analogs, but the extent of their similarity is largely unknown. Particularly important is the presence/absence of deep-diving suction feeders among Mesozoic marine reptiles because this would indicate the establishment of mesopelagic cephalopod and fish communities in the Mesozoic. A recent study suggested that diverse suction feeders, resembling the extant beaked whales, evolved among ichthyosaurs in the Triassic. However, this hypothesis has not been tested quantitatively. We examined four osteological features of jawed vertebrates that are closely linked to the mechanism of suction feeding, namely hyoid corpus ossification/calcification, hyobranchial apparatus robustness, mandibular bluntness, and mandibular pressure concentration index. Measurements were taken from 18 species of Triassic and Early Jurassic ichthyosaurs, including the presumed suction feeders. Statistical comparisons with extant sharks and marine mammals of known diets suggest that ichthyosaurian hyobranchial bones are significantly more slender than in suction-feeding sharks or cetaceans but similar to those of ram-feeding sharks. Most importantly, an ossified hyoid corpus to which hyoid retractor muscles attach is unknown in all but one ichthyosaur, whereas a strong integration of the ossified corpus and cornua of the hyobranchial apparatus has been identified in the literature as an important feature of suction feeders. Also, ichthyosaurian mandibles do not narrow rapidly to allow high suction pressure concentration within the oral cavity, unlike in beaked whales or sperm whales. In conclusion, it is most likely that Triassic and Early Jurassic ichthyosaurs were 'ram-feeders', without any beaked-whale-like suction feeder among them. When combined with the inferred inability for dim-light vision in relevant Triassic ichthyosaurs, the fossil record of ichthyosaurs does not suggest the establishment of modern

  2. Tissue holding device for use during surgical procedure, has contact body with suction foot and suction mouth that is surrounded by rim, and suction pipe connected to suction chamber

    OpenAIRE

    Vonck, D.; Goossens, R.H.M.; Flipsen, S.F.J.; Jakimowicz, J.J.; Van der Putten, E.P.W.

    2009-01-01

    The device has a locking ring (5), a connector (6), and a contact body (1) with a suction foot and a suction mouth (8), where the mouth is surrounded by a rim (10), which is substantially located in a plane of the suction foot. A suction chamber (9) has a sieve-shaped inner wall (2) and a transparent side wall, and a suction pipe (11) is connected to the chamber.

  3. Dynamic stiffness of horizontally vibrating suction caissons

    DEFF Research Database (Denmark)

    Latini, Chiara; Zania, Varvara; Cisternino, Michele

    2016-01-01

    The promising potential for offshore wind market is on developing wind farms in deeper waters with bigger turbines. In deeper waters the design foundation configuration may consist of jacket structures supported by floating piles or by suction caissons. Taking the soil-structure interaction effects...... into consideration requires the prior estimation of the dynamic impedances of the foundation. Even though numerous studies exist for piles, only limited number of publications can be found for suction caissons subjected to dynamic loads. Therefore, the purpose of this study is to examine the dynamic response...... of this type of foundation using the finite element method (FEM) to account for the interaction with the soil. 3D numerical models for both the soil and the suction caisson are formulated in a frequency domain. The response of the soil surrounding the foundation is considered linear viscoelastic...

  4. Endotracheal intubation skill acquisition by medical students

    Directory of Open Access Journals (Sweden)

    Henry E. Wang MD MS

    2011-08-01

    Full Text Available During the course of their training, medical students may receive introductory experience with advanced resuscitation skills. Endotracheal intubation (ETI – the insertion of a breathing tube into the trachea is an example of an important advanced resuscitation intervention. Only limited data characterize clinical ETI skill acquisition by medical students. We sought to characterize medical student acquisition of ETI procedural skill.11Presented as a poster discussion on 17 October 2007 at the annual meeting of the American Society of Anesthesiologists in San Francisco, CA.The study included third-year medical students participating in a required anesthesiology clerkship. Students performed ETI on operating room patients under the supervision of attending anesthesiologists. Students reported clinical details of each ETI effort, including patient age, sex, Mallampati score, number of direct laryngoscopies and ETI success. Using mixed-effects regression, we characterized the adjusted association between ETI success and cumulative ETI experience.ETI was attempted by 178 students on 1,646 patients (range 1–23 patients per student; median 9 patients per student, IQR 6–12. Overall ETI success was 75.0% (95% CI 72.9–77.1%. Adjusted for patient age, sex, Mallampati score and number of laryngoscopies, the odds of ETI success improved with cumulative ETI encounters (odds ratio 1.09 per additional ETI encounter; 95% CI 1.04–1.14. Students required at least 17 ETI encounters to achieve 90% predicted ETI success.In this series medical student ETI proficiency was associated with cumulative clinical procedural experience. Clinical experience may provide a viable strategy for fostering medical student procedural skills.

  5. Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement

    DEFF Research Database (Denmark)

    Pfeiffer, P; Rudolph, S S; Neimann, Jens Dupont Børglum

    2011-01-01

    This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation.......This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation....

  6. Assessment of Feasibility of Suction Pile/Anchor Installation and Pullout Testing through Field Tests

    Directory of Open Access Journals (Sweden)

    R. Vijaya

    2014-09-01

    Full Text Available Suction pile anchors are large cylindrical (inverted bucket type structure open at the bottom and closed at the top and largely used for mooring of offshore platforms, exploratory vessels etc. Prediction of the mooring capacity of suction piles is a critical issue faced by the design engineers and rational methods are required to produce reliable designs. Tests have been conducted in an existing natural pond within NIOT campus with the objective of developing methodology of deployment, design and logistics for suction pile installation and testing of mooring capacity under static pullout. Small size suction piles with varying diameters and lengths have been used in the tests. The tests have been carried out in the natural pond with constant water depth of 1.5 m with the top 1.5 m layer of bed comprising soft marine clay. It is found that pile geometry, aspect ratio and angle of pullout have a significant influence on the response to pullout. As angle of mooring load application changes from vertical to horizontal the reaction offered by the suction pile changes from skin friction to passive soil resistance. Resistance offered by the internal plug of soil is found to vary according to dimension of the anchor piles.

  7. Experimental study on occurrence-time ratio measurements of air entrainment in a suction sump

    International Nuclear Information System (INIS)

    Inagaki, K; Funaki, J; Hirata, K

    2009-01-01

    In order to get accurate measurements of air entrainment in a suction sump, we design some new simple bubble sensors, which can detect the existence of air bubbles inside a suction pipe with no disturbances by the sensors and with a fine spatial resolution. We force on an intermittency factor γ, that is, an occurrence-time ratio of the air entrainment, and compare the result by the present sensor with those by conventional two methods; namely, visual and auditory ones. As a result, we show the criteria which specify lower-accuracy conditions in the conventional methods. By the visual method, the accuracy of the γ becomes low, when γ is less than 0.05. By the auditory method, the accuracy of γ becomes low, when the submergence depth S of the suction pipe is close to the critical one S c .

  8. Suction of MHD boundary layer flows

    International Nuclear Information System (INIS)

    Rao, B.N.

    1985-01-01

    The boundary layer growth with tensor electrical conductivity and the transpiration number has been examined using local nonsimilarity solutions method. It is found that suction will cause the increase in wall shearing stress and decrease in thicknesses of the boundary layer. (Auth.)

  9. Hydrodynamics of suction feeding in fish

    NARCIS (Netherlands)

    Muller, M.

    1983-01-01

    1. Suction feeding is the dominant way to obtain food in teleosts. Its high demands on structures due to the required velocities and forces leads to the expectation that a biophysical analysis will aid to reveal the adaptive significance of head and body structures related to this

  10. Numerical Study of Piping Limits for Suction Installation of Offshore Skirted Foundations an Anchors in Layered Sand

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Thilsted, C. L.

    2010-01-01

    Skirted foundations and anchors have proved to be competitive solutions for various types of fixed offshore platforms, subsea systems and an attractive foundation alternative for offshore wind turbines. One main design challenge for skirted structures in sand is to penetrate the skirted deep enough...... to obtain the required capacity. In order to overcome the high penetration resistance in sand suction assisted penetration is needed. Suction installation may cause the formation of piping channels, which break down the hydraulic seal and prevent further installation. This paper presents a numerical study...... of failure limits during suction installation in respect to both homogenous and layered soil profile. A numerical flow analysis is performed to determine the hydraulic gradients developing in response to the suction applied, and the results are presented as simple closed form solutions useful for evaluation...

  11. Kinematics of suction feeding in the seahorse Hippocampus reidi.

    Science.gov (United States)

    Roos, Gert; Van Wassenbergh, Sam; Herrel, Anthony; Aerts, Peter

    2009-11-01

    Fish typically use a rostro-caudal wave of head expansion to generate suction, which is assumed to cause a uni-directional, anterior-to-posterior flow of water in the expanding head. However, compared with typical fish, syngnathid fishes have a remarkably different morphology (elongated snout, small hyoid, immobile pectoral girdle) and feeding strategy (pivot feeding: bringing the small mouth rapidly close to the prey by neurocranial dorsorotation). As a result, it is unclear how suction is generated in Syngnathidae. In this study, lateral and ventral expansions of the head were quantified in Hippocampus reidi and linked to the kinematics of the mouth, hyoid and neurocranium. In addition, the flow velocities inside the bucco-pharyngeal cavity and in front of the mouth were calculated. Our data suggest that the volume changes caused by lateral expansion are dominant over ventral expansion. Maximum gape, neurocranium rotation and hyoid depression are all reached before actual volume increase and before visible prey movement. This implies that, unlike previously studied teleosts, hyoid rotation does not contribute to ventral expansion by lowering the floor of the mouth during prey capture in H. reidi. The lateral volume changes show a rostro-caudal expansion, but the maximal flow velocity is not near the mouth aperture (as has been demonstrated for example in catfish) but at the narrow region of the buccal cavity, dorsal to the hyoid.

  12. influence of head flexion after endotracheal intuba- tion on ...

    African Journals Online (AJOL)

    David Ofori-Adjei

    2008-09-01

    Sep 1, 2008 ... Cataract is a common cause of visual impairment in older individuals. ... After induction of general anesthesia and endotracheal intubation, the ..... Stress re- sponse to tracheal intubation in patients undergoing coronary artery surgery: direct laryngoscopy versus an intubating laryngeal mask airway.

  13. A comparison of the disconnection technique with continuous bronchial suction for lung deflation when using the Arndt endobronchial blocker during video-assisted thoracoscopy: A randomised trial.

    Science.gov (United States)

    El-Tahan, Mohamed R

    2015-06-01

    The use of the Arndt endobronchial blocker has not gained widespread acceptance during video-assisted thoracoscopic surgery (VATS) because of its high cost and longer time to operative lung collapse especially in patients with chronic obstructive pulmonary disease (COPD). The use of a ventilator disconnection technique has been shown to produce a comparable degree of lung collapse when used with either a double-lumen tube or an Arndt endobronchial blocker. We hypothesised that the use of bronchial suction through the suction port of the endobronchial blocker would be associated with a comparable time to achieve optimum lung collapse as the disconnection technique. A randomised, double-blind study. Single university hospital. Fifty-eight patients with spontaneous pneumothorax scheduled for elective VATS using the Arndt endobronchial blocker for one-lung ventilation (OLV). Patients were randomly assigned to one of two groups (n = 29 per group) to deflate the operative lung with either disconnection of the endotracheal tube from the ventilator for 60 s prior to inflation of the endobronchial blocker or connection of a suction pressure of -30 cmH2O to the suction port of the endobronchial blocker through the barrel of a 1 ml syringe. The primary outcome was the time to total lung collapse. Secondary outcomes included surgeon rating of lung collapse, overall surgeon satisfaction, need for further fibreoptic bronchial suction manoeuvres and intraoperative hypoxaemia. The bronchial suction technique was associated with a significantly shorter time to total lung collapse than the disconnection method [93 (95% confidence interval, 95% CI 81.3 to 103.7) vs. 197 (95% CI 157.4 to 237) s respectively; P < 0.001]. Both the disconnection and bronchial suction groups had a comparable surgical rating of excellent lung collapse 40 min after the start of OLV (65.5 vs. 79.3%, respectively; P = 0.24), overall surgeon satisfaction [median (interquartile range, IQR) 9 (8 to 10) vs. 9 (8

  14. The effectiveness of an endotracheal tube holder

    Directory of Open Access Journals (Sweden)

    Byung Gun Lim

    2016-01-01

    Full Text Available The security of the endotracheal tube (ETT is important in the anesthesia and intensive care settings. Recently, an ETT holder instead of an adhesive tape is frequently used to provide the fixation of the ETT. There are some studies that focused on the effectiveness of the ETT holder in preventing displacement of ETT compared to an adhesive tape (1, 2. I have experienced the use of an ETT holder (E-holder, KS medical, Bucheon, Korea in many different anesthesia settings and recognized its usefulness and convenience other than ETT security in the following specific settings.  Firstly, the ETT holder is definitely effective for patients undergoing procedures that frequently require the adjustment of ETT (or double lumen tube location including thoracic surgery. The location of double lumen tube needed for lung separation can be modified for effective ventilation during anesthetic induction or surgery, and after position changes. The tube can be easily relocated to the proper place for lung separation and effective ventilation by unlocking/relocking the button of the ETT holder under flexible bronchoscopic guidance (Fig. 1A, which can facilitate the operative procedure to be performed easily and quickly. Secondly, the ETT holder can be useful in procedures requiring the prone position (3. Especially, it is useful in all circumstances requiring the adjustment of ETT in the prone position. For instance, it is definitely useful for patients with Duchene muscular dystrophy undergoing scoliosis surgery under prone position. Adolescent patients with Duchene muscular dystrophy frequently have tracheobronchial malacia. If so, the airway pressure can be elevated due to the narrowing of the lesion of malacia when changed to the prone position (4. To overcome this problem, a reinforced ETT should be relocated so that it passes the narrowed tracheal lesion under flexible bronchoscopic guidance (Fig. 1B. However, the approach for this management is somewhat

  15. Bernoulli Suction Effect on Soap Bubble Blowing?

    Science.gov (United States)

    Davidson, John; Ryu, Sangjin

    2015-11-01

    As a model system for thin-film bubble with two gas-liquid interfaces, we experimentally investigated the pinch-off of soap bubble blowing. Using the lab-built bubble blower and high-speed videography, we have found that the scaling law exponent of soap bubble pinch-off is 2/3, which is similar to that of soap film bridge. Because air flowed through the decreasing neck of soap film tube, we studied possible Bernoulli suction effect on soap bubble pinch-off by evaluating the Reynolds number of airflow. Image processing was utilized to calculate approximate volume of growing soap film tube and the volume flow rate of the airflow, and the Reynolds number was estimated to be 800-3200. This result suggests that soap bubbling may involve the Bernoulli suction effect.

  16. [Successful double-lumen endotracheal tube exchange with a soft-tipped extra firm exchange catheter in a patient with severe subcutaneous emphysema].

    Science.gov (United States)

    Okamoto, Kaori; Komasawa, Nobuyasu; Ishio, Junichi; Nakano, Shoko; Tatsumi, Shinichi; Minami, Toshiaki

    2014-07-01

    We report a case of successful double-lumen endotracheal tube exchange with a soft-tipped extra firm exchange catheter in a patient with severe subcutaneous emphysema. A 70-year-old man underwent right lower lobectomy for primary lung cancer under general anesthesia. He developed pneumothorax on postoperative day (POD) 14, which led to subcutaneous emphysema. An emergent operation was performed on POD20 to close the pulmonary fistula under general anesthesia with a single-lumen endotracheal tube and bronchial blocker. Subcutaneous emphysema became worse and pharyngeal emphysema was also suspected; re-operation to close the pulmonary or bronchial fistula was planned. We decided to place a double-lumen tube to precisely detect the fistula. Under the guide of a Pentax-AWS Airwayscope, the single-lumen endotracheal tube was exchanged uneventfully to a 35 Fr double-lumen endotracheal tube with a 110 cm soft-tipped extra firm exchange catheter. The fistula was detected by a leak test and the operation was performed uneventfully, leading to improvement of subcutaneous emphysema.

  17. Dynamic stiffness of suction caissons - vertical vibrations

    Energy Technology Data Exchange (ETDEWEB)

    Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars

    2006-12-15

    The dynamic response of offshore wind turbines are affected by the properties of the foundation and the subsoil. The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three-dimensional coupled Boundary Element/Finite Element model. Comparisons are made with known analytical and numerical solutions in order to evaluate the static and dynamic behaviour of the Boundary Element/Finite Element model. The vertical frequency dependent stiffness has been determined for different combinations of the skirt length, Poisson's ratio and the ratio between soil stiffness and skirt stiffness. Finally the dynamic behaviour at high frequencies is investigated. (au)

  18. Half versus full vacuum suction drainage after modified radical mastectomy for breast cancer- a prospective randomized clinical trial[ISRCTN24484328

    Directory of Open Access Journals (Sweden)

    Singh JP

    2005-01-01

    Full Text Available Abstract Background Suction drains are routinely used after modified radical mastectomy and are an important factor contributing to increased hospital stay as the patients are often discharged only after their removal. Amongst various factors that influence the amount of postoperative drainage, the negative suction pressure applied to the drain has been reported to be of great significance. While a high negative suction pressure is expected to drain the collection and reduce the dead space promptly, it may also prevent the leaking lymphatics from closing and lead to increased drainage from the wound. Against this background a prospective randomized clinical study was conducted to compare the amount and duration of drainage between a half negative suction and full vacuum suction drainage in patients following modified radical mastectomy. The associated postoperative morbidity was also compared between the two groups. Methods 85 FNAC (fine needle aspiration cytology proven cases of locally advanced breast cancer were randomized. (Using randomly ordered sealed envelops, which were opened immediately before the closure of the wound in to 50 patients with full vacuum suction (pressure = 700 g/m2 and 35 cases in to half vacuum suction drainage (pressure = 350 g/m2 groups. The two groups were comparable in respect of age, weight, and technique of operation and extent of axillary dissection. Surgery was performed by the same surgical team comprising of five surgeons (two senior and three resident surgeons using a standardized technique with electrocautery. External compression dressing was provided over the axilla for first 48 hrs and following that patients were encouraged to do active and passive shoulder exercises. The outcomes measured were postoperative morbidity and the length of hospital stay. Statistical methods used: Descriptive studies were performed with SPSS version 10 and group characteristics were compared using student t-test. Results

  19. Advances on development of suction and temperature controlled oedometer cell

    International Nuclear Information System (INIS)

    Ye Weimin; Zhang Yawei; Chen Bao; Wang Min

    2010-01-01

    Oedometer cells for unsaturated soils can be classified into two types, that is, conventional unsaturated oedometer cells (high-suction unsaturated oedometer cell, high-suction and high-pressure unsaturated oedometer cell) and temperature controlled unsaturated oedometer cells. Among them, the osmotic, vapor equilibrium and axis translation techniques are often employed for suction control. The thermostat bath method and thermostatically controlled heater method are commonly used for temperature control. The lever loading system, hydraulic loading system and air pressure loading system are commonly means used for vertical pressure. Combination of osmotic (or axis translation) technique with vapor equilibrium method employed for the full range suction control, thermostatically liquid temperature control method, and the hydraulic loading system, could be used for suction, temperature and loading control in the design for unsaturated oedometer cells in the future, which can be used for study of buffer/backfill materials under high-temperature, high pressure and full range suction conditions. (authors)

  20. Laryngeal granuloma: a complication of prolonged endotracheal intubation.

    OpenAIRE

    Keiser, G. J.; Bozentka, N. E.; Gold, B. D.

    1991-01-01

    Laryngeal granuloma is an uncommon complication arising from irritation of the laryngeal structures. We present a case where bilateral laryngeal granulomas became clinically evident 3 mo after orthognathic surgery. The patient, a 19-yr-old female, developed acute dyspnea after experiencing gradual voice loss. Excision of the lesions under endotracheal general anesthesia led to an uneventful outcome. The causes, predisposing factors, diagnostic features, and treatment of laryngeal granuloma ar...

  1. Investigation of suction anchor pullout capacity under undrained conditions

    OpenAIRE

    Jarand, Pollestad

    2015-01-01

    Master's thesis in Offshore technology Floating units are dependent on reliable mooring systems to ensure safety during marine operations. Suction anchors have proved to be a technologically viable and cost-effective concept. They are capable of precision installation, re-use, and provide large resistive capacity. This thesis investigates load capacity and failure modes of suction anchors subjected to vertical, horizontal (lateral), and incline loading. Suction anchor design co...

  2. Evaluation of hypopharyngeal suction to eliminate aspiration: the Retro-Esophageal Suction (REScue) catheter.

    Science.gov (United States)

    Belafsky, Peter C; Mehdizadeh, O B; Ledgerwood, L; Kuhn, M

    2015-02-01

    Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 % (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 % (0/24 trials; p  0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p 12 Fr) at the level of the UES reduced aspiration by 100 % and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.

  3. Normative Values and Interrelationship of MDVP Voice Analysis Parameters Before and After Endotracheal Intubation

    DEFF Research Database (Denmark)

    Sørensen, Martin Kryspin; Durck, Tina Trier; Bork, Kristian

    2016-01-01

    normative values for adults and investigates the correlation between these MDVP parameters in relation to the "standardized" trauma of endotracheal intubation. METHODS: Preoperative and postoperative assessments of vocal fold pathology with flexible videolaryngoscopy and voice analysis with MDVP using...... the best-of-three standardized recording were performed in 121 patients with normal voices included consecutively in the RCT. The procedures of anesthesia were standardized. RESULTS: The normative MDVP values of this study are consistently lower compared with most normative values presented in other...... studies. The preoperative to postoperative differences in jitter values (jitter and relative average perturbation) were closely correlated to the shimmer values for patients with postoperative vocal fold edemas. In the patients with edema, the preoperative to postoperative differences in jitter had...

  4. Suction power output and the inertial cost of rotating the neurocranium to generate suction in fish.

    Science.gov (United States)

    Van Wassenbergh, Sam; Day, Steven W; Hernández, L Patricia; Higham, Timothy E; Skorczewski, Tyler

    2015-05-07

    To expand the buccal cavity, many suction-feeding fishes rely on a considerable contribution from dorsal rotation of the dorsal part of the head including the brains, eyes, and several bones forming the braincase and skull roof (jointly referred to as the neurocranium). As the neurocranium takes up a large part of the total mass of the head, this rotation may incur a considerable inertial cost. If so, this would suggest a significant selective pressure on the kinematics and mass distribution of the neurocranium of suction feeders. Here, an inverse dynamic model is formulated to calculate the instantaneous power required to rotate the neurocranium, approximated by a quarter ellipsoid volume of homogeneous density, as well as to calculate the instantaneous suction power based on intra-oral pressure and head volume quantifications. We applied this model to largemouth bass (Micropterus salmoides) and found that the power required to rotate the neurocranium accounts for only about 4% of the power required to suck water into the mouth. Furthermore, recovery of kinetic energy from the rotating neurocranium converted into suction work may be possible during the phase of neurocranial deceleration. Thus, we suggest that only a negligible proportion of the power output of the feeding muscles is lost as inertial costs in the largemouth bass. Consequently, the feeding performance of piscivorous suction feeders with generalised morphology, comparable to our model species, is not limited by neurocranial motion during head expansion. This suggests that it is thus not likely to be a factor of importance in the evolution of cranial shape and size. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. A retrospective study of the use of active suction wound drains in dogs and cats.

    Science.gov (United States)

    Bristow, P C; Halfacree, Z J; Baines, S J

    2015-05-01

    To report indications for use and complications associated with commonly used closed active suction wound drains in a large number of clinical cases. Retrospective review of medical case records (from 2004 to 2010) for dogs and cats that had a closed active suction drain placed into a wound. Only the four most common drain types were included: Mini Redovac®, Redovac®, Jackson Pratt® and Wound Evac®. Two hundred and fifty-three drains were placed in 33 cats and 195 dogs. Mini Redovac drains were used most frequently in cats (76 · 5%) and Redovac drains in dogs (54 · 3%). The infection rate for clean surgeries in dogs was 15 · 6% (unattainable in cats). Major complications occurred in four dogs; minor complications occurred in 12 drains in cats (35 · 3%), and in 74 drains in dogs (33 · 8%). There was no statistically significant association between the type of drain and complication rate for either species. Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management. © 2015 British Small Animal Veterinary Association.

  6. Suction v. conventional curettage in incomplete abortion A ...

    African Journals Online (AJOL)

    This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients undergoing suction curettage had a significantly lower intra-operative blood loss (P < 0,0001) and a significantly higher mean ...

  7. Endotracheal tube cuff pressure monitoring during neurosurgery - Manual vs. automatic method

    Directory of Open Access Journals (Sweden)

    Mukul Kumar Jain

    2011-01-01

    Full Text Available Background: Inflation and assessment of the endotracheal tube cuff pressure is often not appreciated as a critical aspect of endotracheal intubation. Appropriate endotracheal tube cuff pressure, endotracheal intubation seals the airway to prevent aspiration and provides for positive-pressure ventilation without air leak. Materials and Methods: Correlations between manual methods of assessing the pressure by an experienced anesthesiologists and assessment with maintenance of the pressure within the normal range by the automated pressure controller device were studied in 100 patients divided into two groups. In Group M, endotracheal tube cuff was inflated manually by a trained anesthesiologist and checked for its pressure hourly by cuff pressure monitor till the end of surgery. In Group C, endotracheal tube cuff was inflated by automated cuff pressure controller and pressure was maintained at 25-cm H 2 O throughout the surgeries. Repeated measure ANOVA was applied. Results: Repeated measure ANOVA results showed that average of endotracheal tube cuff pressure of 50 patients taken at seven different points is significantly different (F-value: 171.102, P-value: 0.000. Bonferroni correction test shows that average of endotracheal tube cuff pressure in all six groups are significantly different from constant group (P = 0.000. No case of laryngomalacia, tracheomalacia, tracheal stenosis, tracheoesophageal fistula or aspiration pneumonitis was observed. Conclusions: Endotracheal tube cuff pressure was significantly high when endotracheal tube cuff was inflated manually. The known complications of high endotracheal tube cuff pressure can be avoided if the cuff pressure controller device is used and manual methods cannot be relied upon for keeping the pressure within the recommended levels.

  8. Theoretical Analysis of Effects of Wall Suction on Entropy Generation Rate in Laminar Condensate Layer on Horizontal Tube

    Directory of Open Access Journals (Sweden)

    Tong-Bou Chang

    2014-01-01

    Full Text Available The effects of wall suction on the entropy generation rate in a two-dimensional steady film condensation flow on a horizontal tube are investigated theoretically. In analyzing the liquid flow, the effects of both the gravitational force and the viscous force are taken into account. In addition, a film thickness reduction ratio, Sf, is introduced to evaluate the effect of wall suction on the thickness of the condensate layer. The analytical results show that, the entropy generation rate depends on the Jakob number Ja, the Rayleigh number Ra, the Brinkman number Br, the dimensionless temperature difference ψ, and the wall suction parameter Sw. In addition, it is shown that in the absence of wall suction, a closed-form correlation for the Nusselt number can be derived. Finally, it is shown that the dimensionless entropy generation due to heat transfer, NT, increases with an increasing suction parameter Sw, whereas the dimensionless entropy generation due to liquid film flow friction, NF, decreases.

  9. Endotracheal tube placement by EMT-Basics in a rural EMS system.

    Science.gov (United States)

    Pratt, Jeffrey C; Hirshberg, Alan J

    2005-01-01

    To evaluate the effectiveness of an intubation-training module and special-waiver project in which Emergency Medical Technician (EMT)-Basics were trained to perform endotracheal intubations in a rural community. This was a prospective observational study over a four-year period (July 1998 through May 2002) of all intubation attempts by EMT-Basics in the field. The authors observed intubation data, training methods, and quality-assurance methods of a special-waiver project agreed to by the State Department of Public Health to train and allow EMT-Basics to intubate patients. Data were from documentation unique to the project. Project documentation evaluated the placement and complication(s) of endotracheal tube (ETT) placement after arrival to the emergency department. An intubation attempt was defined as direct laryngoscopy. A successful attempt was defined as an appropriately sized ETT placed and secured in the trachea below the vocal cords and above the carina. Confirmation of placement in the field included accepted clinical methods and the use of qualitative colorimetric end-tidal carbon dioxide detectors. The EMT-Basics were trained using a paramedic curriculum, including operating room intubations on live adult patients. All patients were in either cardiopulmonary or respiratory arrest. Thirty-two intubations were performed by EMT-Basics. Thirty attempts were successful and two were unsuccessful (94%; 95% confidence interval [CI] 80-98%). Unsuccessful ETT placements were managed with accepted basic life support airway standards. There were no unrecognized esophageal ETT placements (0%; 95% CI 0-11%). This study demonstrated that with an intensive training program using selected highly motivated providers and close monitoring, a program of EMT-Basic ETT placement in a rural setting can achieve acceptable success rates in patients in cardiac or respiratory arrest.

  10. Use of Microcuff ® endotracheal tubes in paediatric laparoscopic surgeries

    Directory of Open Access Journals (Sweden)

    Rameshwar Mhamane

    2015-01-01

    Full Text Available Background and Aims: Traditionally, uncuffed endotracheal tubes have been used in children. Cuffed tubes may be useful in special situations like laparoscopy. Microcuff ® endotracheal tube is a specifically designed cuffed endotracheal tube for the paediatric airway. We studied the appropriateness of Microcuff ® tube size selection, efficacy of ventilation, and complications, in children undergoing laparoscopy. Methods: In a prospective, observational study, 100 children undergoing elective laparoscopy were intubated with Microcuff ® tube as per recommended size. We studied appropriateness of size selection, sealing pressure, ability to ventilate with low flow, quality of capnography and post-extubation laryngospasm or stridor. Results: Mean age of the patients was 5.44 years (range 8 months 5 days-9 years 11 months. There was no resistance for tube passage during intubation in any patient. Leak on intermittent positive pressure ventilation at airway pressure ≤20 cm H 2 O was present in all patients. Mean sealing pressure was 11.72 (1.9 standard deviation [SD] cm H 2 O. With the creation of pnemoperitoneum, mean intracuff pressure increased to 12.48 (3.12 SD cm H 2 O. With head low positioning, mean cuff pressure recorded was 13.32 (2.92 SD. Ventilation at low flow (mean flow 1 L/min, plateau-type capnography was noted in all patients. Mean duration of intubation was 83.50 min. Coughing at extubation occurred in 6 patients. Partial laryngospasm occurred in 4 patients, which responded to continuous positive airway pressure via face mask. Severe laryngospasm or stridor was not seen in any patient. Conclusion: Microcuff ® tubes can be safely used in children if size selection recommendations are followed and cuff pressure is strictly monitored. Advantages are better airway seal and effective ventilation, permitting use of low flows.

  11. Vapor pressure lowering effects due to salinity and suction pressure in the depletion of vapor-dominated geothermal reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Battistelli, A. [Aquater S.p.A., Pisa (Italy); Calore, C. [Istituto Internazionale per le Ricerche Geotermiche-CNR, Pisa (Italy); Pruess, K. [Lawrence Berkeley Lab., Berkeley, CA (United States)

    1995-03-01

    The equation-of-state module able to handle saline brines with non-condensible gas, developed for the TOUGH2 simulator, has been improved to include vapor pressure lowering (VPL) due to suction pressure as represented by Kelvin`s equation. In this equation the effects of salt are considered whereas those of non-condensible gas have currently been neglected. Numerical simulations of fluid production from tight matrix blocks have been performed to evaluate the impact of VPL effects due to salinity and suction pressure on the depletion behaviour of vapor-dominated geothermal reservoirs. Previous studies performed neglected VPL due to suction pressure showed that for initial NaCl mass fractions above threshold values, {open_quotes}sealing{close_quotes} of the block occurs and large amounts of liquid fluid may not be recovered. On the other hand, below the threshold value the matrix block dries out due to fluid production. The inclusion of VPL due to suction pressure does not allow complete vaporization of the liquid phase. As a result, the threshold NaCl concentration above which sealing of the matrix block occurs is increased. Above the {open_quotes}critical{close_quotes} NaCl concentration, block depletion behaviour with and without the VPL due to suction pressure is almost identical, as liquid phase saturation remains high even after long production times. As the VPL due to suction pressure depends mainly on capillary pressure, the shape of capillary pressure functions used in numerical simulations is important in determining VPL effects on block depletion.

  12. A new heat and moisture exchanger for laryngectomized patients: endotracheal temperature and humidity

    NARCIS (Netherlands)

    Scheenstra, R.J.; Muller, S.H.; Vincent, A.; Ackerstaff, A.H.; Jacobi, I.; Hilgers, F.J.M.

    2011-01-01

    Objective: To assess the endotracheal temperature and humidity and clinical effects of 2 models of a new heat and moisture exchanger (HME): Rplus, which has regular breathing resistance, and Lplus, which has lower breathing resistance. Methods: We measured endotracheal temperature and humidity in 10

  13. A new heat and moisture exchanger for laryngectomized patients: endotracheal temperature and humidity

    NARCIS (Netherlands)

    Scheenstra, Renske J.; Muller, Saar H.; Vincent, Andrew; Ackerstaff, Annemieke H.; Jacobi, Irene; Hilgers, Frans J. M.

    2011-01-01

    To assess the endotracheal temperature and humidity and clinical effects of 2 models of a new heat and moisture exchanger (HME): Rplus, which has regular breathing resistance, and Lplus, which has lower breathing resistance. We measured endotracheal temperature and humidity in 10 laryngectomized

  14. Vortical and acoustical mode coupling inside a porous tube with uniform wall suction.

    Science.gov (United States)

    Jankowskia, T A; Majdalani, J

    2005-06-01

    This paper considers the oscillatory motion of gases inside a long porous tube of the closed-open type. In particular, the focus is placed on describing an analytical solution for the internal acoustico-vortical coupling that arises in the presence of appreciable wall suction. This unsteady field is driven by longitudinal oscillatory waves that are triggered by small unavoidable fluctuations in the wall suction speed. Under the assumption of small amplitude oscillations, the time-dependent governing equations are linearized through a regular perturbation of the dependent variables. Further application of the Helmholtz vector decomposition theorem enables us to discriminate between acoustical and vortical equations. After solving the wave equation for the acoustical contribution, the boundary-driven vortical field is considered. The method of matched-asymptotic expansions is then used to obtain a closed-form solution for the unsteady momentum equation developing from flow decomposition. An exact series expansion is also derived and shown to coincide with the numerical solution for the problem. The numerically verified end results suggest that the asymptotic scheme is capable of providing a sufficiently accurate solution. This is due to the error associated with the matched-asymptotic expansion being smaller than the error introduced in the Navier-Stokes linearization. A basis for comparison is established by examining the evolution of the oscillatory field in both space and time. The corresponding boundary-layer behavior is also characterized over a range of oscillation frequencies and wall suction velocities. In general, the current solution is found to exhibit features that are consistent with the laminar theory of periodic flows. By comparison to the Sexl profile in nonporous tubes, the critically damped solution obtained here exhibits a slightly smaller overshoot and depth of penetration. These features may be attributed to the suction effect that tends to

  15. Deriving the suction stress of unsaturated soils from water retention curve, based on wetted surface area in pores

    Science.gov (United States)

    Greco, Roberto; Gargano, Rudy

    2016-04-01

    The evaluation of suction stress in unsaturated soils has important implications in several practical applications. Suction stress affects soil aggregate stability and soil erosion. Furthermore, the equilibrium of shallow unsaturated soil deposits along steep slopes is often possible only thanks to the contribution of suction to soil effective stress. Experimental evidence, as well as theoretical arguments, shows that suction stress is a nonlinear function of matric suction. The relationship expressing the dependence of suction stress on soil matric suction is usually indicated as Soil Stress Characteristic Curve (SSCC). In this study, a novel equation for the evaluation of the suction stress of an unsaturated soil is proposed, assuming that the exchange of stress between soil water and solid particles occurs only through the part of the surface of the solid particles which is in direct contact with water. The proposed equation, based only upon geometric considerations related to soil pore-size distribution, allows to easily derive the SSCC from the water retention curve (SWRC), with the assignment of two additional parameters. The first parameter, representing the projection of the external surface area of the soil over a generic plane surface, can be reasonably estimated from the residual water content of the soil. The second parameter, indicated as H0, is the water potential, below which adsorption significantly contributes to water retention. For the experimental verification of the proposed approach such a parameter is considered as a fitting parameter. The proposed equation is applied to the interpretation of suction stress experimental data, taken from the literature, spanning over a wide range of soil textures. The obtained results show that in all cases the proposed relationships closely reproduces the experimental data, performing better than other currently used expressions. The obtained results also show that the adopted values of the parameter H0

  16. Evaluation of a new laser-resistant fabric and copper foil-wrapped endotracheal tube.

    Science.gov (United States)

    Sosis, M B; Braverman, B; Caldarelli, D D

    1996-07-01

    The risk of an endotracheal tube's combustion during laser airway surgery necessitates the use of special anesthetic techniques and equipment to prevent this complication. This study was designed to evaluate the Laser-Trach(TM), a new laser-resistant rubber endotracheal tube for use during laser airway surgery. The Laser-Trach endotracheal tubes that were evaluated were size 6.0 mm internal diameter (ID) red rubber endotracheal tubes which had been commercially wrapped by Kendall-Sheridan (Mansfield, Mass.) with copper foil tape and overwrapped with fabric. The fabric layer was saturated with water prior to our tests, as recommended by the manufacturer. The Laser-Trach endotracheal tubes were compared with plain (bare) size 6.0 mm ID Rusch red rubber endotracheal tubes. The tubes under study were positioned horizontally on wet towels in air and had 5 L x min(-1) of oxygen flowing through them. They were subjected to continuous laser radiation at 40 W from either a CO2 or an Nd-YAG laser. The Nd-YAG laser was propagated via a 600-micron fiber bundle. Each laser was directed perpendicularly at the shaft of the endotracheal tube being studied, and its output was continued until a blowtorch fire occurred or 60 seconds had elapsed. Sixty seconds of CO2 laser fire did not ignite any of the eight Laser-Trach endotracheal tubes tested. However, blowtorch ignition of all eight bare rubber tubes tested occurred after 0.87 +/- 0.21 (mean +/- SD) seconds of CO2 laser fire. Nd-YAG laser contact with the Laser-Trach endotracheal tubes caused the perforation and blowtorch ignition of all eight tubes tested after 18.79 +/- 7.83 seconds. This was a significantly (Presistant to the C02 laser. However, this endotracheal tube is not recommended for use with the Nd-YAG laser.

  17. Place Atrium to Water Seal (PAWS): Assessing Wall Suction Versus No Suction for Chest Tubes After Open Heart Surgery.

    Science.gov (United States)

    Kruse, Tamara; Wahl, Sharon; Guthrie, Patricia Finch; Sendelbach, Sue

    2017-08-01

    Traditionally chest tubes are set to -20 cm H 2 O wall suctioning until removal to facilitate drainage of blood, fluid, and air from the pleural or mediastinal space in patients after open heart surgery. However, no clear evidence supports using wall suction in these patients. Some studies in patients after pulmonary surgery indicate that using chest tubes with a water seal is safer, because this practice decreases duration of chest tube placement and eliminates air leaks. To show that changing chest tubes to a water seal after 12 hours of wall suction (intervention) is a safe alternative to using chest tubes with wall suction until removal of the tubes (usual care) in patients after open heart surgery. A before-and-after quality improvement design was used to evaluate the differences between the 2 chest tube management approaches in chest tube complications, output, and duration of placement. A total of 48 patients received the intervention; 52 received usual care. The 2 groups (intervention vs usual care) did not differ significantly in complications (0 vs 2 events; P = .23), chest tube output (H 1 = 0.001, P = .97), or duration of placement (median, 47 hours for both groups). Changing chest tubes from wall suction to water seal after 12 hours of wall suction is a safe alternative to using wall suctioning until removal of the tubes. ©2017 American Association of Critical-Care Nurses.

  18. Novel device (AirWave) to assess endotracheal tube migration: a pilot study.

    Science.gov (United States)

    Nacheli, Gustavo Cumbo; Sharma, Manish; Wang, Xiaofeng; Gupta, Amit; Guzman, Jorge A; Tonelli, Adriano R

    2013-08-01

    Little is known about endotracheal tube (ETT) migration during routine care among critically ill patients. AirWave is a novel device that uses sonar waves to measure ETT migration and obstructions in real time. The aim of the present study is to assess the accuracy of the AirWave to evaluate ETT migration. In addition, we determined the degree of variation in ETT position and tested whether more pronounced migration occurs in specific clinical scenarios. After institutional review board approval, we included mechanically ventilated patients from February 2012 to May 2012. A chest radiography (CXR) was obtained at baseline and 24 hours when clinically indicated. The ETT distance at the lips was recorded at baseline and every 4 hours. The AirWave system continuously recorded ETT position changes from baseline, and luminal obstructions. A total of 42 patients (age: 61 [SD ±13] years, men: 52%) were recruited. A total of 19 patients had measurements of ETT migration at 24 hours by the 3 methodologies used in this study. The mean (SD) of the ETT migration at 24 hours was +0.04 (1.2), -0.42 (0.7) and +0.34 (1.81) cm when measured by portable CXR, ETT distance at the teeth and AirWave device, respectively. Bland-Altman analysis of tube migration at 24 hours comparing the AirWave with CXR readings showed a bias of 0.1 cm with 95% limit of agreement of -3.8 and +4.3 cm. Comparison of tube migration at 24 hours determined by AirWave with ETT distance at the lips revealed a bias of -0.4 with 95% limit of agreement -3.7 to +3 cm, similar to the values observed between CXR and ETT distance at the lips (bias of -0.3 cm, 95% limit of agreement of -3.4 to +2.8 cm). Factors associated with ETT migration at 24 hours were ETT size and initial measurement from ETT tip to carina by portable CXR. AirWave detected in eight patients some degree of ETT obstruction (30% ± 9.6%) that resolved with prompt ETT catheter suction. The AirWave may provide useful information regarding ETT

  19. Effect of continuous oral suctioning on the development of ventilator-associated pneumonia: a pilot randomized controlled trial.

    Science.gov (United States)

    Chow, Meyrick C M; Kwok, Shu-Man; Luk, Hing-Wah; Law, Jenny W H; Leung, Bartholomew P K

    2012-11-01

    Both continuous and intermittent aspiration of subglottic secretions by means of specially designed endotracheal tubes containing a separate dorsal lumen that opens into the subglottic region have been shown to be useful in reducing ventilator-associated pneumonia (VAP). However, the high cost of these tubes restricts their use. The aim of this pilot randomized controlled trial was to test the effect of a low-cost device (saliva ejector) for continuous oral suctioning (COS) on the incidence of VAP in patients receiving mechanical ventilation. The study was conducted in the six-bed medical-surgical ICU of a hospital with over 400 beds that provides comprehensive medical services to the public. The design of this study was a parallel-group randomized controlled trial. While both the experimental and control groups used the conventional endotracheal tube, the saliva ejector was only applied to patients assigned to the experimental group. The device was put between the patient's cheek and teeth, and then connected to 100mmHg of suction for the continuous drainage of saliva. Fourteen patients were randomized to receive COS and 13 patients were randomized to the control group. The two groups were similar in demographics, reasons for intubation, co-morbidity, and risk factors for acquiring VAP. VAP was found in 3 patients (23.1%; 71 episodes of VAP per 1000 ventilation days) receiving COS and in 10 patients (83.3%; 141 episodes of VAP per 1000 ventilation days) in the control group (relative risk, 0.28; 95% confidence interval, 0.10-0.77; p=0.003). The duration of mechanical ventilation in the experimental group was 3.2 days (SD 1.3), while that in the control group was 5.9 days (SD 2.8) (p=0.009); and the length of ICU stay was 4.8 days (SD 1.6) versus 9.8 days (SD 6.3) for the experimental and control groups, respectively (p=0.019). Continuous clearance of oral secretion by the saliva ejector may have an important role to play in reducing the rate of VAP, decreasing the

  20. Active technique by suction to control the flow structure over a van model

    Science.gov (United States)

    Harinaldi, Budiarso, Warjito, Kosasih, Engkos A.; Tarakka, Rustan; Simanungkalit, Sabar P.

    2012-06-01

    Today research trend in car aerodynamics are carried out from the point of view of the durable development. Some car companies have the objective to develop control solution that enable to reduce the aerodynamic drag of vehicle. It provides the possibility to modify the flow separation to reduce the development of the swirling structures around the vehicle. In this study, a family van is modeled with a modified form of Ahmed's body by changing the orientation of the flow from its original form (modified/reversed Ahmed Body). This model is equipped with a suction on the rear side to comprehensively examine the pressure field modifications that occur. The investigation combines computational and experimental work. The computational simulation used is k-epsilon flow turbulence model. The reversed Ahmed body used in the investigation has slant angle (φ) 35° at the front part. In the computational work, meshing type is tetra/hybrid element with hex core type and the grid number is more than 1.7 million in order to ensure detail discretization and more accurate calculation results. The boundary condition is upstream velocity of 11.1 m/s. Mean free stream at far upstream region is assumed in a steady state condition and uniform. The suction velocity is set at 1 m/s. Meanwhile in the experimental work a reversed Ahmed model is tested in a controlled wind tunnel experiments. The main measurement is the drag aerodynamic measurement at rear of the body of the model using strain gage. The results show that the application of a suction in the rear part of the van model give the effect of reducing the wake and the vortex is formed. Aerodynamic drag reduction close to 24% for the computational approach and 14.8% for the experimental approach by introducing a suction have been obtained.

  1. Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement.

    Science.gov (United States)

    Pfeiffer, P; Rudolph, S S; Børglum, J; Isbye, D L

    2011-11-01

    This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation. A prospective, paired, and investigator-blinded study carried out in the operating theatre. Twenty-five adult patients requiring endotracheal intubation were included. During intubation, transtracheal ultrasound was performed to visualize passage of the endotracheal tube. During bag ventilation, bilateral lung ultrasound was performed for the detection of lung sliding as a sign of ventilation simultaneous with capnography and auscultation of the epigastrium and chest. Primary outcome measure was time difference to confirmed endotracheal intubation between ultrasound and auscultation alone. Secondary outcome measure was time difference between ultrasound and auscultation combined with capnography. Both methods verified endotracheal tube placement in all patients. In 68% of patients, endotracheal tube placement was visualized by real-time transtracheal ultrasound. Comparing ultrasound with the combination of auscultation and capnography, there was a significant difference between the two methods. Median time for ultrasound was 40 s [interquartile range (IQR) 35-48 s] vs. 48 s (IQR 45-53 s), P auscultation alone. Median time for auscultation alone was 42 s (IQR 37-47 s), P = 0.6, with a mean difference of -0.88 s in favour of ultrasound (95% CI -4.2-2.5 s). Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and capnography. © 2011 The Authors. Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

  2. Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation

    Directory of Open Access Journals (Sweden)

    Matthew Hansen

    2016-09-01

    Full Text Available Introduction: The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. Methods: This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas. We geocoded scene addresses using the automated address locator created in the cloud-based mapping platform ArcGIS, supplemented with manual address geocoding for remaining cases. We then use the Getis-Ord Gi spatial statistic feature in ArcGIS to map statistically significant spatial clusters (hot spots of pediatric EMS runs throughout the county. We then superimposed all intubation procedures performed during the study period on maps of pediatric EMS-run hot spots, pediatric population density, fire stations, and hospitals. We also performed multivariable logistic regression to determine if distance traveled to the hospital was associated with intubation after controlling for several confounding variables. Results: We identified a total of 7,797 pediatric EMS runs during the study period and 38 endotracheal intubations. In univariate analysis we found that patients who were intubated were similar to those who were not in gender and whether or not they were transported to a children’s hospital. Intubated patients tended to be transported shorter distances and were older than non-intubated patients. Increased distance from the hospital was associated with reduced odds of intubation after controlling for age, sex, scene location, and trauma system entry status in a multivariate logistic

  3. Boundary layer on a flat plate with suction

    International Nuclear Information System (INIS)

    Favre, A.; Dumas, R.; Verollet, E.

    1961-01-01

    This research done in wind tunnel concerns the turbulent boundary layer of a porous flat plate with suction. The porous wall is 1 m long and begins 1 m downstream of the leading edge. The Reynolds number based on the boundary layer thickness is of the order of 16.300. The suction rate defined as the ratio of the velocity perpendicular to the wall to the external flow velocity ranges from 0 to 2 per cent. The pressure gradient can be controlled. The mean velocity profiles have been determined for various positions and suction rates by means of total pressure probes together with the intensities of the turbulent velocity fluctuations components, energy spectra and correlations by means of hot wire anemometers, spectral analyser and correlator. The stream lines, the values of the viscous and turbulent shear stresses, of the local wall friction, of the turbulent energy production term, with some information on the dissipation of the energy have been derived from these measurements. For these data the integral of equation of continuity in boundary layer have been drawn. The suction effects on the boundary layer are important. The suction thoroughly alters the mean velocity profiles by increasing the viscous shear stresses near the wall and decreasing them far from the wall, it diminishes the longitudinal and transversal turbulence intensities, the turbulent shear stresses, and the production of energy of turbulence. These effects are much stressed in the inner part of the boundary layer. On the other hand the energy spectra show that the turbulence scale is little modified, the boundary layer thickness being not much diminished by the suction. The suction effects can be appreciated by comparing twice the suction rate to the wall friction coefficient (assumed airtight), quite noticeable as soon as the rate is about unity, they become very important when it reaches ten. (author) [fr

  4. Analisis Perubahan Nilai Suction Akibat Hujan Terhadap Kestabilan Lereng

    OpenAIRE

    Martini, Martini

    2009-01-01

    Infiltration of rainfall into slope will have an effect on to condition of slope hydrology and more specifically to characteristic of slope soils, for example pore water pressure value, level of saturation, weight contents of soil, shear strength of soil. Pore water pressure value at dry soil condition or wet condition called as with pore water pressure value negatife or value suction. This suction value will tend to declines and in the end becomes equal to zero or bigger than 0 ( positive po...

  5. Management of avulsed permanent maxillary central incisors during endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Ritesh R Kalaskar

    2016-01-01

    Full Text Available Avulsion is serious injury that may encounter during endotracheal intubation and its management often presents a challenge. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. The present article describes the management of air-dried maxillary permanent incisors that have been avulsed due to direct laryngoscopy during the induction of general anesthesia for tonsillectomy procedure. The replanted maxillary central incisors had maintained its function and esthetic for 1 year after replantation. Children in a mixed dentition phase are high-risk group children for traumatic dental injury during laryngoscopy; therefore, Anesthetic Departments should have local protocols to refer patients for dental treatment postoperatively in the event of trauma.

  6. Endotracheal tube defects: Hidden causes of airway obstruction

    Directory of Open Access Journals (Sweden)

    Sofi Khalid

    2010-01-01

    Full Text Available Manufacturing defects of endotracheal tube (ETT are still encountered in anesthesia practice. Many such defects go unnoticed during routine inspection prior to their use. Such defects in ETT may lead to partial or complete airway obstruction in an intubated patient. We report a case of partial airway obstruction with a prepacked, single use, uncuffed ETT due to a manufacturing defect in the form of a plastic meniscus at the distal end of the tube. This case report highlights the significance of standard monitoring of ventilation and the role of a vigilant clinician in detecting such defects in avoiding critical events as can arise from the use of such defective ETTs. It also emphasizes the need for double checking ETTs prior to their use.

  7. Comparison of prophylactic effects of polyurethane cylindrical or tapered cuff and polyvinyl chloride cuff endotracheal tubes on ventilator-associated pneumonia.

    Directory of Open Access Journals (Sweden)

    Ata Mahmoodpoor

    2013-07-01

    Full Text Available Because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of pneumonia, improved design of tracheal tubes with new cuff material and shape have reduced the size and number of folds, which together with the addition of suction ports above the cuff to drain pooled subglottic secretions leads to reduced aspiration of oropharyngeal secretions. So we conducted a study to compare the prophylactic effects of polyurethane-cylindrical or tapered cuff and polyvinyl chloride cuff endotracheal tubes (ETT on ventilator-associated pneumonia. This randomized clinical trial was carried out in a 12 bed surgical intensive care unit. 96 patients expected to require mechanical ventilation more than 96 hours were randomly allocated to one of three following groups: Polyvinyl chloride cuff (PCV ETT, Polyurethane (PU cylindrical Sealguard ETT and PU Taperguard ETT. Cuff pressure monitored every three hours 3 days in all patients. Mean cuff pressure didn't have significant difference between three groups during 72 hours. Pneumonia was seen in 11 patients (34% in group PVC, 8 (25% in Sealguard and 7 (21% in Taperguard group. Changes in mean cuff pressure between Sealguard and PVC tubes and also between Taperguard and PVC tubes did not show any significant difference. There was no significant difference in overinflation between three groups. The use of ETT with PU material results in reducing ventilator-associated pneumonia compared to ETT with PVC cuff. In PU tubes Taperguard has less incidence of ventilator-associated pneumonia compared to Sealguard tubes.

  8. Entropy Generation in a Rotating Couette Flow with Suction/Injection

    Directory of Open Access Journals (Sweden)

    S. Das

    2015-05-01

    Full Text Available The present paper is concerned with an analytical study of entropy generation in viscous incompressible Couette flow with suction/injection in a rotating frame of reference. One of the plate is held at rest and the other one moves with an uniform velocity.The flow induced by the moving plate. An exact solution of governing equations has been obtained in closed form. The entropy generation number and the Bejan number are also obtained. The influences of each of the governing parameters on velocity, temperature, entropy generation and Bejan number are discussed with the help of graphs.

  9. Suction generation in white-spotted bamboo sharks Chiloscyllium plagiosum.

    Science.gov (United States)

    Wilga, Cheryl D; Sanford, Christopher P

    2008-10-01

    After the divergence of chondrichthyans and teleostomes, the structure of the feeding apparatus also diverged leading to alterations in the suction mechanism. In this study we investigated the mechanism for suction generation during feeding in white-spotted bamboo sharks, Chiloscyllium plagiosum and compared it with that in teleosts. The internal movement of cranial elements and pressure in the buccal, hyoid and pharyngeal cavities that are directly responsible for suction generation was quantified using sonomicrometry and pressure transducers. Backward stepwise multiple linear regressions were used to explore the relationship between expansion and pressure, accounting for 60-96% of the variation in pressure among capture events. The progression of anterior to posterior expansion in the buccal, hyoid and pharyngeal cavities is accompanied by the sequential onset of subambient pressure in these cavities as prey is drawn into the mouth. Gape opening triggers the onset of subambient pressure in the oropharyngeal cavities. Peak gape area coincides with peak subambient buccal pressure. Increased velocity of hyoid area expansion is primarily responsible for generating peak subambient pressure in the buccal and hyoid regions. Pharyngeal expansion appears to function as a sink to receive water influx from the mouth, much like that of compensatory suction in bidirectional aquatic feeders. Interestingly, C. plagiosum generates large suction pressures while paradoxically compressing the buccal cavity laterally, delaying the time to peak pressure. This represents a fundamental difference from the mechanism used to generate suction in teleost fishes. Interestingly, pressure in the three cavities peaks in the posterior to anterior direction. The complex shape changes that the buccal cavity undergoes indicate that, as in teleosts, unsteady flow predominates during suction feeding. Several kinematic variables function together, with great variation over long gape cycles to

  10. Lack of agreement and trending ability of the endotracheal cardiac output monitor compared with thermodilution

    DEFF Research Database (Denmark)

    Møller-Sørensen, H; Hansen, K L; Ostergaard, M

    2012-01-01

    BACKGROUND: Minimally invasive monitoring systems of central haemodynamics are gaining increasing popularity. The present study investigated the precision of the endotracheal cardiac output monitor (ECOM) system and its agreement with pulmonary artery catheter thermodilution (PAC TD) for measuring...

  11. Long-term outcome of conventional endotracheal tube balloon dilation of tracheal stenosis in a dog

    OpenAIRE

    Kahane, Nili; Segev, Gilad

    2014-01-01

    This report describes a successful dilation of tracheal stenosis in a 16-year-old dog using a conventional endotracheal tube balloon. This technique should be considered as palliative treatment when owners decline other therapeutic options.

  12. Long-term outcome of conventional endotracheal tube balloon dilation of tracheal stenosis in a dog.

    Science.gov (United States)

    Kahane, Nili; Segev, Gilad

    2014-01-01

    This report describes a successful dilation of tracheal stenosis in a 16-year-old dog using a conventional endotracheal tube balloon. This technique should be considered as palliative treatment when owners decline other therapeutic options.

  13. Experience of monitoring the recurrent laryngeal nerve in thyroid surgery with endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Liang Feng

    2017-01-01

    Full Text Available Purpose:To analysis clinical experience of applying recurrent laryngeal monitoring endotracheal tube (NIM EMG Endotracheal Tube in the surgery of thyroid. Method: A retrospective analysis of 84 patients who underwent endotracheal intubation laryngeal nerve monitoring by thyroid surgery in the Chinese-Japanese Friendship Hospital of Jilin University from March to December in 2015. To summarize the experience of intubation with NIM EMG Endotracheal Tube. Result 77 (91.7%had initial intubation achievement in the 84 patients.FROM the 77 cases we had gotten s atisfactory nerve monitoring signal.Whereas there are 7 cases (8.3% appear abnormal EMG or signal missing, in the 7 cases there is one which being intubated too deep, 3 cases which being intubated too shallow and 3 cases with malrotation intubation.Conclusion: We got the satisfactory signals after adjust1ing the tube by using the visual laryngoscope.

  14. Real-time tracheal ultrasonography for confirmation of endotracheal tube placement during cardiopulmonary resuscitation.

    Science.gov (United States)

    Chou, Hao-Chang; Chong, Kah-Meng; Sim, Shyh-Shyong; Ma, Matthew Huei-Ming; Liu, Shih-Hung; Chen, Nai-Chuan; Wu, Meng-Che; Fu, Chia-Ming; Wang, Chih-Hung; Lee, Chien-Chang; Lien, Wan-Ching; Chen, Shyr-Chyr

    2013-12-01

    This study aimed to evaluate the accuracy of tracheal ultrasonography for assessing endotracheal tube position during cardiopulmonary resuscitation (CPR). We performed a prospective observational study of patients undergoing emergency intubation during CPR. Real-time tracheal ultrasonography was performed during the intubation with the transducer placed transversely just above the suprasternal notch, to assess for endotracheal tube positioning and exclude esophageal intubation. The position of trachea was identified by a hyperechoic air-mucosa (A-M) interface with posterior reverberation artifact (comet-tail artifact). The endotracheal tube position was defined as endotracheal if single A-M interface with comet-tail artifact was observed. Endotracheal tube position was defined as intraesophageal if a second A-M interface appeared, suggesting a false second airway (double tract sign). The gold standard of correct endotracheal intubation was the combination of clinical auscultation and quantitative waveform capnography. The main outcome was the accuracy of tracheal ultrasonography in assessing endotracheal tube position during CPR. Among the 89 patients enrolled, 7 (7.8%) had esophageal intubations. The sensitivity, specificity, positive predictive value, and negative predictive value of tracheal ultrasonography were 100% (95% confidence interval [CI]: 94.4-100%), 85.7% (95% CI: 42.0-99.2%), 98.8% (95% CI: 92.5-99.0%) and 100% (95% CI: 54.7-100%), respectively. Positive and negative likelihood ratios were 7.0 (95% CI: 1.1-43.0) and 0.0, respectively. Real-time tracheal ultrasonography is an accurate method for identifying endotracheal tube position during CPR without the need for interruption of chest compression. Tracheal ultrasonography in resuscitation management may serve as a powerful adjunct in trained hands. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Overcoming the problem of residual microbial contamination in dental suction units left by conventional disinfection using novel single component suction handpieces in combination with automated flood disinfection.

    Science.gov (United States)

    Boyle, M A; O'Donnell, M J; Russell, R J; Galvin, N; Swan, J; Coleman, D C

    2015-10-01

    Decontaminating dental chair unit (DCU) suction systems in a convenient, safe and effective manner is problematic. This study aimed to identify and quantify the extent of the problems using 25 DCUs, methodically eliminate these problems and develop an efficient approach for reliable, effective, automated disinfection. DCU suction system residual contamination by environmental and human-derived bacteria was evaluated by microbiological culture following standard aspiration disinfection with a quaternary ammonium disinfectant or alternatively, a novel flooding approach to disinfection. Disinfection of multicomponent suction handpieces, assembled and disassembled, was also studied. A prototype manual and a novel automated Suction Tube Cleaning System (STCS) were developed and tested, as were novel single component suction handpieces. Standard aspiration disinfection consistently failed to decontaminate DCU suction systems effectively. Semi-confluent bacterial growth (101-500 colony forming units (CFU) per culture plate) was recovered from up to 60% of suction filter housings and from up to 19% of high and 37% of low volume suction hoses. Manual and automated flood disinfection of DCU suction systems reduced this dramatically (ranges for filter cage and high and low volume hoses of 0-22, 0-16 and 0-14CFU/plate, respectively) (P<0.0001). Multicomponent suction handpieces could not be adequately disinfected without prior removal and disassembly. Novel single component handpieces, allowed their effective disinfection in situ using the STCS, which virtually eliminated contamination from the entire suction system. Flood disinfection of DCU suction systems and single component handpieces radically improves disinfection efficacy and considerably reduces potential cross-infection and cross-contamination risks. DCU suction systems become heavily contaminated during use. Conventional disinfection does not adequately control this. Furthermore, multicomponent suction handpieces

  16. Dielectric elastomer actuators for octopus inspired suction cups.

    Science.gov (United States)

    Follador, M; Tramacere, F; Mazzolai, B

    2014-09-25

    Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms.

  17. Octopus-like suction cups: from natural to artificial solutions.

    Science.gov (United States)

    Tramacere, F; Follador, M; Pugno, N M; Mazzolai, B

    2015-05-13

    Octopus suckers are able to attach to all nonporous surfaces and generate a very strong attachment force. The well-known attachment features of this animal result from the softness of the sucker tissues and the surface morphology of the portion of the sucker that is in contact with objects or substrates. Unlike artificial suction cups, octopus suckers are characterized by a series of radial grooves that increase the area subjected to pressure reduction during attachment. In this study, we constructed artificial suction cups with different surface geometries and tested their attachment performances using a pull-off setup. First, smooth suction cups were obtained for casting; then, sucker surfaces were engraved with a laser cutter. As expected, for all the tested cases, the engraving treatment enhanced the attachment performance of the elastomeric suction cups compared with that of the smooth versions. Moreover, the results indicated that the surface geometry with the best attachment performance was the geometry most similar to octopus sucker morphology. The results obtained in this work can be utilized to design artificial suction cups with higher wet attachment performance.

  18. Dielectric elastomer actuators for octopus inspired suction cups

    International Nuclear Information System (INIS)

    Follador, M; Tramacere, F; Mazzolai, B

    2014-01-01

    Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms. (paper)

  19. Turbulent flow with suction in smooth and rough pipes

    International Nuclear Information System (INIS)

    Verdier, Andre.

    1977-11-01

    It concerns an experimental study of turbulent flow inside a pipe with rough and porous wall and suction applied through it. The first part recall the basic knowledge concerning the turbulent flow with roughness. In second part statistical equations of fluid wall stress are written in the case of a permeable rough wall, in order to underline the respective role played by viscosity and pressure terms. In the third part the dynamic equilibrium of the flow is experimentally undertaken in the smooth and rough range with and without wall suction. Some empirical formulae are proposed for the mean velocity profiles in the inertial range and for friction velocity with suction. In the case of the sand roughness used, it does not seem that critical Reynolds number of transition from smooth to rough range is varied [fr

  20. Water born pollutants sampling using porous suction samples

    International Nuclear Information System (INIS)

    Baig, M.A.

    1997-01-01

    The common standard method of sampling water born pollutants in the vadoze zone is core sampling and it is followed by extraction of pore fluid. This method does not allow sampling at the same location next time and again later on. There is an alternative approach for sampling fluids (water born pollutants) from both saturated and unsaturated regions of vadose zone using porous suction samplers. There are three types of porous suction samplers, vacuum-operated, pressure-vacuum lysimeters, high pressure vacuum samples. The suction samples are operated in the range of 0-70 centi bars and usually consist of ceramic and polytetrafluorethylene (PTFE). The operation range of PTFE is higher than ceramic cups. These samplers are well suited for in situ and repeated sampling form the same location. This paper discusses the physical properties and operating condition of such samplers to the utilized under our environmental sampling. (author)

  1. Spinal cord electrophysiology II: extracellular suction electrode fabrication.

    Science.gov (United States)

    Garudadri, Suresh; Gallarda, Benjamin; Pfaff, Samuel; Alaynick, William

    2011-02-20

    Development of neural circuitries and locomotion can be studied using neonatal rodent spinal cord central pattern generator (CPG) behavior. We demonstrate a method to fabricate suction electrodes that are used to examine CPG activity, or fictive locomotion, in dissected rodent spinal cords. The rodent spinal cords are placed in artificial cerebrospinal fluid and the ventral roots are drawn into the suction electrode. The electrode is constructed by modifying a commercially available suction electrode. A heavier silver wire is used instead of the standard wire given by the commercially available electrode. The glass tip on the commercial electrode is replaced with a plastic tip for increased durability. We prepare hand drawn electrodes and electrodes made from specific sizes of tubing, allowing consistency and reproducibility. Data is collected using an amplifier and neurogram acquisition software. Recordings are performed on an air table within a Faraday cage to prevent mechanical and electrical interference, respectively.

  2. MAXIMUM AIR SUCTION INTO HORIZONTAL OPEN ENDED CYLINDRICAL LOUVERED PIPE

    Directory of Open Access Journals (Sweden)

    SAMEER RANJAN SAHU

    2017-02-01

    Full Text Available The main approach behind the present numerical investigation is to estimate the mass flow rate of air sucked into a horizontal open-ended louvered pipe from the surrounding atmosphere. The present numerical investigation has been performed by solving the conservation equations for mass, momentum and energy along with two equation based k-ɛ model for a louvered horizontal cylindrical pipe by finite volume method. It has been found from the numerical investigation that mass suction rate of air into the pipe increases with increase in louvered opening area and the number of nozzles used. Keeping other parameters fixed, for a given mass flow rate there exists an optimum protrusion of nozzle for highest mass suction into the pipe. It was also found from the numerical investigation that increasing the pipe diameter the suction mass flow rate of air was increased.

  3. INCOMPRESSIBLE LAMINAR BOUNDARY LAYER CONTROL BY BLOWING AND SUCTION

    Directory of Open Access Journals (Sweden)

    AZZEDINE NAHOUI

    2013-12-01

    Full Text Available A two-dimensional incompressible laminar boundary layer and its control using blowing and suction over a flat plate and around the NACA 0012 and 661012 profiles, is studied numerically. The study is based on the Prandtl boundary layer model using the finite differences method and the Crank-Nicolson scheme. The velocity distribution, the boundary layer thickness and the friction coefficient, are determined and presented with and without control. The application of the control technique, has demonstrated its positive effect on the transition point and the friction coefficient. Both control procedures are compared for different lengths, speeds and angles of blowing and suction.

  4. Pad for holding a load against a surface by suction

    International Nuclear Information System (INIS)

    Farmer, R.C.; Goldsmith, H.A.; Proudlove, M.J.

    1981-01-01

    This invention concerns suction pads for supporting loads. Specifically, the suction pad is part of a pair of pads located at the ends of a bridge forming a vehicle for transporting instruments for the non-destructive testing of a large vessel intended to contain a fuel assembly for a nuclear reactor immersed in a liquid metal coolant. For example, the vehicle is of the type described in the French patent application filed this day under the heading 'Vehicle for transporting instruments for testing against a wall' [fr

  5. Device for the prehension by means of suction cups

    International Nuclear Information System (INIS)

    Gabillet, Maurice

    1980-01-01

    The difficulties encountered while utilising suction-cups, are mainly caused by the skirts. The skirts are more or less adaptable to the surface of the objects to be handled. The skirt of the device presented, is made out of a round supple elastic bag containing solid particles. By creating a vacuum in the bag, the particles become a solid entity. The bag filled with the particles becomes rigid and can take exactly the shape of the object to be lifted. By creating a second vacuum in the axis of the bag, the object can be lifted. Several suction-cups can be used simultaneously

  6. Ultrasonography for Proper Endotracheal Tube Placement Confirmation in Out-of-hospital Cardiac Arrest Patients: Two-center Experience

    Directory of Open Access Journals (Sweden)

    Jen-Tang Sun

    2014-06-01

    Conclusion: Real-time tracheal ultrasonography is an accurate method for identifying endotracheal tube position during cardiopulmonary resuscitation without the need for interruption of chest compression.

  7. The use of suction blisters to measure sunscreen protection against UVR-induced DNA damage.

    Science.gov (United States)

    Josse, Gwendal; Douki, Thierry; Le Digabel, Jimmy; Gravier, Eleonore; Questel, Emmanuel

    2018-02-01

    The formation of DNA photoproducts caused by solar UVR exposure needs to be investigated in-vivo and in particular in order to assess sunscreens' level of protection against solar genotoxicity. The study's purposes were: i) to evaluate if the roof of suction blisters is an appropriate sampling method for measuring photoproducts, and ii) to measure in-vivo sunscreen protection against cyclobutane pyrimidine dimers. Skin areas on the interior forearms of eight healthy volunteers were exposed in-vivo to 2 MED of simulated solar radiation (SSR) and to 15 MED on a sunscreen protected area. After irradiation, six suction blisters were induced and the blister roofs were collected. Analysis of SSR-induced CPDs was performed by two independent methods: a chromatography coupled to mass spectroscopy (HPLC-MS/MS) approach and a 3D-imaging of CPD immunostaining by multiphoton microscopy on floating epidermal sheets. HPLC-MS/MS analyses showed that SSR-unexposed skin presented no CPD dimers, whereas 2 MED SSR-exposed skin showed a significant number of TT-CPD. The sunscreen covered skin exposed to 15 MED appeared highly protected from DNA damage, as the amount of CPD-dimers remained below the detection limit. The multiphoton-immunostaining analysis consistently showed that no CPD staining was observed on the non-SSR-exposed skin. A significant increase of CPD staining intensity and number of CPD-positive cells were observed on the 2 MED SSR-exposed skin. Sunscreen protected skin presented a very low staining intensity and the number of CPD-positive cells remained very close to non-SSR-exposed skin. This study showed that suction blister samples are very appropriate for measuring CPD dimers in-vivo, and that sunscreens provide high protection against UVR-induced DNA damage. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Radon Sub-slab Suctioning System Integrated in Insulating Layer

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2013-01-01

    This poster presents a new radon sub-slab suctioning system. This system makes use of a grid of horizontal pressurised air ducts located within the lower part of the rigid insulation layer of the ground floor slab. For this purpose a new system of prefabricated lightweight elements is introduced...

  9. 21 CFR 878.5040 - Suction lipoplasty system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suction lipoplasty system. 878.5040 Section 878.5040 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Classification. Class II (special controls). Consensus standards and labeling restrictions. [63 FR 7705, Feb. 17...

  10. Suction blister lesions and epithelialization monitored by optical coherence tomography

    DEFF Research Database (Denmark)

    Ahlström, M G; Gjerdrum, L M R; Larsen, H F

    2018-01-01

    suction blister was raised on each buttock, and the blister roof was excised. Lesions were covered with moisture-retaining dressing. In Study 1, the lesions were OCT-scanned on day 0 (D0), D2 and D4 and excised for histological examination. In Study 2, the progress of epithelialization and skin barrier...

  11. Improved Suction Technique for the Characterization of Construction Materials

    DEFF Research Database (Denmark)

    Thygesen, Lisbeth Garbrecht; Hansen, Kurt Kielsgaard

    2007-01-01

    The suction technique is a method from soil science that is used for the study of moisture storage capacity in porous construction materials at high relative humidity levels (above approximately 93%). The samples to be studied are placed in a pressurized container (an extractor) on a water...

  12. 21 CFR 878.4780 - Powered suction pump.

    Science.gov (United States)

    2010-04-01

    ...) Identification. A powered suction pump is a portable, AC-powered or compressed air-powered device intended to be used to remove infectious materials from wounds or fluids from a patient's airway or respiratory support system. The device may be used during surgery in the operating room or at the patient's bedside...

  13. Tube suction test for evaluating durability of cementitiously stabilized soils.

    Science.gov (United States)

    2011-06-01

    In a comprehensive laboratory study, different tests namely, unconfined compressive strength (UCS) at the end of freeze-thaw/wet-dry (F-T/W-D) cycles, resilient modulus (Mr) at the end of F-T/W-D cycles, vacuum saturation, tube suction, and moisture ...

  14. Tube suction test for evaluating durability of cementitiously stabilized soils.

    Science.gov (United States)

    2011-06-01

    In a comprehensive laboratory study, different tests namely, unconfined compressive strength (UCS) at the end of freeze-thaw/wet-dry (FT/ : W-D) cycles, resilient modulus (Mr) at the end of F-T/W-D cycles, vacuum saturation, tube suction, and moistur...

  15. 18-gauge needle cap as adjunct to prevent kinking of endotracheal tube.

    Science.gov (United States)

    Chan, Fuan Chiang; Kawamoto, Henry K; Bradley, James P

    2012-11-01

    A self-retaining Dingman mouth retractor is widely used to keep the mouth open during cleft palate and intraoral surgery. The airway is at risk of being crushed or occluded as the gag (tongue plate) of the Dingman mouth retractor is being pushed against the endotracheal tube.Kinking of the endotracheal tube between the teeth and Dingman mouth retractor has been reported even with the oral Ring-Adair-Elwyn or flexometallic or armored endotracheal tubes. To minimize kinking of the endotracheal tube and its consequent complications, we routinely insert an 18-gauge needle cap at the potential space between the teeth and the tongue plate (gag) of the Dingman mouth retractor, which is situated lateral to the endotracheal tube. In our experience of approximately 5000 intraoral cases using a Dingman mouth retractor and 18-gauge needle cap, we have not had any tooth avulsion or aspiration of the 18-gauge foreign body while maintaining a consistent and secured airway during cleft palate and intraoral surgery.

  16. New approach to the suction force at the leading edge of a profile with zero thickness

    NARCIS (Netherlands)

    Sparenberg, JA; de Jager, EM

    2004-01-01

    This paper considers the suction force at the leading edge of a profile with zero thickness in an incompressible and inviscid fluid flow. The theory is linear, and the approach to the suction force is from the innerside of the profile. It is shown that the suction force can be considered as an

  17. Tracheal palpation to assess endotracheal tube depth: an exploratory study.

    Science.gov (United States)

    McKay, William P; Klonarakis, Jim; Pelivanov, Vladko; O'Brien, Jennifer M; Plewes, Chris

    2014-03-01

    Correct placement of the endotracheal tube (ETT) occurs when the distal tip is in mid-trachea. This study compares two techniques used to place the ETT at the correct depth during intubation: tracheal palpation vs placement at a fixed depth at the patient's teeth. With approval of the Research Ethics Board, we recruited American Society of Anesthesiologists physical status I-II patients scheduled for elective surgery with tracheal intubation. Clinicians performing the tracheal intubations were asked to "advance the tube slowly once the tip is through the cords". An investigator palpated the patient's trachea with three fingers spread over the trachea from the larynx to the sternal notch. When the ETT tip was felt in the sternal notch, the ETT was immobilized and its position was determined by fibreoptic bronchoscopy. The position of the ETT tip was compared with our hospital standard, which is a depth at the incisors or gums of 23 cm for men and 21 cm for women. The primary outcome was the incidence of correct placement. Correct placement of the ETT was defined as a tip > 2.5 cm from the carina and > 3.5 cm below the vocal cords. Movement of the ETT tip was readily palpable in 77 of 92 patients studied, and bronchoscopy was performed in 85 patients. Placement by tracheal palpation resulted in more correct placements (71 [77%]; 95% confidence interval [CI] 74 to 81) than hospital standard depth at the incisors or gums (57 [61%]; 95% CI 58 to 66) (P = 0.037). The mean (SD) placement of the ETT tip in palpable subjects was 4.1 (1.7) cm above the carina, 1.9 cm (1.5-2.3 cm) below the ideal mid-tracheal position. Tracheal palpation requires no special equipment, takes only a few seconds to perform, and may improve ETT placement at the correct depth. Further studies are warranted.

  18. A Novel Artificial Intelligence System for Endotracheal Intubation.

    Science.gov (United States)

    Carlson, Jestin N; Das, Samarjit; De la Torre, Fernando; Frisch, Adam; Guyette, Francis X; Hodgins, Jessica K; Yealy, Donald M

    2016-01-01

    Adequate visualization of the glottic opening is a key factor to successful endotracheal intubation (ETI); however, few objective tools exist to help guide providers' ETI attempts toward the glottic opening in real-time. Machine learning/artificial intelligence has helped to automate the detection of other visual structures but its utility with ETI is unknown. We sought to test the accuracy of various computer algorithms in identifying the glottic opening, creating a tool that could aid successful intubation. We collected a convenience sample of providers who each performed ETI 10 times on a mannequin using a video laryngoscope (C-MAC, Karl Storz Corp, Tuttlingen, Germany). We recorded each attempt and reviewed one-second time intervals for the presence or absence of the glottic opening. Four different machine learning/artificial intelligence algorithms analyzed each attempt and time point: k-nearest neighbor (KNN), support vector machine (SVM), decision trees, and neural networks (NN). We used half of the videos to train the algorithms and the second half to test the accuracy, sensitivity, and specificity of each algorithm. We enrolled seven providers, three Emergency Medicine attendings, and four paramedic students. From the 70 total recorded laryngoscopic video attempts, we created 2,465 time intervals. The algorithms had the following sensitivity and specificity for detecting the glottic opening: KNN (70%, 90%), SVM (70%, 90%), decision trees (68%, 80%), and NN (72%, 78%). Initial efforts at computer algorithms using artificial intelligence are able to identify the glottic opening with over 80% accuracy. With further refinements, video laryngoscopy has the potential to provide real-time, direction feedback to the provider to help guide successful ETI.

  19. Investigation on creep behavior of geo-materials with suction control technique

    Directory of Open Access Journals (Sweden)

    Nishimura Tomoyoshi

    2016-01-01

    Full Text Available The compacted bentonite which has typical couple problem associated to thermal - hydration - mechanical – chemical (THMC consist of one component of engineered barrier. Recently, the couple THMC formulation modelling suggested by some researchers can be predicted basically phenomena for engineered barrier that approach to correct evaluate satisfied facilities. The compacted bentonite is essentially unsaturated condition, some behaviors for bentonite has similar or close with generally expansive unsaturated soils. Therefore, hydrations have given significant influence on deformation of compacted bentonite such as swelling. There are many researches for swelling behavior of compacted bentonite within soaking. Extended theoretical or experimental investigations for unsaturated soil mechanics are possible to describe the strength-deformation behavior of compacted bentonite with suction controlling principle. A new method of determining the failure phase such as great axis deformation and destructions like strip of surface in the laboratory is described and the creep behavior of compacted bentonite is considered under maintain of high relative humidity environment. The creep deformation measured using improved cyclic relative humidity control apparatus in terms of specific suction control technique.

  20. Whistle from Afar: A Case of Endotracheal Metastasis in Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Bitoti Chattopadhyay

    2012-01-01

    Full Text Available Endotracheal metastasis is a rare situation, usually associated with malignancies of breast and gastrointestinal tract, specially colon. Papillary carcinoma of thyroid commonly disseminates through lymphatic channels and tracheal involvement through vascular route is rarely reported. Here, we report a case of tracheal metastasis from papillary carcinoma of thyroid. The patient responded to external beam radiation therapy with cobalt 60 beams in a dose of 44 Gy followed by a 16 Gy boost. The patient is under followup and is presently asymptomatic. This paper adds to the repertoire of evidence in treatment of endotracheal metastasis.

  1. Complete Obstruction of Endotracheal Tube in an Infant with a Retropharyngeal and Anterior Mediastinal Abscess

    Directory of Open Access Journals (Sweden)

    Dennis B. Thapa

    2017-01-01

    Full Text Available Intraoperative ventilatory failure is not an uncommon complication; however, acute endotracheal obstruction by a foreign body or blood clot can be difficult to quickly discriminate from other causes. Once the diagnosis is made, quick action is needed to restore ventilation. The ultimate solution is to exchange the endotracheal tube; however, there can be other ways of resolving this in situations where reintubation would be difficult or unsafe. This case report discusses such an event in an infant with multiple airway challenges including a retropharyngeal and anterior mediastinal abscess. We have also formulated a pathway based on various case reports involving complete ETT obstruction.

  2. Complete Obstruction of Endotracheal Tube in an Infant with a Retropharyngeal and Anterior Mediastinal Abscess.

    Science.gov (United States)

    Thapa, Dennis B; Greene, Nathaniel H; Udani, Andrea G

    2017-01-01

    Intraoperative ventilatory failure is not an uncommon complication; however, acute endotracheal obstruction by a foreign body or blood clot can be difficult to quickly discriminate from other causes. Once the diagnosis is made, quick action is needed to restore ventilation. The ultimate solution is to exchange the endotracheal tube; however, there can be other ways of resolving this in situations where reintubation would be difficult or unsafe. This case report discusses such an event in an infant with multiple airway challenges including a retropharyngeal and anterior mediastinal abscess. We have also formulated a pathway based on various case reports involving complete ETT obstruction.

  3. On equations for the total suction and its matric and osmotic components

    International Nuclear Information System (INIS)

    Dao, Vinh N.T.; Morris, Peter H.; Dux, Peter F.

    2008-01-01

    A clear fundamental understanding of suctions is crucial for the study of the behaviour of plastic cement mortar and concrete, including plastic shrinkage cracking. In this paper, the expression relating the change in free energy of the pore water with an isothermal change in pressure is first derived. Based upon definitions of suctions, it is then shown that total, matric, and osmotic suctions can all be expressed in the same thermodynamic form. The widely accepted, but not yet satisfactorily validated, assumption that the total suction comprises matric and osmotic components is then confirmed theoretically. The well-known Kelvin equation for matric suction, and Morse and van't Hoff equations for osmotic suction are subsequently derived from the corresponding thermodynamic equations. The applicability of latter two equations in evaluating the osmotic suctions of cement mortar and concrete is highlighted

  4. Evaluation of Endotracheal Tube Scraping on Airway Resistance.

    Science.gov (United States)

    Scott, J Brady; Dubosky, Meagan N; Vines, David L; Sulaiman, Adewunmi S; Jendral, Kyle R; Singh, Gagan; Patel, Ankeet; Kaplan, Carl A; Gurka, David P; Balk, Robert A

    2017-11-01

    Spontaneous breathing trials (SBTs) are used to assess the readiness for discontinuation of mechanical ventilation. When airway resistance (R aw ) is elevated, the imposed work of breathing can lead to prolongation of mechanical ventilation. Biofilm and mucus build-up within the endotracheal tube (ETT) can increase R aw . Scraping the ETT can remove the biofilm build-up and decrease mechanical R aw . The primary aim of this study was to evaluate the impact of ETT scraping on R aw . The secondary aim was to determine whether decreasing R aw would impact subsequent SBT success. Intubated, mechanically ventilated subjects were enrolled if they failed an SBT and had an R aw of > 10 cm H 2 O/L/s. SBT failure was based on institutional guidelines, and R aw was calculated by subtracting the difference between the measured peak and plateau pressures using a square flow waveform with an inspiratory flow set at 60 L/min. The endOclear device was inserted into the ETT and withdrawn per manufacturer's guidelines. Scraping was repeated until the ETT was cleared. Change in R aw was compared pre- and post-ETT scraping using a paired t test. A Mann-Whitney U test evaluated the difference in percentage change in R aw between SBT groups. Twenty-nine subjects completed the study. The mean pre- and post-ETT scraping R aw values were 15.17 ± 3.83 and 12.05 ± 3.19 cm H 2 O/L/s, respectively ( P < .001). Subsequent SBT success was 48%; however, there was no difference in percentage change in R aw between subsequent passed SBT (18.61% [interquartile range 8.90-33.93%]) and failed SBT (23.88% [interquartile range 0.00-34.80%]), U = 78.5, z = -0.284, P = .78. No adverse events were noted with ETT scraping. This study demonstrated that ETT scraping can reduce R aw . The decrease in R aw post-ETT scraping did not affect subsequent SBT success. Copyright © 2017 by Daedalus Enterprises.

  5. Safety System for Controlling Fluid Flow into a Suction Line

    Science.gov (United States)

    England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)

    2018-01-01

    A safety system includes a sleeve fitted within a pool's suction line at its inlet. The sleeve terminates with a plate that resides within the suction line. The plate has holes formed therethrough. A housing defining distinct channels is fitted in the sleeve so that the distinct channels lie within the sleeve. Each of the distinct channels has a first opening on one end thereof and a second opening on another end thereof. The second openings reside in the sleeve. The first openings are in fluid communication with the water in the pool, and are distributed around a periphery of an area of the housing that prevents coverage of all the first openings when a human interacts therewith. A first sensor is coupled to the sleeve to sense pressure therein, and a second pressure sensor is coupled to the plate to sense pressure in one of the plates' holes.

  6. External Suction and Fluid Output in Chest Drains After Lobectomy

    DEFF Research Database (Denmark)

    Lijkendijk, Marike; Neckelmann, Kirsten; Licht, Peter B

    2018-01-01

    influences the amount of fluid. METHODS: We randomly assigned (1:1) 106 patients who underwent lobectomy to either low (-5 cm H2O) or high (-20 cm H2O) external suction using an electronic chest drainage system. Only one chest drain was allowed, and we used strict algorithms for chest drain removal, which...... was delegated to staff nurses: air leakage less than 20 mL/min for 6 hours regardless of fluid output, provided it was serous. The primary end point was fluid output after 24 and 48 hours. RESULTS: Mean fluid output was significantly higher with high suction after both 24 (338 ± 265 mL versus 523 ± 215 m...

  7. The application of suction caisson technology to offshore wind turbines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-09-15

    A mathematical model describing the behaviour of caisson foundations for offshore wind turbines has been developed. The model has been verified and calibrated through laboratory and field work. Simultaneously, conceptual designs of wind turbine foundations incorporating suction caissons were studied using the same model. It was concluded that much of the seabed around Britain is well suited to the use of caissons and monopod and quadropod structures are superior to tripods. Although suction caissons are vulnerable to scour, rock dumping can largely eliminate this potential problem. The next phase will be to install a fully instrumented full-scale prototype to monitor the effects of wind and waves. The main contractor was SLP Engineering Limited and about 75 per cent of the funding came from the DTI.

  8. Review of pump suction reducer selection: Eccentric or concentric reducers

    OpenAIRE

    Mahaffey, R M; van Vuuren, S J

    2014-01-01

    Eccentric reducers are traditionally recommended for the pump suction reducer fitting to allow for transportation of air through the fitting to the pump. The ability of a concentric reducer to provide an improved approach flow to the pump while still allowing air to be transported through the fitting is investigated. Computational fluid dynamics (CFD) were utilised to analyse six concentric and six eccentric reducer geometries at four different inlet velocities to determine the flow velocity ...

  9. INCOMPRESSIBLE LAMINAR BOUNDARY LAYER CONTROL BY BLOWING AND SUCTION

    OpenAIRE

    AZZEDINE NAHOUI; LAKHDAR BAHI

    2013-01-01

    A two-dimensional incompressible laminar boundary layer and its control using blowing and suction over a flat plate and around the NACA 0012 and 661012 profiles, is studied numerically. The study is based on the Prandtl boundary layer model using the finite differences method and the Crank-Nicolson scheme. The velocity distribution, the boundary layer thickness and the friction coefficient, are determined and presented with and without control. The application of the control technique, has de...

  10. Modelling suction instabilities in soils at varying degrees of saturation

    Directory of Open Access Journals (Sweden)

    Buscarnera Giuseppe

    2016-01-01

    Full Text Available Wetting paths imparted by the natural environment and/or human activities affect the state of soils in the near-surface, promoting transitions across different regimes of saturation. This paper discusses a set of techniques aimed at quantifying the role of hydrologic processes on the hydro-mechanical stability of soil specimens subjected to saturation events. Emphasis is given to the mechanical conditions leading to coupled flow/deformation instabilities. For this purpose, energy balance arguments for three-phase systems are used to derive second-order work expressions applicable to various regimes of saturation. Controllability analyses are then performed to relate such work input with constitutive singularities that reflect the loss of strength under coupled and/or uncoupled hydro-mechanical forcing. A suction-dependent plastic model is finally used to track the evolution of stability conditions in samples subjected to wetting, thus quantifying the growth of the potential for coupled failure modes upon increasing degree of saturation. These findings are eventually linked with the properties of the field equations that govern pore pressure transients, thus disclosing a conceptual link between the onset of coupled hydro-mechanical failures and the evolution of suction with time. Such results point out that mathematical instabilities caused by a non-linear suction dependent behaviour play an important role in the advanced constitutive and/or numerical tools that are commonly used for the analysis of geomechanical problems in the unsaturated zone, and further stress that the relation between suction transients and soil deformations is a key factor for the interpretation of runaway failures caused by intense saturation events.

  11. Modulation method of scroll compressor based on suction gas bypass

    International Nuclear Information System (INIS)

    Wang Baolong; Han Linjun; Shi Wenxing; Li Xianting

    2012-01-01

    The air conditioners and heat pumps tend to work in much mild environments and part load situations rather than provide the rated full capacity under severe rated testing conditions. Both the capacity and inner compression ratio of the compressor should be regulated according to the working condition for higher energy efficiency and occupants’ comfort. A potential modulating technology of the scroll compressor, suction gas bypass, is investigated in this paper. The principle and operation method are illuminated and the adaptability is validated by experiments and simulations. As a conclusion, an appropriate suction gas bypass can reduce the inner compression loss of the scroll compressor under over compression conditions, enhance the system COP and also largely decrease the heating/cooling capacity of the refrigeration/heat pump system. - Highlights: ► Suction gas bypass (SGB) is an effective regulating method of scroll compressor. ► SGB reduces the inner compression loss under over compression conditions. ► SGB largely decreases the heating/cooling capacity of the refrigeration system.

  12. Primary Total Knee Replacement: Is Suction a Portal of Infection?

    Science.gov (United States)

    Budnar, Vijaya M; Amirfeyz, Rouin; Ng, Michael; Bannister, Gordon C; Blom, Ashley W

    2009-01-01

    INTRODUCTION Pulsed lavage during a total knee replacement usually leaves a pool of fluid on the surgical drapes. It is common practice to suck away this fluid using the same suction device used intra-operatively. This could be a cause of direct wound contamination. We hypothesised that bacteria contaminate fluid that collects around the foot in total knee replacement surgery and that suction equipment could be a portal of contamination. We also hypothesised that bacterial count in the fluid is lower if chlorhexidine, rather than saline, is used in the pulsed lavage. PATIENTS AND METHODS Forty patients undergoing primary total knee replacement were divided into two groups. The first group had pulsed lavage with normal saline and the second with 0.05% chlorhexidine. RESULTS At the end of the operation, 20 ml of fluid, pooled on the surgical drapes was aspirated and cultured for bacterial growth. None of the fluid samples showed bacterial growth. CONCLUSIONS Suction device used peri-operatively during knee replacement is unlikely to be a cause of wound contamination. Pulsed lavage with normal saline is as effective as lavage with chlorhexidine. PMID:19335972

  13. Reliable site for suction blister induction and harvesting

    Directory of Open Access Journals (Sweden)

    Laxmisha Chandrashekar

    2005-01-01

    Full Text Available Background: Suction blister grafting is a useful modality of treatment of patients with resistant and stable vitiligo. However, there have been no detailed studies to find out the best donor site for blister formation. Methods: The study was conducted between the period of October 2004 and February 2005 in the dermatology department at a tertiary care center. Nine patients with vitiligo (focal vitiligo, 3; mucosal vitiligo, 2; acrofacial vitiligo, 2; vitiligo vulgaris, 1; and segmental vitiligo, 1 were selected for blister harvesting and grafting. The blisters were raised using the method described by Gupta et al. Results: Suction blisters were attempted to be raised at 52 sites, but only 38 blisters could be raised, 24 complete and 14 incomplete. Blisters were raised in all the three cases on the flexor aspect of the arm (100%, 15 of 17 cases (88.2% on the flexor aspect of the forearm, 4 of 5 cases (80% on the abdomen, 11 of 16 cases (68.7% on the anterolateral thigh, and less frequently over leg or foot. Complete blisters were formed in 13/15 cases (86.6% on the flexor aspect of the forearm, 6/11 cases (54.5% on the anterolateral thigh, and in all cases over leg. Conclusion: The flexor aspect of the forearm is a good site for suction blister harvesting.

  14. Sphingosine Prevents Bacterial Adherence to Endotracheal Tubes: A Novel Mechanism to Prevent Ventilator-Associated Pneumonia

    Science.gov (United States)

    2016-06-21

    and resists the antimicrobial properties of the host defense” [9]. Bacterial adhesion is the first step in biofilm formation [10]; thus, prevention...ETTs. Future in vitro and animal studies are necessary to establish the safety of sphingolipid coatings, and future randomized clinical trials will...SUBJECT TERMS Ventilator-associated pneumonia, VAP, Gram-negative, bacteria, endotracheal tubes, sphingosine, antimicrobial coating 16. SECURITY

  15. SUPRAGLOTTIC JET VENTILATION VERSUS CONVENTIONAL ENDOTRACHEAL VENTILATION IN MINOR LARYNGEAL SURGERIES

    Directory of Open Access Journals (Sweden)

    Illendual Upendranath

    2016-08-01

    Full Text Available Any attempt at intubation will cause many cardiovascular responses and the major concern during this time is to attenuate the same. Similar response is seen during procedures on Larynx in microlaryngeal surgery which produces an intense cardiovascular stimulation during suspension laryngoscopy and intubation. AIM OF STUDY Supraglottic jet ventilation versus conventional endotracheal ventilation in minor laryngeal surgeries. To evaluate the haemodynamic response in supraglottic jet ventilation and conventional intubation in minor laryngeal surgeries. METHODS Patients were randomised to 2 Groups: 30 patients in each group; Group A - in whom supraglottic jet ventilation was planned and Group B - in whom endotracheal intubation was planned. RESULT The haemodynamic response in terms of increase in MAP and HR is significantly more with endotracheal intubation than with supraglottic jet ventilation. CONCLUSION Our study showed that supraglottic jet ventilation showed a better haemodynamic stability when compared to conventional endotracheal intubation in patients undergoing minor laryngeal surgeries. Statistical scores were also in favour of the patients treated with supraglottic jet ventilation based on the p values.

  16. Endotracheal temperature and humidity measurements in laryngectomized patients: intra- and inter-patient variability

    NARCIS (Netherlands)

    Scheenstra, R.J.; Muller, S.H.; Vincent, A.; Sinaasappel, M.; Zuur, J.K.; Hilgers, F.J.M.

    2009-01-01

    This study assesses intra- and inter-patient variability in endotracheal climate (temperature and humidity) and effects of heat and moister exchangers (HME) in 16 laryngectomized individuals, measured repeatedly (N = 47). Inhalation Breath Length (IBL) was 1.35 s without HME and 1.05 s with HME (P <

  17. Endotracheal temperature and humidity measurements in laryngectomized patients: intra- and inter-patient variability

    NARCIS (Netherlands)

    Scheenstra, R. J.; Muller, S. H.; Vincent, A.; Sinaasappel, M.; Zuur, J. K.; Hilgers, Frans J. M.

    2009-01-01

    This study assesses intra- and inter-patient variability in endotracheal climate (temperature and humidity) and effects of heat and moister exchangers (HME) in 16 laryngectomized individuals, measured repeatedly (N = 47). Inhalation Breath Length (IBL) was 1.35 s without HME and 1.05 s with HME (P

  18. Distribution of endotracheally instilled surfactant protein SP-C in lung-lavaged rabbits.

    NARCIS (Netherlands)

    Bambang Oetomo, Sidarto; de Leij, Louis; Curstedt, T; ter Haar, J G; Schoots, Coenraad; Wildevuur, Charles; Okken, Albert

    In lung-lavaged surfactant-deficient rabbits (n = 6) requiring artificial ventilation, porcine surfactant was instilled endotracheally. This resulted in improvement of lung function so that the animals could be weaned off artificial ventilation. The animals were killed 4 1/2 h after surfactant

  19. Verification of endotracheal intubation in obese patients - temporal comparison of ultrasound vs. auscultation and capnography

    DEFF Research Database (Denmark)

    Pfeiffer, P; Bache, Stefan Holst; Isbye, D L

    2012-01-01

    Ultrasound (US) may have an emerging role as an adjunct in verification of endotracheal intubation. Obtaining optimal US images in obese patients is generally regarded more difficult than for other patients. This study compared the time consumption of bilateral lung US with auscultation and capno...

  20. Management of dogs and cats with endotracheal tube tracheal foreign bodies

    Science.gov (United States)

    Nutt, Laura K.; Webb, Jinelle A.; Prosser, Kirsten J.; Defarges, Alice

    2014-01-01

    Two cats and 3 dogs were treated for an endotracheal tube tracheal foreign body (ETFB) during recovery from general anesthesia. Bronchoscopy was used to remove the ETFB. Animals were clinically normal at discharge. While rare, ETFB can occur upon recovery from anesthesia. Bronchoscopy is an effective way to remove ETFB. PMID:24891640

  1. Verification of endotracheal intubation in obese patients - temporal comparison of ultrasound vs. auscultation and capnography.

    Science.gov (United States)

    Pfeiffer, P; Bache, S; Isbye, D L; Rudolph, S S; Rovsing, L; Børglum, J

    2012-05-01

    Ultrasound (US) may have an emerging role as an adjunct in verification of endotracheal intubation. Obtaining optimal US images in obese patients is generally regarded more difficult than for other patients. This study compared the time consumption of bilateral lung US with auscultation and capnography for verifying endotracheal intubation in obese patients. A prospective, paired and investigator-blinded study performed in the operating theatre. Twenty-four adult patients requiring endotracheal intubation for bariatric surgery were included. During post-intubation bag ventilation, bilateral lung US was performed for detection of lungsliding indicating lung ventilation simultaneous with capnography and auscultation of epigastrium and chest. Primary outcome measure was the time difference to confirmed endotracheal intubation between US and auscultation alone. The secondary outcome measure was time difference between US and auscultation combined with capnography. Both methods verified endotracheal tube placement in all patients. No significant difference was found between US compared with auscultation alone. Median time for verification by auscultation alone was 47.5 s [interquartile (IQR) 40-51 s], with a mean difference of -0.3 s in favor of US (95% confidence interval -3.5-2.9 s) P = 0.87. Comparing US with the combination of auscultation and capnography, there was a significant difference between the two methods. Median time for verification by US was 43 s (IQR 40-51 s) vs. 55 s (IQR 46-65 s), P auscultation alone and faster than the standard method of auscultation and capnography. © 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.

  2. [The role of endotracheal aspiration in the diagnosis of ventilator associated pneumonia].

    Science.gov (United States)

    Gürgün, Alev; Korkmaz Ekren, Pervin; Bacakoğlu, Feza; Başoğlu, Ozen Kaçmaz; Dirican, Nigar; Aydemir, Şöhret; Nart, Deniz; Sayıner, Abdullah

    2013-01-01

    Ventilator associated pneumonia (VAP) is one of the most important causes of mortality in patients treated with invasive mechanical ventilation (IMV) in intensive care unit (ICU). Microbiological examinations are required as clinical and radiological findings are usually insufficient in the diagnosis. Twenty four patients who were receiving IMV because of respiratory failure, had a Clinical Pulmonary Infection Score (CPIS) of ≥ 6 in the follow-up and died with the suspicion of VAP were enrolled in our study. Six patients were excluded as post-mortem biopsy could not be performed. The patients who had pre-mortem CPIS ≥ 6, in whom a causative organism was identified from the culture of post-mortem lung biopsy and/or histopathological examination of lung biopsy was compatible with pneumonia were diagnosed as VAP. In the 18 patients in whom a post-mortem lung biopsy was performed, quantitative culture results of endotracheal aspirate performed 48 hours prior to death were compared with microbiological and histopathological results of post-mortem lung biopsy specimens, and the role of endotracheal aspirate in the diagnosis of VAP was evaluated retrospectively. Out of 18 patients (12 men, mean age 67.0 ± 13.0 years) included in the study, 11 (61.1%) were diagnosed as VAP. The quantitative culture of endotracheal aspirate was positive in 9 (81.8%) out of 11 patients diagnosed as VAP. The sensitivity, specificity, positive and negative predictive values of endotracheal aspirate culture for identifying VAP were found to be 81.8%, 14.3%, 60.0% and 33.3%, respectively. Our study shown that quantitative culture of endotracheal aspirate is a practical and reliable method that can be used for the diagnosis of VAP in patients receiving IMV in ICU and having CPIS ≥ 6.

  3. Seepage Study for Suction Installation of Bucket Foundation in Different Soil Combinations

    DEFF Research Database (Denmark)

    Koteras, Aleksandra Katarzyna; Ibsen, Lars Bo; Clausen, Johan Christian

    2016-01-01

    Research has proven the bucket foundation to be a feasible and an attractive solution for offshore wind turbines. Its potential derives partly from the cost-effectiveness due to the suction-assisted installation. The suction applied under the bucket lid produces a downward driving force and addit......Research has proven the bucket foundation to be a feasible and an attractive solution for offshore wind turbines. Its potential derives partly from the cost-effectiveness due to the suction-assisted installation. The suction applied under the bucket lid produces a downward driving force...... around the bucket skirt. The exceedance of critical suction might lead to installation failure due to formation of piping channels, which break the hydraulic seal between the skirt and soil. The excess pore pressure arising due to applied suction changes the effective stress, hence the penetration...

  4. Comparative study of the characteristics of some suction devices for gas sampling applications

    International Nuclear Information System (INIS)

    Donguy, R.; Drouet, J.

    1959-06-01

    Gas sampling (used to determine the characteristics of dusts or aerosols contained in a gas) needs a suction device. In order to select the right device and the right conditions of use, the characteristics and performances of various suction devices (helicoidal and centrifugal aspirators, air pumps, volumetric pumps) have been experimentally measured: flow rate, head loss, sampling volume and duration, aerosol and dust concentration, gas density, nature of the gas, suction circuit configuration, etc

  5. Characterization of zebrafish larvae suction feeding flow using μPIV and optical coherence tomography

    OpenAIRE

    Pekkan, Kerem; Uslu, Fazıl E.; Chang, Brain; Mani, Karthick; Chen, Chia-Yuan; Holzman, Roi

    2016-01-01

    The hydrodynamics of suction feeding is critical for the survival of fish larvae; failure to capture food during the onset of autonomous feeding can rapidly lead to starvation and mortality. Fluid mechanics experiments that investigate the suction feeding of suspended particles are limited to adult fishes, which operate at large Reynolds numbers. This manuscript presents the first literature results in which the external velocity fields generated during suction feeding of early zebrafish larv...

  6. CFD Analysis of a Centrifugal Fan for Performance Enhancement using Converging Boundary Layer Suction Slots

    OpenAIRE

    K. Vasudeva Karanth; N. Yagnesh Sharma

    2009-01-01

    Generally flow behavior in centrifugal fan is observed to be in a state of instability with flow separation zones on suction surface as well as near the front shroud. Overall performance of the diffusion process in a centrifugal fan could be enhanced by judiciously introducing the boundary layer suction slots. With easy accessibility of CFD as an analytical tool, an extensive numerical whole field analysis of the effect of boundary layer suction slots in discrete regions ...

  7. Numerical Buckling Analysis of Large Suction Caissons for Wind Turbines on Deep Water

    DEFF Research Database (Denmark)

    Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo

    2013-01-01

    Using large suction caissons for offshore wind turbines is an upcoming cost-effective technology also referred to as bucket foundations. During operation, the monopod bucket foundation is loaded by a large overturning moment from the wind turbine and the wave loads. However, during installation...... the suction caisson is loaded by external pressure (internal suction) due to evacuation of water inside the bucket and vertical forces due to gravity. The risk of structural buckling during installation of large-diameter suction caissons is addressed using numerical methods. Initial imperfect geometries...

  8. Modification of Flow Structure Over a Van Model By Suction Flow Control to Reduce Aerodynamics Drag

    Directory of Open Access Journals (Sweden)

    Harinaldi Harinaldi

    2012-05-01

    Full Text Available Automobile aerodynamic studies are typically undertaken to improve safety and increase fuel efficiency as well as to  find new innovation in automobile technology to deal with the problem of energy crisis and global warming. Some car companies have the objective to develop control solutions that enable to reduce the aerodynamic drag of vehicle and  significant modification progress is still possible by reducing the mass, rolling friction or aerodynamic drag. Some flow  control method provides the possibility to modify the flow separation to reduce the development of the swirling structures around the vehicle. In this study, a family van is modeled with a modified form of Ahmed's body by changing the orientation of the flow from its original form (modified/reversed Ahmed body. This model is equipped with a suction on the rear side to comprehensively examine the pressure field modifications that occur. The investigation combines computational and experimental work. Computational approach used  a commercial software with standard k-epsilon flow turbulence model, and the objectives was  to determine the characteristics of the flow field and aerodynamic drag reduction that occurred in the test model. Experimental approach used load cell in order to validate the aerodynamic drag reduction obtained by computational approach. The results show that the application of a suction in the rear part of the van model give the effect of reducing the wake and the vortex formation. Futhermore, aerodynamic drag reduction close to 13.86% for the computational approach and 16.32% for the experimental have been obtained.

  9. Dynamic stiffness of suction caissons - torsion, sliding and rocking

    Energy Technology Data Exchange (ETDEWEB)

    Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars

    2006-12-15

    This report concerns the dynamic soil-structure interaction of steel suction caissons applied as foundations for offshore wind turbines. An emphasis is put on torsional vibrations and coupled sliding/rocking motion, and the influence of the foundation geometry and the properties of the surrounding soil is examined. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency-dependent coefficients corresponding to the different degrees of freedom. The dynamic stiffness coefficients for the skirted foundation are evaluated by means of a three-dimensional coupled boundary element/finite element model. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been carried out for different combinations of the skirt length and the Poisson's ratio of the subsoil. Finally, the high-frequency impedance has been determined for future use in lumped-parameter models of wind turbine foundations in aero-elastic codes. (au)

  10. The impact of soil suction variation on earthquake intensity indices

    Directory of Open Access Journals (Sweden)

    Biglari Mahnoosh

    2016-01-01

    Full Text Available Soil properties can completely change the ground motion characteristics as they travel from the bedrock to the surface because, soil as a low-pass filter, may amplify or deamplify seismic motions in some frequencies on the wave travelling path. Recent studies about the advanced unsaturated soil mechanics clearly shows that dynamic properties of soils, including small-strain shear modulus (Gmax, shear modulus reduction (G/Gmax, and damping ratio (D curves are affected by changes in the soil suction level. The current study present nonlinear time-dependent analysis of three different unsaturated soils available in the literature with different ranges of nonlinear behaviour that earlier have been studied on unsaturated dynamic models. Since, the earthquake intensity parameters can be used to describe the damage potential of an earthquake, the focus of this paper is to evaluate the impact of the suction variation on the engineering ground motion parameters, including peak values of strong motion, Vmax/Amax, root-mean-square acceleration, Arias intensity, characteristic intensity, cumulative absolute velocity, acceleration spectrum intensity, effective design acceleration, A95 parameter and predominant period separately under the near-field and the far-field seismicity categories.

  11. Temperature measurement in WTE boilers using suction pyrometers.

    Science.gov (United States)

    Rinaldi, Fabio; Najafi, Behzad

    2013-11-15

    The temperature of the flue-gas in the post combustion zone of a waste to energy (WTE) plant has to be maintained within a fairly narrow range of values, the minimum of which is prescribed by the European Waste Directive 2000/76/CE, whereas the maximum value must be such as to ensure the preservation of the materials and the energy efficiency of the plant. A high degree of accuracy in measuring and controlling the aforementioned temperature is therefore required. In almost the totality of WTE plants this measurement process is carried out by using practical industrial thermometers, such as bare thermocouples and infrared radiation (IR) pyrometers, even if affected by different physical contributions which can make the gas temperature measurements incorrect. The objective of this paper is to analyze errors and uncertainties that can arise when using a bare thermocouple or an IR pyrometer in a WTE plant and to provide a method for the in situ calibration of these industrial sensors through the use of suction pyrometers. The paper describes principle of operation, design, and uncertainty contributions of suction pyrometers, it also provides the best estimation of the flue-gas temperature in the post combustion zone of a WTE plant and the estimation of its expanded uncertainty.

  12. Temperature Measurement in WTE Boilers Using Suction Pyrometers

    Directory of Open Access Journals (Sweden)

    Fabio Rinaldi

    2013-11-01

    Full Text Available The temperature of the flue-gas in the post combustion zone of a waste to energy (WTE plant has to be maintained within a fairly narrow range of values, the minimum of which is prescribed by the European Waste Directive 2000/76/CE, whereas the maximum value must be such as to ensure the preservation of the materials and the energy efficiency of the plant. A high degree of accuracy in measuring and controlling the aforementioned temperature is therefore required. In almost the totality of WTE plants this measurement process is carried out by using practical industrial thermometers, such as bare thermocouples and infrared radiation (IR pyrometers, even if affected by different physical contributions which can make the gas temperature measurements incorrect. The objective of this paper is to analyze errors and uncertainties that can arise when using a bare thermocouple or an IR pyrometer in a WTE plant and to provide a method for the in situ calibration of these industrial sensors through the use of suction pyrometers. The paper describes principle of operation, design, and uncertainty contributions of suction pyrometers, it also provides the best estimation of the flue-gas temperature in the post combustion zone of a WTE plant and the estimation of its expanded uncertainty.

  13. Endotracheal intubation: application of virtual reality to emergency medical services education.

    Science.gov (United States)

    Mayrose, James; Myers, Jeffrey W

    2007-01-01

    Virtual reality simulation has been identified as an emerging educational tool with significant potential to enhance teaching of residents and students in emergency clinical encounters and procedures. Endotracheal intubation represents a critical procedure for emergency care providers. Current methods of training include working with cadavers and mannequins, which have limitations in their representation of reality, ethical concerns, and overall availability with access, cost, and location of models. This paper will present a human airway simulation model designed for tracheal intubation and discuss the aspects that lend itself to use as an educational tool. This realistic and dynamic model is used to teach routine intubations, while future models will include more difficult airway management scenarios. This work provides a solid foundation for future versions of the intubation simulator, which will incorporate two haptic devices to allow for simultaneous control of the laryngoscope blade and endotracheal tube.

  14. Comparison of expandable endotracheal stents in the treatment of surgically induced piglet tracheomalacia.

    Science.gov (United States)

    Mair, E A; Parsons, D S; Lally, K P; Van Dellen, A F

    1991-09-01

    Present surgical alternatives for pediatric tracheobronchomalacia are limited and associated with many potentially undesirable complications. The feasibility of different intraluminal expandable endotracheal stents for the treatment of surgically induced tracheomalacia was analyzed in 27 piglets. A potentially fatal tracheomalacia was surgically created. Either a stainless steel "zig-zag" stent or a woven polymeric stent was then implanted. Tracheal patency, mucosal function, histopathologic respiratory tract changes, and effects of the stent on esophageal motility were evaluated over a 16-week period. Piglets with steel stents uniformly experienced intense inflammation leading to tracheal dysfunction and death. Piglets with polymeric stents experienced minimal respiratory symptoms. Expandable polymeric endotracheal stents alleviate surgically induced piglet tracheomalacia, were easy to insert, allowed for tracheal growth, and reduced the need for high-risk surgical procedures with prolonged ventilatory support.

  15. Comparison of an Endotracheal Cardiac Output Monitor to a Pulmonary Artery Catheter

    Science.gov (United States)

    2017-12-04

    8217-’ ’ ,, Background In combat, initial resuscitation and life saving measures are in itiated by securing a patent airway and administering fluid therapy. Wh...ile methods of fluid resuscitation remain controversial , maintenance of a patent airway and hemodynamic stabi lity as indicated by invasive...monito ri ng can influence the overall outcome of an injured individual. A patent airway may be maintained via an endotracheal tube . The use of

  16. A Randomized Comparison of In-hospital Rescuer Positions for Endotracheal Intubation in a Difficult Airway

    OpenAIRE

    Le Parc, Joanna M.; Bischof, Jason J.; King, Andrew M.; Greenberger, Sarah; Way, David P.; Panchal, Ashish R.; Finnegan, Geoffrey I.; Terndrup, Thomas E.

    2018-01-01

    Introduction: Emergency endotracheal intubation (ETI) is a common and critical procedure performed in both prehospital and in-hospital settings. Studies of prehospital providers have demonstrated that rescuer position influences ETI outcomes. However, studies of in-hospital rescuer position for ETI are limited. While we adhere to strict standards for the administration of ETI, we posited that perhaps requiring in-hospital rescuers to stand for ETI is an obstacle to effectiveness. Our objectiv...

  17. The LMACTrach, a Aew Approach for Endotracheal Intubation: Apilot Study in 100 Patients Undergoing Elective Surgery

    OpenAIRE

    Valiollah Hassani; Maryam Zafarghandi; Mohammad Farhadi

    2010-01-01

    Backgroundand endotracheal intubation under direct vision in both anticipated and unexpecteddifficult intubation situations.: The LMA CTrach system is a new device for airway managementMethodsdifferent types of elective surgeries. After randomly selecting the patients for intubationwith this new device, the airway characteristics, height,weight, dental overbiteand thyromental distance were all evaluated before induction.Our goal was to exploreprimarily the success rate of intubation with LMAC...

  18. Automated Control of Endotracheal Tube Cuff Pressure during Simulated Flight

    Science.gov (United States)

    2016-06-21

    accomplished in the intensive care unit (ICU) with stand-alone devices as well as those integral to a ventilator [13,14]. We hypothesized that closed loop ... Administration approved automatic cuff pressure adjustment devices (Intellicuff, Hamilton Medical , Reno, NV; Pyton, ARM Medical , Bristol, CT; Cuff Sentry, Outcome...711th Human Performance Wing U.S. Air Force School of Aerospace Medicine Int’l Expeditionary Educ & Training Dept Air Force Expeditionary Medical

  19. [Difficult Ventilation Requiring Emergency Endotracheal Intubation during Awake Craniotomy Managed by Laryngeal Mask Airway].

    Science.gov (United States)

    Matsuda, Asako; Mizota, Toshiyuki; Tanaka, Tomoharu; Segawa, Hajime; Fukuda, Kazuhiko

    2016-04-01

    We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased. We immediately started manual ventilation, but the airway resistance was extremely high and we could not adequately ventilate the patient. We administered muscle relaxant for suspected laryngospasm, but ventilatory status did not improve; so we decided to conduct emergency endotracheal intubation. We tried to intubate using Airwayscope or LMA-Fastrach, but they were not effective in our case. Finally trachea was intubated using transnasal fiberoptic bronchoscopy. We discuss airway management during awake craniotomy, focusing on emergency endotracheal intubation during surgery.

  20. Effectiveness of the endotracheal tube cuff on the trachea: physical and mechanical aspects

    Directory of Open Access Journals (Sweden)

    Maira Soliani Del Negro

    2014-12-01

    Full Text Available Introduction: The inflation pressure of the endotracheal tube cuff can cause ischemia of the tracheal mucosa at high pressures; thus, it can cause important tracheal morbidity and tracheal microaspiration of the oropharyngeal secretion, or it can even cause pneumonia associated with mechanical ventilation if the pressure of the cuff is insufficient. Objective: In order to investigate the effectiveness of the RUSCH® 7.5 mm endotracheal tube cuff, this study was designed to investigate the physical and mechanical aspects of the cuff in contact with the trachea. Methods: For this end, we developed an in vitro experimental model to assess the flow of dye (methylene blue by the inflated cuff on the wall of the artificial material. We also designed an in vivo study with 12 Large White pigs under endotracheal intubation. We instilled the same dye in the oral cavity of the animals, and we analyzed the presence or not of leakage in the trachea after the region of the cuff after their deaths (animal sacrifice. All cuffs were inflated at the pressure of 30 cmH2O. Results: We observed the passage of fluids through the cuff in all in vitro and in vivo experimental models. Conclusion: We conclude that, as well as several other cuff models in the literature, the RUSCH® 7.5 mm tube cuffs are also not able to completely seal the trachea and thus prevent aspiration of oropharyngeal secretions. Other prevention measures should be taken.

  1. Effects of suction-dredging for cockles on non-target fauna in the Wadden Sea

    NARCIS (Netherlands)

    Hiddink, JG

    2003-01-01

    Suction dredging for cockles removes large cockles from tidal flats and may also cause mortality of non-target fauna and make the habitat less suitable for some species. This study examines whether suction dredging for cockles on tidal flats of the Dutch Wadden Sea had affected densities of

  2. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange (oxygenator...

  3. Development of advanced stability theory suction prediction techniques for laminar flow control. [on swept wings

    Science.gov (United States)

    Srokowski, A. J.

    1978-01-01

    The problem of obtaining accurate estimates of suction requirements on swept laminar flow control wings was discussed. A fast accurate computer code developed to predict suction requirements by integrating disturbance amplification rates was described. Assumptions and approximations used in the present computer code are examined in light of flow conditions on the swept wing which may limit their validity.

  4. A Technique for Controlling Matric Suction on Filter Papers . GroWth ...

    African Journals Online (AJOL)

    'Abstract. Moist filter papers are widely usedfor seed gennination tests but their water confent and matric suction are not usually controlled. A technique for controlling filter paper matric suction is described and usedfor germination studies involving fresh and aged sorghum seed (Sorghummcolor (L) Moench). Filter papers ...

  5. A Technique for Controlling Matric Suction on Filter Papers Used in ...

    African Journals Online (AJOL)

    Moist filter papers are widely usedfor seed gennination tests but their water confent and matric suction are not usually controlled. A technique for controlling filter paper matric suction is described and usedfor germination studies involving fresh and aged sorghum seed (Sorghummcolor (L) Moench). Filter papers wetted to ...

  6. Investigation on compression behaviour of highly compacted GMZ01 bentonite with suction and temperature control

    Energy Technology Data Exchange (ETDEWEB)

    Ye, W.M., E-mail: ye_tju@tongji.edu.cn [Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092 (China); United Research Center for Urban Environment and Sustainable Development, The Ministry of Education, Shanghai 200092 (China); Zhang, Y.W.; Chen, B.; Zheng, Z.J.; Chen, Y.G. [Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092 (China); Cui, Y.J. [Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092 (China); Ecole des Ponts ParisTech, UR Navier/CERMES 77455 (France)

    2012-11-15

    Highlights: Black-Right-Pointing-Pointer Heating induced volumetric change of GMZ01 bentonite depends on suction. Black-Right-Pointing-Pointer Suction has significant influence on compressibility. Black-Right-Pointing-Pointer Temperature has slight influence on compressibility. - Abstract: In this paper, an oedometer with suction and temperature control was developed. Mechanical compaction tests have been performed on the highly compacted GMZ01 bentonite, which has been recognized as potential buffer/backfill material for construction of Chinese high-level radioactive waste (HLW) geological repository, under conditions of suction ranging from 0 to 110 MPa, temperature from 20 to 80 Degree-Sign C and vertical pressure from 0.1 to 80 MPa. Based on the test results, suction and temperature effects on compressibility parameters are investigated. Results reveal that: (1) at high suctions, heating induced an expansion, while contraction is induced by heating at low suctions. The thermal expansion coefficient of GMZ01 bentonite measured is 1 Multiplication-Sign 10{sup -4} Degree-Sign C{sup -1}; (2) with increasing suction, the elastic compressibility {kappa} and the plastic compressibility {lambda}(s) of the highly compacted GMZ01 bentonite decrease, while the pre-consolidation pressure increases markedly; (3) with increasing temperature, the elastic compressibility of compacted GMZ01 bentonite changes insignificantly, while the plastic compressibility {lambda}(s) slightly decreases and the yield surface tends to shrink.

  7. Investigation on compression behaviour of highly compacted GMZ01 bentonite with suction and temperature control

    International Nuclear Information System (INIS)

    Ye, W.M.; Zhang, Y.W.; Chen, B.; Zheng, Z.J.; Chen, Y.G.; Cui, Y.J.

    2012-01-01

    Highlights: ► Heating induced volumetric change of GMZ01 bentonite depends on suction. ► Suction has significant influence on compressibility. ► Temperature has slight influence on compressibility. - Abstract: In this paper, an oedometer with suction and temperature control was developed. Mechanical compaction tests have been performed on the highly compacted GMZ01 bentonite, which has been recognized as potential buffer/backfill material for construction of Chinese high-level radioactive waste (HLW) geological repository, under conditions of suction ranging from 0 to 110 MPa, temperature from 20 to 80 °C and vertical pressure from 0.1 to 80 MPa. Based on the test results, suction and temperature effects on compressibility parameters are investigated. Results reveal that: (1) at high suctions, heating induced an expansion, while contraction is induced by heating at low suctions. The thermal expansion coefficient of GMZ01 bentonite measured is 1 × 10 −4 °C −1 ; (2) with increasing suction, the elastic compressibility κ and the plastic compressibility λ(s) of the highly compacted GMZ01 bentonite decrease, while the pre-consolidation pressure increases markedly; (3) with increasing temperature, the elastic compressibility of compacted GMZ01 bentonite changes insignificantly, while the plastic compressibility λ(s) slightly decreases and the yield surface tends to shrink.

  8. 78 FR 20316 - Final Issuance of General NPDES Permits (GP) for Small Suction Dredges in Idaho

    Science.gov (United States)

    2013-04-04

    ... System (NPDES) General Permit (IDG-37-0000) to placer mining operations in Idaho for small suction... Small Suction Dredges in Idaho AGENCY: Environmental Protection Agency, Region 10. ACTION: Final notice... significant economic impact on a substantial number of small entities.'' EPA has concluded that NPDES general...

  9. A Report on Deliverable Three: Determine a Standard Performance Test for Military Suction Device Use

    Science.gov (United States)

    2017-09-20

    evaluating device suction while either wetted or completely immersed is highly important to predict performance in battlefield scenarios. Summary...mechanical, electrical, and environmental. OBJECTIVE: Research and review current test methods outlined in ISO 10079 and published journal articles...of contemporary oropharyngeal suction. The American journal of emergency medicine 17, 611- 613 (1999). 4. Hodgetts, T., Mahoney, P., Evans, G

  10. Numerical simulation and experimental investigation on suction heating of a BOG compressor

    International Nuclear Information System (INIS)

    Jia, Xiaohan; Zhao, Bin; Feng, Jianmei; Zheng, Sulu; Peng, Xueyuan

    2016-01-01

    Highlights: • An investigation focusing on suction heating of a BOG compressor is carried out. • There is frost on the cylinder cover as the compressor at lower suction temperature. • The suction and discharge flow rate decrease with rising suction temperature. • The volumetric efficiency has a maximum value with increasing suction temperature. • The temperature coefficient increased with suction temperature or rotational speed. - Abstract: One of the key components of a liquefied natural gas (LNG) receiving terminal is the boil-off gas (BOG) compressor, which is used to pump out the BOG from the LNG storage tank to ensure safety in the transportation and receiving systems. Owing to the ultra-low suction temperature, the heat exchange between the intake gas and the cylinder, piston, and cylinder cover cannot be ignored as in normal conditions. This paper presents an investigation focusing on suction heating of the BOG compressor. A finite element model with dynamic mesh was established to simulate the suction process. At the same time, a performance test rig was built to study the characteristics of the BOG compressor under low suction temperature conditions and verify the numerical model. Consequently, the results of the simulation were in good agreement with experimental results. Both results implied that the temperature of cylinder surface increased starting from the cylinder cover to the crankcase. In addition, at lower suction temperature, the temperature difference between various points on the cylinder surface and cylinder cover was much larger than that at higher suction temperature. With increasing suction temperature, the temperature coefficient increased markedly, and the difference between gas temperatures at the beginning and end of the suction process, as well as the compressor flow rate, decreased significantly; however, the volumetric efficiency increased first and then decreased. Furthermore, the temperature coefficient clearly increased

  11. Cavitation simulation and NPSH prediction of a double suction centrifugal pump

    International Nuclear Information System (INIS)

    Li, P; Huang, Y F; Li, J

    2012-01-01

    This paper illustrates the flow field numerical analysis of the double-suction centrifugal pump. For the study of the cavitation flow inside the double-suction centrifugal pump, the professional pump/motor simulation software PumpLinx and its Full Cavitation Model has been employed. According to the PumpLinx calculation result and the Cavitation damage index, the cavitation position, level and the cavitation characteristics of the double-suction centrifugal pump has been predicted. For the further objective, the simulation of the flow field in the double-suction centrifugal pump under different inlet conditions has been carried out. By the result analysis, NPSHr has been predicted; the reliability of the results has been verified by comparing with the experimental data. At the same time, this practice can provide guidance for the optimal design of double-suction pump.

  12. Effect of suction on the mechanical characteristics of uniformly compacted rammed earth

    Science.gov (United States)

    El Hajjar, A.; Chauhan, P.; Prime, N.; Plé, O.

    2018-04-01

    Rammed earth, in the current environmental situation, is an alternative construction technique which can help in reducing energy and raw material consumption owing to its “sustainable” characteristics. To fully understand its behavior and properties, recent scientific investigations consider it as a compacted unsaturated material with suction as its one of the main sources of strength. Eathern constructions face, over their lifetime, variations in the suction state which have a significant impact on their mechanical characteristics. In the present contribution, unconfined compression tests are performed, with and without unload-reload cycles, on homogeneously compacted samples subjected to various suction conditions. This study shows that both the unconfined compressive strength and Young modulus reduce with the reduction of suction states. Suction also seems to influence the amount of plastic strains and damage phenomenon. Indeed, the soils analyzed are slightly active and shows both plasticity behavior and damage phenomenon.

  13. Suction blister grafting - Modifications for easy harvesting and grafting

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Full Text Available Suction blister grafting is a simple modality of treatment of patients with resistant and stable vitiligo. But raising the blisters may be time consuming and transferring to the recipient site may be difficult as the graft is ultrathin. By doing some modifications we can make the technique simpler and easier. We can decrease the blister induction time by intradermal injection of saline, exposure to Wood′s lamp, intrablister injection of saline. By these methods we can decrease the blister induction time from 2-3 hrs to 45-90 minutes. After harvesting the graft, it can be transferred to the recipient area by taking the graft on a sterile glass slide, on the gloved finger, rolling the graft over a sterile syringe and then spreading on the recipient area, or taking on the sterile wrapper of paraffin dressing and then placing over the recipient area.

  14. Design of triaxial test with controlled suction: measure of strain

    International Nuclear Information System (INIS)

    Gasc-Barbier, M.; Cosenza, Ph.; Ghoreychi, M.; Chanchole, S.; Cosenza, Ph.; Tessier, D.

    2000-01-01

    Experimental study of mechanical behavior of clayey materials under hygrometric condition is usually performed either on unloaded samples or by means of classical odometer tests used in soil mechanics. Such methods are not well adapted to hard deep clayey rocks with little deformability, porosity and permeability. Moreover, stress and strain tensors having a significant effect on hygro-mechanical behaviour and properties cannot be measured and investigated appropriately by classical tests. This is why a specific triaxial test was designed in which the sample is surrounded by a fiber glass tissue allowing air circulation and then by silicon on which confining pressure is applied. Thus, equilibrium between air and sample was reduced. Stress and strain tensors were also measured in time on the sample subjected to a mechanical loading and to a controlled suction. After presentation of the test, preliminary results are given. (authors)

  15. Boundary layer development on turbine airfoil suction surfaces

    Science.gov (United States)

    Sharma, O. P.; Wells, R. A.; Schlinker, R. H.; Bailey, D. A.

    1981-01-01

    The results of a study supported by NASA under the Energy Efficient Engine Program, conducted to investigate the development of boundary layers under the influence of velocity distributions that simulate the suction sides of two state-of-the-art turbine airfoils, are presented. One velocity distribution represented a forward loaded airfoil ('squared-off' design), while the other represented an aft loaded airfoil ('aft loaded' design). These velocity distributions were simulated in a low-speed, high-aspect-ratio wind tunnel specifically designed for boundary layer investigations. It is intended that the detailed data presented in this paper be used to develop improved turbulence model suitable for application to turbine airfoil design.

  16. Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation.

    Science.gov (United States)

    Qureshi, Mosarrat J; Kumar, Manoj

    2018-03-15

    Providing effective positive pressure ventilation is considered to be the single most important component of successful neonatal resuscitation. Ventilation is frequently initiated manually with bag and face mask (BMV) followed by endotracheal intubation if respiratory depression continues. These techniques may be difficult to perform successfully resulting in prolonged resuscitation or neonatal asphyxia. The laryngeal mask airway (LMA) may achieve initial ventilation and successful resuscitation faster than a bag-mask device or endotracheal intubation. Among newborns requiring positive pressure ventilation for cardio-pulmonary resuscitation, is LMA more effective than BMV or endotracheal intubation for successful resuscitation? When BMV is either insufficient or ineffective, is effective positive pressure ventilation and successful resuscitation achieved faster with the LMA compared to endotracheal intubation? We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2017, Issue 1), MEDLINE via PubMed (1966 to 15 February 2017), Embase (1980 to 15 February 2017), and CINAHL (1982 to 15 February 2017). We also searched clinical trials registers, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. We included randomised and quasi-randomised controlled trials that compared LMA for neonatal resuscitation with either BMV or endotracheal intubation and reported on any outcomes related to neonatal resuscitation specified in this review. Two review authors independently evaluated studies for risk of bias assessments, and extracted data using Cochrane Neonatal criteria. Categorical treatment effects were described as relative risks and continuous treatment effects were described as the mean difference, with 95% confidence intervals (95% CI) of estimates. We included seven trials that involved a total of 794 infants. Five

  17. Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries

    Science.gov (United States)

    2017-11-13

    Airway Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries...Consumer Style Comparison Table of Suction Pump Devices ............................. 103 Appendix H – Web Links for Images for Consumer- Style ...0022 pg. 6 Executive Summary Suction is a critical component of airway management , which is the second leading cause of preventable

  18. Bottom Feeding and Beyond: How the Premaxillary Protrusion of Cypriniforms Allowed for a Novel Kind of Suction Feeding.

    Science.gov (United States)

    Hernandez, L Patricia; Staab, Katie Lynn

    2015-07-01

    While much of the functional work on suction feeding has involved members of Acanthopterygii, an earlier cypriniform radiation led to over 3200 species filling nearly every freshwater trophic niche. Within the great majority of acanthomorph clades that have been investigated suction feeding and the underlying morphology responsible for the generation of rapid suction have been largely conserved. This conserved feeding-apparatus is often associated with increasing the force experienced by the prey item, thus making a strike on elusive prey more effective. Cypriniforms' trophic anatomy is comprised of a number of novelties used for benthic feeding, which characterized early members of this clade. The modified cypriniform structure of the oral jaws represents a situation in which a particular type of suction feeding allowed for probing the benthos with a more functionally maneuverable anatomy. Requisite evolutionary modifications included origin and elongation of a median kinethmoid, duplications of certain divisions of the muscles of the adductor mandibulae, and origin of a dorsal, intra-buccal muscular palatal organ used in winnowing detritus. The elongated kinethmoid (coupled with modified adductor muscles) allowed for a type of premaxillary protrusion that decoupled the upper and lower jaws, enabled premaxillary protrusions with a closed mouth, and facilitated benthic feeding by increasing functional flexibility. The resultant flow of fluid generated by cypriniforms is also quite flexible, with multiple instances of peak flow in a single feeding event. This greatly modified morphology allowed for a degree of kinematic maneuverability not seen within most acanthomorphs. Later cypriniform radiations into piscivorous, insectivorous, or planktivorous feeding guilds were associated with shortening of the kinethmoid and with simplified morphology of the adductor, likely involving an emphasis on ram feeding. Although this suite of morphological novelties seemingly

  19. A comparison of tape-tying versus a tube-holding device for securing endotracheal tubes in adults.

    Science.gov (United States)

    Murdoch, E; Holdgate, A

    2007-10-01

    During the transfer of intubated patients, endotracheal tube security is paramount. This study aims to compare two methods of securing an endotracheal tube in adults: tying with a cloth tape versus the Thomas Endotracheal Tube Holder (Laerdal). A manikin-based study was performed using paramedics and critical care doctors (consultants and senior trainees) as participants. Each participant was asked to secure an endotracheal tube that had been placed within the trachea of a manikin a total of six times, the first three times using tied cloth tape and the last three times using a Thomas Endotracheal Tube Holder. Following each 'fixation' and after the participant had left the room, the security of the tube was tested by applying a fixed force laterally and to the right by dropping a 1.25 kg weight a distance of 50 cm. The amount of movement of the tube with respect to the teeth was measured and recorded in millimetres. Two-hundred-and-seventy tube fixations (135 tied vs. 135 tube holder) were performed by 45 participants. The degree of tube movement was significantly higher when the tube was secured with a tie compared with when the tube holder was used (median movement 22 mm vs. 4 mm, P tube holder device minimised tube movement in a manikin model when compared with conventional tape tying. The use of this device when transporting intubated patients may reduce the risk of tube displacement though further clinical studies are warranted.

  20. A compliant underactuated hand with suction flow for underwater mobile manipulation

    KAUST Repository

    Stuart, Hannah S.

    2014-05-01

    © 2014 IEEE. Fingertip suction is investigated using a compliant, underactuated, tendon-driven hand designed for underwater mobile manipulation. Tendon routing and joint stiffnesses are designed to provide ease of closure while maintaining finger rigidity, allowing the hand to pinch small objects, as well as secure large objects, without diminishing strength. While the hand is designed to grasp a range of objects, the addition of light suction flow to the fingertips is especially effective for small, low-friction (slippery) objects. Numerical simulations confirm that changing suction parameters can increase the object acquisition region, providing guidelines for future versions of the hand.

  1. Magnetohydrodynamic peristaltic motion of a Newtonian fluid through porous walls through suction and injection

    Science.gov (United States)

    Sivaiah, R.; Hemadri Reddy, R.

    2017-11-01

    In this paper, we investigate the peristaltic transport of a conducting Newtonian fluid bounded by permeable walls with suction and injection moving with constant velocity of the wave in the wave frame of reference under the consideration of long wavelength and low Reynolds number. The analytical solution for the velocity field, pressure gradient and the frictional force are obtained. The effect of suction/injection parameter, amplitude ratio and the permeability parameter including slip on the flow quantities are discussed graphically. It is found that the greater the suction/injection parameter, the smaller the pressure rise against the pump works. Further, the pressure rise increases with increasing Magnetic parameter.

  2. A compliant underactuated hand with suction flow for underwater mobile manipulation

    KAUST Repository

    Stuart, Hannah S.; Wang, Shiquan; Gardineer, Bayard; Christensen, David L.; Aukes, Daniel M.; Cutkosky, Mark

    2014-01-01

    © 2014 IEEE. Fingertip suction is investigated using a compliant, underactuated, tendon-driven hand designed for underwater mobile manipulation. Tendon routing and joint stiffnesses are designed to provide ease of closure while maintaining finger rigidity, allowing the hand to pinch small objects, as well as secure large objects, without diminishing strength. While the hand is designed to grasp a range of objects, the addition of light suction flow to the fingertips is especially effective for small, low-friction (slippery) objects. Numerical simulations confirm that changing suction parameters can increase the object acquisition region, providing guidelines for future versions of the hand.

  3. Risk factors for endotracheal intubation and mechanical ventilation in patients with opioids intoxication

    International Nuclear Information System (INIS)

    Mirmoghtadaee, P.; Mood, N.E.; Sabzghabaee, A.M.; Yaraghi, A.

    2012-01-01

    Objectives: Patients poisoned with opioids sometimes need endotracheal intubation with or without the use of mechanical ventilation. This study was done to determine the prognostic risk factors for of the need for endotracheal intubation and mechanical ventilation. Methodology: In this cross-sectional study which was performed in Isfahan (Iran), one hundred (n=100) opioid poisoned patients whom their overdoses were diagnosed by their full and reliable history, physical examination and positive response to naloxone; vital signs at the hospital admission, blood biochemistry, ABG details and also the type and estimated dosage of opioid, route of consumption, and their need to mechanical ventilation were evaluated. Results: Patients were mostly aged between 20-40 years old. Seventy nine patients were male and 26 cases (21 men) required endotracheal intubation and 15 cases (14 men) needed both intubation and mechanical ventilation. The most consumed opiates among the poisoned patients were opium (35%), heroin (16%), Tramadol (15%), Methadone (9%), crack (6%), Diphenoxylate (4%) and others (15%). There was a significant difference between the mean heart rates and respiratory rate of the patients who were connected to the ventilator and others (99.8 +- 21.8 and 87.3 +- 16.3; p=0.01). The lower level of consciousness [OR: 2.2 95% Confidence Interval (CI): 1.2-4.2], and lower admission level of hemoglobin (OR: 3.6; CI:1.2-10.8) were among the factors for predicting the need for intubation and ventilation. Conclusion: Determining the risk factors with prognostic value for the need to intubation or ventilation seems to be necessary for improving the standard of therapy in opioids poisoned patients. (author)

  4. Low-dose esmolol: hemodynamic response to endotracheal intubation in normotensive patients

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    Suresh Lakshmanappa

    2012-06-01

    Full Text Available Abstract Purpose: Endotracheal intubation is a frequently utilized and highly invasive component of anesthesia that is often accompanied by potentially harmful hemodynamic pressor responses. The purpose of this study was to investigate the efficiency of a single pre-induction 1 mg/kg bolus injection of esmolol for attenuating these hemodynamic responses to endotracheal intubation in normotensive patients. Material and methods: The study was composed of 100 randomly selected male and female patients between the ages of 18 and 60 that were scheduled for elective surgery and belonged to ASA grade I or II. Two minutes prior to intubation the control group received 10 mL of saline (n=50 and the experimental group received an injection of esmolol 1 mg/kg diluted to 10 mL (n=50. Heart rate (HR, systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, and rate pressure product (RPP were compared to basal values before receiving medication (T-0, during pre-induction (T-1, induction (T-2, intubation (T-3, and post-intubation at 1 (T-4, 3 (T-6, 5 (T-8, and 10 (T-13 minutes. Results: Esmolol significantly attenuated the hemodynamic responses to endotracheal intubation at the majority of measured points. Attenuation of HR (10.8%, SBP (7.04%, DBP (3.99%, MAP (5%, and RPP (16.9% was observed in the esmolol group when compared to the control group values. Conclusions: A single pre-induction 1 mg/kg bolus injection of esmolol successfully attenuated the hemodynamic pressor response in normotensive patients. A significant attenuation of heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure was observed at the majority of measured time points in the esmolol administered group compared to the control group. [J Contemp Med 2012; 2(2.000: 69-76

  5. Report on technical measurements concerning measurement of the suction of tanks at Fangel biomass conversion plant

    International Nuclear Information System (INIS)

    1992-05-01

    The inconveniences caused by the odours emerging from the biomass conversion plant in Fangel, Denmark, and the actions taken in an attempt to reduce them, are described. The plant has on several occasions been threatened with being closed down because of the smell. Airtight coverings have been fixed on all the open tanks, and the suction element has been tested to see if it is airtight. Ozone has been added in order to help get rid of the smell. Measurements have shown that it is possible to attain a small vacuum in the storage tank under normal operation, if there is a surfeit of pumping there will be too high pressure. In relation to pumping-in the pressure can be too high in the first and medium tank. Flow, pressure, hydrogen sulphide and methane concentration changes significantly in relation to the various pumping frequences. The level of hydrogen sulphide removal in the biofilter was 70-85%. The flow of hydrogen sulphide becomes less after the addition of ozone. Measurements implied that the tanks were airtight. Larger vacuums can be achieved by changing the shape of the pipe system and increasing the flow. (AB)

  6. Monitoring tidal volumes in preterm infants at birth: mask versus endotracheal ventilation.

    Science.gov (United States)

    van Vonderen, Jeroen J; Hooper, Stuart B; Krabbe, Vera B; Siew, Melissa L; Te Pas, Arjan B

    2015-01-01

    Upper airway distention during mask ventilation could reduce gas volumes entering the lung compared with ventilation via an endotracheal tube. Therefore, respiratory tract volumes were measured in lambs and tidal volumes were compared in preterm infants before and after intubation. In seven preterm lambs, volumes of the airways (oropharynx, trachea, lungs) were assessed. In 10 preterm infants, delta pressures, tidal volumes and leak were measured during ventilation 2 min before (mask ventilation) and 2 min after intubation (endotracheal ventilation). Inflations coinciding with breaths were excluded. Amount of upper airway distention in lambs and differences in inspiratory and expiratory tidal volume before and after intubation. In lambs, the combined trachea and oropharynx contributed to 14 (12-21) % (median (IQR), whereas the oropharynx contributed to 9 (7-10) % of the total tidal volume measured at the mouth. In preterm infants, inspiratory (11.1 (7.9-22.6) mL/kg vs 5.8 (3.9-9.6) mL/kg (p=0.01)) and expiratory (8.3 (6.8-15.4) mL/kg vs 4.9 (3.9-9.6) mL/kg (p=0.02)) tidal volumes were significantly larger during mask ventilation compared with endotracheal ventilation. Leak was 18.7 (3.3-28.7) % before versus 0 (0-2.3) % after intubation (p0.05). During mask ventilation, expiratory tidal volume increased from 10.0 (5.4-15.6) mL/kg to 11.3 (7.6-17.0) mL/kg (p=0.01), but remained unchanged during endotracheal ventilation. During neonatal mask ventilation, distention of the upper respiratory tract contributes to the tidal volumes measured and should be taken into account when targeting tidal volumes during mask ventilation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Study on the performance improvement of multiblade fans. Effects of suction cones; Tayoku fan no seino kaizen ni kansuru kenkyu. Suction cone no eikyo

    Energy Technology Data Exchange (ETDEWEB)

    Kuratani, F.; Ogawa, T. [Hyogo University of Teacher Education, Hyogo (Japan); Yamamoto, S.

    1999-07-25

    In order to improve the performance of a multiblade fan, the effects of three types of suction cones of the fan casing on the fan efficiency and noise are investigated experimentally. The first type of the suction cone is the insertion type, which is inserted into the inside of the fan impeller. The second type is the extrusion type, which extrudes outside from the casing surface. The third type is the combination type of two types. The results of those three types are compared with those of the commonly used suction cone. The followings are made clear: (1) The insertion type and the extrusion type are effective in improving the efficiency and reducing noise. (2) The optimal lengths of the insertion and the extrusion exist. (3) The combination type is more effective in improving the efficiency. (4) The combination type with the skewed cutoff of the fan casing shows the best effect. (author)

  8. MEASUREMENT OF ENDOTRACHEAL TUBE CUFF PRESSURE IN MECHANICALLYVENTILATED PATIENTS ON ARRIVAL TO INTENSIVE CARE UNIT - A CROSS-SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Arun Kumar Ajjappa

    2017-04-01

    Full Text Available BACKGROUND The monitoring of Endotracheal Tube (ETT cuff pressure in intubated patients on arrival to intensive care unit is very essential. The cuff pressure must be within an optimal range of 20-30cm H2O ensuring ventilation with no complications related to cuff overinflation and underinflation. This can be measured with a cuff pressure manometer. The aim of the study is to measure the endotracheal tube cuff pressure in patients on arrival to intensive care unit and to identify prevalence of endotracheal cuff underinflation and overinflation. MATERIALS AND METHODS A cross-sectional study was done on mechanically-ventilated patients who were intubated in casualty (emergency department on arrival to intensive care unit in S.S. Institute of Medical Sciences and Research Centre, Davangere. About 50 critically-ill patients intubated with a high volume, low pressure endotracheal tube were included in the study. An analogue manometer was used to measure the endotracheal tube cuff pressure. It was compared with the recommended level. The settings of mechanical ventilation, endotracheal tube size and peak airway pressure were recorded. RESULTS It was found that the mean cuff pressure was 64.10 cm of H2O with a standard deviation of 32.049. Of the measured cuff pressures, only 2% had pressures within an optimal range (20-30cm of H2O. 88% had cuff pressures more than 30cm of H2O. The mean peak airway pressure found to be 20.50cm of H2O with a Standard Deviation (SD of 5.064. CONCLUSION This study is done to emphasise the importance of cuff pressure measurement in all mechanically-ventilated patients as cuff pressure is found to be high in most of the patients admitted to intensive care unit. Complications of overinflation and underinflation can only be prevented if the acceptable cuff pressures are achieved.

  9. Evaluation of Karl Storz CMAC TipTM Device Versus Traditional Airway Suction in a Cadaver Model

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    Demis N. Lipe

    2014-07-01

    Full Text Available Introduction: We compared the efficacy of Karl Storz CMAC TipTM with inline suction to CMAC with traditional suction device in cadaveric models simulating difficult airways, using media mimicking pulmonary edema and vomit. Methods: This was a prospective, cohort study in which we invited emergency medicine faculty and residents to participate. Each participant intubated 2 cadavers (one with simulated pulmonary edema and one with simulated vomit, using CMAC with inline suction and CMAC with traditional suction. Thirty emergency medicine providers performed 4 total intubations each in a crossover trial comparing the CMAC with inline suction and CMAC with traditional suction. Two intubations were performed with simulated vomit and two with simulated pulmonary edema. The primary outcome was time to successful intubation; and the secondary outcome was proportion of successful intubation. Results: The median time to successful intubation using the CMAC with inline suction versus traditional suction in the pulmonary edema group was 29s and 30s respectively (p=0.54. In the vomit simulation, the median time to successful intubation was 40s using the CMAC with inline suction and 41s using the CMAC with traditional suction (p=0.70. There were no significant differences in time to successful intubation between the 2 devices. Similarly, the proportions of successful intubation were also not statistically significant between the 2 devices. The proportions of successful intubations using the inline suction were 96.7% and 73.3%, for the pulmonary edema and vomit groups, respectively. Additionally using the handheld suction device, the proportions for the pulmonary edema and vomit group were 100% and 66.7%, respectively. Conclusion: CMAC with inline suction was no different than CMAC with traditional suction and was associated with no statistically significant differences in median time to intubation or proportion of successful intubations. [West J Emerg Med

  10. Remora fish suction pad attachment is enhanced by spinule friction.

    Science.gov (United States)

    Beckert, Michael; Flammang, Brooke E; Nadler, Jason H

    2015-11-01

    The remora fishes are capable of adhering to a wide variety of natural and artificial marine substrates using a dorsal suction pad. The pad is made of serial parallel pectinated lamellae, which are homologous to the dorsal fin elements of other fishes. Small tooth-like projections of mineralized tissue from the dorsal pad lamella, known as spinules, are thought to increase the remora's resistance to slippage and thereby enhance friction to maintain attachment to a moving host. In this work, the geometry of the spinules and host topology as determined by micro-computed tomography and confocal microscope data, respectively, are combined in a friction model to estimate the spinule contribution to shear resistance. Model results are validated with natural and artificially created spinules and compared with previous remora pull-off experiments. It was found that spinule geometry plays an essential role in friction enhancement, especially at short spatial wavelengths in the host surface, and that spinule tip geometry is not correlated with lamellar position. Furthermore, comparisons with pull-off experiments suggest that spinules are primarily responsible for friction enhancement on rough host topologies such as shark skin. © 2015. Published by The Company of Biologists Ltd.

  11. Volume of blood suctioned during vacuum-assisted breast biopsy predicts later hematoma formation

    Directory of Open Access Journals (Sweden)

    Panopoulou Effrosyni

    2010-03-01

    Full Text Available Abstract Background To evaluate whether the volume of blood suctioned during vacuum-assisted breast biopsy (VABB is associated with hematoma formation and progression, patient's age and histology of the lesion. Findings 177 women underwent VABB according to standardized protocol. The volume of blood suctioned and hematoma formation were noted at the end of the procedure, as did the subsequent development and progression of hematoma. First- and second-order logistic regression was performed, where appropriate. Cases with hematoma presented with greater volume of blood suctioned (63.8 ± 44.7 cc vs. 17.2 ± 32.9 cc; p Conclusion The likelihood of hematoma is increasing along with increasing amount of blood suctioned, reaching a plateau approximately at 80 cc of blood lost.

  12. Feeding kinematics, suction, and hydraulic jetting performance of harbor seals (Phoca vitulina.

    Directory of Open Access Journals (Sweden)

    Christopher D Marshall

    Full Text Available The feeding kinematics, suction and hydraulic jetting capabilities of captive harbor seals (Phoca vitulina were characterized during controlled feeding trials. Feeding trials were conducted using a feeding apparatus that allowed a choice between biting and suction, but also presented food that could be ingested only by suction. Subambient pressure exerted during suction feeding behaviors was directly measured using pressure transducers. The mean feeding cycle duration for suction-feeding events was significantly shorter (0.15±0.09 s; P<0.01 than biting feeding events (0.18±0.08 s. Subjects feeding in-water used both a suction and a biting feeding mode. Suction was the favored feeding mode (84% of all feeding events compared to biting, but biting comprised 16% of feeding events. In addition, seals occasionally alternated suction with hydraulic jetting, or used hydraulic jetting independently, to remove fish from the apparatus. Suction and biting feeding modes were kinematically distinct regardless of feeding location (in-water vs. on-land. Suction was characterized by a significantly smaller gape (1.3±0.23 cm; P<0.001 and gape angle (12.9±2.02°, pursing of the rostral lips to form a circular aperture, and pursing of the lateral lips to occlude lateral gape. Biting was characterized by a large gape (3.63±0.21 cm and gape angle (28.8±1.80°; P<0.001 and lip curling to expose teeth. The maximum subambient pressure recorded was 48.8 kPa. In addition, harbor seals were able to jet water at food items using suprambient pressure, also known as hydraulic jetting. The maximum hydraulic jetting force recorded was 53.9 kPa. Suction and hydraulic jetting where employed 90.5% and 9.5%, respectively, during underwater feeding events. Harbor seals displayed a wide repertoire of behaviorally flexible feeding strategies to ingest fish from the feeding apparatus. Such flexibility of feeding strategies and biomechanics likely forms the basis of their

  13. Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage.

    Science.gov (United States)

    Wittmann, F W; Ring, P A

    1984-01-01

    In a retrospective comparison of blood loss following uncemented total knee replacement, in which either continuous or intermittent suction drainage was used, measured blood loss was significantly greater with continuous drainage. However, a method of calculating actual blood loss demonstrated no significant difference. With intermittent drainage, more blood remains undetected around the knee joint; this technique should therefore be abandoned in favour of continuous suction drainage. PMID:6747978

  14. Natural convection boundary layer with suction and mass transfer in a porous medium

    International Nuclear Information System (INIS)

    Bestman, A.R.

    1989-03-01

    The free convection boundary layer flow with simultaneous heat and mass transfer in a porous medium is studied when the boundary wall moves in its own plane with suction. The study also incorporates chemical reaction for the very simple model of a binary reaction with Arrhenius activation energy. For large suction asymptotic approximate solutions are obtained for the flow variables for various values of the activation energy. (author). 10 refs, 2 figs

  15. Supermarket refrigeration. Optimization of suction pressure in existing refrigerators; Supermarktkaelte. Saugdruck optimieren in Bestandskaelteanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Philipp; Mueller, Markus [Eckelmann AG, Wiesbaden (Germany)

    2012-06-15

    The new E*LDS firmware E*COP{sup +} from Eckelmann AG (Wiesbaden, Federal Republic of Germany) for the optimization of the suction pressure supplies a demand-oriented adaptation of the suction pressure. The new feature is ideal for an update of existing systems with thermostatic expansion valves. Using this update operators of supermarket operators may save about 10% energy with little effort.

  16. Characterization of zebrafish larvae suction feeding flow using μPIV and optical coherence tomography

    Science.gov (United States)

    Pekkan, Kerem; Chang, Brian; Uslu, Fazil; Mani, Karthick; Chen, Chia-Yuan; Holzman, Roi

    2016-07-01

    The hydrodynamics of suction feeding is critical for the survival of fish larvae; failure to capture food during the onset of autonomous feeding can rapidly lead to starvation and mortality. Fluid mechanics experiments that investigate the suction feeding of suspended particles are limited to adult fishes, which operate at large Reynolds numbers. This manuscript presents the first literature results in which the external velocity fields generated during suction feeding of early zebrafish larvae (2500-20,000 μm total length) are reported using time-resolved microscopic particle image velocimetry. For the larval stages studied, the maximum peak suction velocity of the inflow bolus is measured at a finite distance from the mouth tip and ranges from 1 to 8 mm/s. The average pressure gradient and the velocity profile proximal to the buccal (mouth) cavity are calculated, and two distinct trends are identified. External recirculation regions and reverse flow feeding cycles are also observed and quantified. One of the unresolved questions in fish suction feeding is the shape and dynamics of the buccal cavity during suction feeding; optical coherence tomography imaging is found to be useful for reconstructing the mouth kinematics. The projected area of the mouth cavity during the feeding cycle varies up to 160 and 22 % for the transverse and mid-sagittal planes, respectively. These findings can inspire novel hydrodynamically efficient biomedical and microfluidic devices.

  17. Corner Separation Control by Boundary Layer Suction Applied to a Highly Loaded Axial Compressor Cascade

    Directory of Open Access Journals (Sweden)

    Yangwei Liu

    2014-11-01

    Full Text Available Control of corner separation has attracted much interest due to its improvement of performance and energy utilization in turbomachinery. Numerical studies have been performed under both design and off-design flow conditions to investigate the effects of boundary layer suction (BLS on corner separation in a highly loaded compressor cascade. Two new BLS slot configurations are proposed and a total of five suction slot configurations were studied and compared. Averaged static pressure rise, exit loss coefficient, passage blockage and flow turning angle have been given and compared systematically over a range of operation incidence angles. Distributions of significant loss removal, blade loading, exit deviation and total pressure loss at 3 degree and 7 degree incidence have also been studied. Under the same suction mass flows of 0.7% of the inlet mass flows, the pitchwise suction slot on the endwall shows a better optimal performance over the whole operation incidence among single suction slots. By using of the new proposed compound slot configuration with one spanwise slot on the blade suction side and one pitchwise slot on the endwall, the maximum reduction of total pressure loss at 7 degree incidence can be 39.4%.

  18. Endotracheal Intubation Using the Macintosh Laryngoscope or KingVision Video Laryngoscope during Uninterrupted Chest Compression

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    Ewelina Gaszynska

    2014-01-01

    Full Text Available Objective. Advanced airway management, endotracheal intubation (ETI, during CPR is more difficult than, for example, during anesthesia. However, new devices such as video laryngoscopes should help in such circumstances. The aim of this study was to assess the performance of the KingVision video laryngoscopes in a manikin cardiopulmonary resuscitation (CPR scenario. Methods. Thirty students enrolled in the third year of paramedic school took part in the study. The simulated CPR scenario was ETI using the standard laryngoscope with a Macintosh blade (MCL and ETI using the KingVision video laryngoscope performed during uninterrupted chest compressions. The primary endpoints were the time needed for ETI and the success ratio. Results. The mean time required for intubation was similar for both laryngoscopes: 16.6 (SD 5.11, median 15.64, range 7.9–27.9 seconds versus 17.91 (SD 5.6, median 16.28, range 10.6–28.6 seconds for the MCL and KingVision, respectively (P=0.1888. On the first attempt at ETI, the success rate during CPR was comparable between the evaluated laryngoscopes: P=0.9032. Conclusion. The KingVision video laryngoscope proves to be less superior when used for endotracheal intubation during CPR compared to the standard laryngoscope with a Mackintosh blade. This proves true in terms of shortening the time needed for ETI and increasing the success ratio.

  19. Comparison of armoured laryngeal mask airway with endotracheal tube for adenotonsillectomy

    International Nuclear Information System (INIS)

    Aziz, L.; Bashir, K.

    2006-01-01

    To assess the reliability of armoured laryngeal mask airway for adenotonsillectomy and to compare the haemodynamic changes during anaesthesia with those of endotracheal tube. A total of 100 patients undergoing adenotonsillectomy between ages 10-35 years and ASA I status were enrolled for the study. Two groups with 50 patients in each group were formed. Group I patients underwent surgery with armoured laryngeal mask airway while group II underwent surgery with endotracheal intubation. Baseline heart rate, systolic blood pressure and diastolic blood pressure were noted pre-operatively, one minute after insertion and every five minutes after induction in both the groups. A change in all these haemodynamic parameters from the baseline was noted. The effect of Boyle Davis Gag and adequacy of surgical access were also noted. Occurrence of cough, laryngospasm and stridor were noted at the time of recovery in both the groups. Baseline variables in both groups were identical. Surgical access was adequate in 48/50 patients in group I while it was adequate in 49/50 patients in group II. The frequencies of cough, laryngeal spasm and stridor were lower in group I. In group I, there was insignificant change from baseline in heart rate, systolic and diastolic blood pressure at one, five and ten minutes after induction. In group II, significant change from baseline was observed in heart rate (p <0.01), systolic blood pressure (p <0.05) and diastolic blood pressure (p <0.05). (author)

  20. The effects of succinylcholine or low-dose rocuronium to aid endotracheal intubation of adult sows

    Science.gov (United States)

    Duke-Novakovski, Tanya; Ambros, Barbara; Auckland, Crissie D.; Harding, John C.S.

    2012-01-01

    This randomized, prospective, blinded study compared the use of succinylcholine or rocuronium to aid endotracheal intubation of 27 adult sows [mean body weight 261 ± 28 (standard deviation) kg]. Preliminary trials allowed development of the intubation technique and skills. The sows were premedicated with azaperone, atropine, and morphine, and anesthesia was induced with thiopental [6 mg/kg body weight (BW)]. Nine sows each received succinylcholine (1.0 mg/kg BW), rocuronium (0.5 mg/kg BW), or saline (15 mL) after induction. Increments of thiopental (1 mg/kg BW) were used if swallowing impaired intubation. Intubation was performed 45 s after injection of the test drug and was timed and scored. The intubation scores were analyzed with Kruskal-Wallis analysis of variance (ANOVA). Time taken for intubation, body weight, and total dose of thiopental were analyzed with ANOVA and Bonferroni’s multiple-comparisons test. No significant differences (at P < 0.05) were found between the groups with regard to intubation score, time taken for intubation, or total thiopental dose. Thus, neuromuscular blocking agents did not aid endotracheal intubation of adult sows anesthetized with thiopental. PMID:22754096

  1. Intraoperative Atelectasis Due to Endotracheal Tube Cuff Herniation: A Case Report

    Directory of Open Access Journals (Sweden)

    Hossein Madineh

    2012-09-01

    Full Text Available Endotracheal tube (ETT cuff herniation is a rare, and often difficult to diagnose, cause of bronchial obstruction. We present a case of outside cuff herniation of an endotracheal tube that caused pulmonary right lung atelectasis. A 29-year-old man ,a case of car accident with multiple fractures, was admitted to the emergency ward and transferred to the operating room(OR for open reduction and internal fixation (ORIF of all fractures .The procedures were done under general anesthesia (G/A. The past medical history of the patient did not indicate any problem. Anesthesia was induced with thiopental, atracurium and then maintained by propofol and remifentanyl infusions and 100% O2 via orally inserted ETT. The patient was positioned in left lateral decubitus position for operation. Two hours after induction of anesthesia, the oxygen saturation level dropped to 85 % and the breath sounds in the right side of the chest were weakened. The chest x-ray images showed right lung atelectasis especially in the upper lobe. The problem was disappeared after removal of the ETT. In this case, we observed that an ETT cuff herniation can be a cause of airway obstruction. If there is a decreased unilateral breath sounds, we recommend replacement or repositioning of ETT.

  2. Work Turbochargers under Reduced Pressure in the Suction Pipe

    Directory of Open Access Journals (Sweden)

    I. V. Filippov

    2014-01-01

    Full Text Available In case consumers have a significant need in the compressed air, the use of turbochargers is a promising direction. The turbocharger operation is largely defined by its running conditions, namely parameters of the intake air and cooling conditions.The paper presents the results of experimental studies of turbochargers type 4CI 425MX4 of series "CENTAC" manufactured by INGERSOL-RAND, which were performed under industrial conditions in a mountainous area with difficult climatic conditions. There were, essentially, no researches of running turbochargers in mountainous areas. The combination of low atmospheric pressure, high temperature of intake air, and specific cooling conditions causes abnormal mode of turbocharger operation. The results of theoretical studies of such modes are found only in N.M. Barannikov’s work while there is no mentioned empirical research at all.Experimental studies were conducted under industrial conditions in the form of passive experiment. All measurements were carried out using a standard measuring system included in the system of compressor monitor and control. During the experimental studies temperature regimes at the turbocharger stage were controlled, and turbocharger pressure ratio and weight output were determined.The results of the research can be formulated as follows:- highland conditions and seasonal variations of atmospheric air have a negative impact on the operation of the turbochargers;- specific work value as an indicator of the economical efficiency exceeds that of the nameplate by 12...21 % depending on the climatic conditions.The problem of functioning normalization of the turbochargers seems to be relevant not only for the considered type of compressor, but also for that of the less power. It is proposed to consider two ways:- installation of the fifth additional stage;- mechanical pressurization in the suction pipe by means of blowers of high power.To make final decision it is necessary to conduct

  3. Rekonstruksi pada Perforasi Palatum Akibat Pneggunaan Gigi Tiruan Lengkap Rahang Atas dengan Suction Cup

    Directory of Open Access Journals (Sweden)

    Cristiani Nadya Pramasari

    2012-12-01

    Full Text Available Latar belakang. Pemasangan suction cup pada gigi tiruan lengkap rahang atas merupakan salah satu cara untuk meningkatkan referensi. Kondisi vakum oleh karena suction cup ini dalam waktu jangka panjang dan tidak terkontrol mengakibatkan nekrosis jaringan yaitu adanya perforasi palatum. Tujuan. Melaporkan rekonstruksi penutupan perforasi palatum sebagai komplikasi penggunaan gigi tiruan lengkap rahang atas dengan suction cup. Laporan Kasus. Pada tanggal 11 September 2012 seorang pria berusia 64 tahun datang ke Poliklinik Bedah Mulut RSUP dr. Sardjito Yogyakarta dengan keluhan terdapat lubang pada langit-langit. Pasien menggunakan gigi palsu buatan tukang gigi dengan perekat berbahan karet pada langit-langit selama 5 tahun. Selama penggunaan gigi palsu pasien sering mengalami sakit dan pembengkakan di langit-langit sampai keluar nanah dan akhirnya terbentuk lubang sehingga jika minum air keluar dari hidung. Pemeriksaan rontgen oklusal rahang atas tampak adanya resorbsi regio palatum durum. Rekonstruksi menggunakan teknik push back modifikasi dilakukan untuk penutupan perforasi palatum di bawah anestesi umum. Kesimpulan. Suction cup pada gigi tiruan lengkap rahang atas mengakibatkan kerusakan jaringan lunak dan jaringan keras rongga mulut. Perforasi palatum yang diakibatkan oleh suction cup ini dapat dilakukan rekonstruksi dengan teknik push back dengan hasil yang cukup optimal.   Background. Suction cups are used to get retention of the complete dentures. The uncontrolled constant vacuum created by the suction cup induces necrosis of tissues and perforation ofpalate. Objective. To report reconstruction for palatal perforation closure as a complication due to prolonged use of maxillary denture with suction cup. Case Report. A 64 years old male patient came to the Department of Oral Surgery, Sardjito General Hospital Yogyakarta on September 11, 2012 with the complaint of hole in his palate. He was wearing dentures for the past 5 years. He also

  4. Endotracheal intubation

    Science.gov (United States)

    ... the esophagus or stomach. Risks include: Bleeding Infection Trauma to the voice box (larynx), thyroid gland, vocal cords and windpipe (trachea), or esophagus Puncture or tearing (perforation) of body parts in the chest cavity, leading to lung collapse

  5. HEAT AND MOISTURE EXCHANGE CAPACITY OF THE UPPER RESPIRATORY TRACT AND THE EFFECT OF TRACHEOTOMY BREATHING ON ENDOTRACHEAL CLIMATE

    NARCIS (Netherlands)

    Scheenstra, Renske J.; Muller, Sara H.; Vincent, Andrew; Hilgers, Frans J. M.

    2011-01-01

    Background. The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. Methods. We plotted the subglottic temperature and humidity measurements

  6. Comparison of rocuronium at two different doses and succinylcholine for endotracheal intubation in adult patients for elective surgeries

    Directory of Open Access Journals (Sweden)

    S G Chavan

    2016-01-01

    Conclusion: Rapid sequence induction of anesthesia with propofol and fentanyl, succinylcholine allowed a more rapid endotracheal intubation sequence and created superior intubation conditions than rocuronium. However, the technique of using a large dose of rocuronium to achieve perfect conditions for tracheal intubation may have application whenever succinylcholine is relatively contraindicated.

  7. Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate

    NARCIS (Netherlands)

    Scheenstra, R.J.; Muller, S.H.; Vincent, A.; Hilgers, F.J.M.

    2011-01-01

    Background. The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. Methods. We plotted the subglottic temperature and humidity measurements

  8. Development of Energy Efficiency Design Map based on acoustic resonance frequency of suction muffler in compressor

    International Nuclear Information System (INIS)

    Oh, Seungjae; Wang, Semyung; Cho, Sungman

    2015-01-01

    Highlights: • Development of Energy Efficiency Design Map. • Experimental validation of Energy Efficiency Design Map. • Suggestion regarding the Acoustically Supercharged Energy Efficiency. • Sensitivity analysis of the Energy Efficiency Ratio with respect to acoustic pressure. • Suggestion regarding the hybrid coupling method for acoustic analysis in compressor. - Abstract: The volumetric efficiency of the Internal Combustion (IC) engine and compressor can be increased by properly adjusting the acoustic resonance frequency of the suction muffler or the suction valve timing without any additional equipment or power source. This effect is known as acoustic supercharging. However, the energy efficiency has become more important than the volumetric efficiency because of the energy shortage issue and factors influencing consumers’ purchasing decisions. Therefore, methods for increasing the energy efficiency using the acoustic effect in the suction part of IC engine and compressor should be considered. In this study, a systematic method for improving the energy efficiency using the acoustic effect in the suction part of the compressor used in refrigerators and air conditioners was developed for the first time. This effect is named as the Acoustically Supercharged Energy Efficiency (ASEE). For the ASEE, first, a hybrid coupling method was suggested for the acoustical analysis in the suction part of the compressor. Next, an Energy Efficiency Design Map (EEDM) was proposed. This can serve as a design guide for suction mufflers in terms of the energy efficiency. Finally, sensitivity analyses of the Energy Efficiency Ratio (EER) and total massflow rate with respect to the acoustic pressure were conducted to identify the relationship between the acoustic pressure and the suction valve motion. This provides the physical background for the EEDM

  9. Endotracheal tube cuff pressures during general anaesthesia while using air versus a 50% mixture of nitrous oxide and oxygen as inflating agents

    Directory of Open Access Journals (Sweden)

    Jesni Joseph Manissery

    2007-01-01

    Full Text Available The present study was aimed at assessing the efficacy of filling a 50% mixture of nitrous oxide : oxygen (50%N 2 O:O 2 in the endotracheal tube cuff to provide stable cuff pressures during general anaesthesia with 67%N 2 O. The endotracheal tube cuff pressures with air (control as the inflating agent in the tubes were found to have a total mean pressure of 62.60±12.33 at the end of one hour of general anaesthesia. When comparing the endotracheal tube cuff pressures in the Mallinckrodt tubes with that of the Portex tubes, with air as the inflating agent, the Portex tubes showed a significantly lower cuff pressures at the end of one hour. The endotracheal tube cuff pressures with 50%N 2 O:O 2 as the inflating agent showed a total mean pressure of 27.63 ± 3.221 at the end of one hour of general anaesthesia. This indicates that inflation of the cuff of the endotracheal tubes with a 50%N 2 O:O 2 rather than air maintains a stable intra cuff pressure. Therefore, the method of using a 50%N 2 O:O 2 for filling endotracheal tube cuff can be adopted for endotracheal tubes with high-volume, low-pressure cuffs to prevent both excessive cuff pressure and disruption of cuff seal, during general anaesthesia lasting up to one hour.

  10. Comparison of Tidal Volumes at the Endotracheal Tube and at the Ventilator.

    Science.gov (United States)

    Kim, Paul; Salazar, Adler; Ross, Patrick A; Newth, Christopher J L; Khemani, Robinder G

    2015-11-01

    Lung protective ventilation for children with acute respiratory distress syndrome requires accurate assessment of tidal volume. Although modern ventilators compensate for ventilator tubing compliance, tidal volume measured at the ventilator may not be accurate, particularly in small children. Although ventilator-specific proximal flow sensors that measure tidal volume at the endotracheal tube have been developed, there is little information regarding their accuracy. We sought to test the accuracy of ventilator measured tidal volume with and without proximal flow sensors against a calibrated pneumotachometer in children. Prospective, observational. Tertiary care PICU. Fifty-one endotracheally intubated and mechanically ventilated children younger than 18 years. Tidal volumes were measured at the ventilator, using a ventilator-specific flow sensor, and a calibrated pneumotachometer connected to the SensorMedics 2600A Pediatric Pulmonary Function Cart. In a pressure control mode of ventilation: median tidal volume measured with the pneumotachometer (9.5 mL/kg [interquartile range, 8.2-11.7 mL/kg]) was significantly higher than tidal volume measured either at the ventilator (8.2 mL/kg [7.1-9.6 mL/kg]) or at the proximal flow sensor (8.1 mL/kg [7.2-10.0 mL/kg]) (p tidal volume measured with the pneumotachometer (10.2 mL/kg [8.8-12.4 mL/kg]) was significantly higher than tidal volume measured either at the ventilator (8.0 mL/kg [7.1-9.7 mL/kg]) or at the proximal flow sensor (8.5 mL/kg [7.3-10.4 mL/kg]) (p Tidal volume measured either at the endotracheal tube with a proximal flow sensor or at the ventilator with compensation for tubing compliance are both significantly lower than tidal volume measured with a calibrated pneumotachometer. This underestimation of delivered tidal volume may be particularly important when managing children with acute respiratory distress syndrome.

  11. Lightwand-Guided Endotracheal Intubation Performed by the Nondominant Hand is Feasible

    Directory of Open Access Journals (Sweden)

    Yi-Wei Kuo

    2007-10-01

    Full Text Available The aim of this study was to evaluate the efficiency of lightwand-guided endotracheal intubation (LWEI performed using either the right (dominant or left (nondominant hand. Two hundred and forty patients aged 21–64 years, with a Mallampati airway classification grade of I—II and undergoing endotracheal intubation under general anesthesia, were enrolled in this randomized and controlled study. Induction of anesthesia was initiated by intravenous administration of fentanyl (2 mg/kg and thiopentone (5mg/kg, and tracheal intubation was facilitated by intravenous atracurium (0.5 mg/kg. In the direct-vision laryngoscope group (group D; n = 80, the intubator held the laryngoscope in the left hand and inserted the endotracheal tube (ETT into the glottic opening with the right hand. In the group in which LWEI was performed with the right hand (group R; n = 80, the intubator lifted the patients' jaws with the left hand and inserted the ETT-LW unit into the glottic openings with the right hand. On the contrary, in the group in which LWEI was performed with the left hand (group L; n = 80, the intubator lifted the jaws with the right hand and inserted the ETT-LW unit with the left hand. Data including total intubation time, the number of intubation attempts, hemodynamic changes during intubation, and side effects following intubation, were collected. Regardless of whether lightwand manipulation was performed with the left hand (group L; 11.4 ± 9.3 s or the right-hand (group R; 12.4 ± 9.2 s, less time was consumed in the LWEI groups than in the laryngoscope group (group D; 17.9 ± 9.9s (p 95% on their first intubation attempts. The changes in mean arterial blood pressure and heart rate were similar among the three groups. A higher incidence of intubation-related oral injury and ventricular premature contractions (VPC was found in group D compared with groups L and R (oral injury: group D 8.5%, group L 1.3%, group R 0%, p = 0.005; VPC: group D 16

  12. A Note regarding Problems with Interaction and Varying Block Sizes in a Comparison of Endotracheal Tubes

    Directory of Open Access Journals (Sweden)

    Richard L. Einsporn

    2014-01-01

    Full Text Available A randomized clinical experiment to compare two types of endotracheal tubes utilized a block design where each of the six participating anesthesiologists performed tube insertions for an equal number of patients for each type of tube. Five anesthesiologists intubated at least three patients with each tube type, but one anesthesiologist intubated only one patient per tube type. Overall, one type of tube outperformed the other on all three effectiveness measures. However, analysis of the data using an interaction model gave conflicting and misleading results, making the tube with the better performance appear to perform worse. This surprising result was caused by the undue influence of the data for the anesthesiologist who intubated only two patients. We therefore urge caution in interpreting results from interaction models with designs containing small blocks.

  13. Catheter and Laryngeal Mask Endotracheal Surfactant Therapy: the CALMEST approach as a novel MIST technique.

    Science.gov (United States)

    Vannozzi, Ilaria; Ciantelli, Massimiliano; Moscuzza, Francesca; Scaramuzzo, Rosa T; Panizza, Davide; Sigali, Emilio; Boldrini, Antonio; Cuttano, Armando

    2017-10-01

    Neonatal respiratory distress syndrome (RDS) is a major cause of mortality and morbidity among preterm infants. Although the INSURE (INtubation, SURfactant administration, Estubation) technique for surfactant replacement therapy is so far the gold standard method, over the last years new approaches have been studied, i.e. less invasive surfactant administration (LISA) or minimally invasive surfactant therapy (MIST). Here we propose an originally modified MIST, called CALMEST (Catheter And Laryngeal Mask Endotracheal Surfactant Therapy), using a particular laryngeal mask as a guide for a thin catheter to deliver surfactant directly in the trachea. We performed a preliminary study on a mannequin and a subsequent in vivo pilot trial. This novel procedure is quick, effective and well tolerated and might represent an improvement in reducing neonatal stress. Ultimately, CALMEST offers an alternative approach that could be extremely useful for medical staff with low expertise in laryngoscopy and intubation.

  14. Easy method of centralized fixation of endotracheal tube in cleft lip and palate surgery

    Directory of Open Access Journals (Sweden)

    S P Bajaj

    2012-01-01

    Full Text Available As we all know that fixation of endotracheal tube is very important aspect in cleft palate and maxillofacial surgery. During cleft palate and oral surgery various methods of fixation and modified tubes are deviced to make surgery safer and ergonomically better. Our method consist of 3 point fixation of tube (RAE with dynaplast, which is freely available, cheap and good Adhesive quality. Dynaplast divided into 3 phalanges (one central and two lateral and one portion undivided as central limb. This undivided central limb is fixed in centre of chin and other 3 phalanges wrap around tube on either side. This fixation totally takes away any lateral movements of tube. This method can be used with any tube (RAE/ Oxford/Flexometallic. Our method is described for its simplicity, ease and convinence and result which impart universally similar results with all different members of our anesthetist team.

  15. Effect of plate permeability on nonlinear stability of the asymptotic suction boundary layer.

    Science.gov (United States)

    Wedin, Håkan; Cherubini, Stefania; Bottaro, Alessandro

    2015-07-01

    The nonlinear stability of the asymptotic suction boundary layer is studied numerically, searching for finite-amplitude solutions that bifurcate from the laminar flow state. By changing the boundary conditions for disturbances at the plate from the classical no-slip condition to more physically sound ones, the stability characteristics of the flow may change radically, both for the linearized as well as the nonlinear problem. The wall boundary condition takes into account the permeability K̂ of the plate; for very low permeability, it is acceptable to impose the classical boundary condition (K̂=0). This leads to a Reynolds number of approximately Re(c)=54400 for the onset of linearly unstable waves, and close to Re(g)=3200 for the emergence of nonlinear solutions [F. A. Milinazzo and P. G. Saffman, J. Fluid Mech. 160, 281 (1985); J. H. M. Fransson, Ph.D. thesis, Royal Institute of Technology, KTH, Sweden, 2003]. However, for larger values of the plate's permeability, the lower limit for the existence of linear and nonlinear solutions shifts to significantly lower Reynolds numbers. For the largest permeability studied here, the limit values of the Reynolds numbers reduce down to Re(c)=796 and Re(g)=294. For all cases studied, the solutions bifurcate subcritically toward lower Re, and this leads to the conjecture that they may be involved in the very first stages of a transition scenario similar to the classical route of the Blasius boundary layer initiated by Tollmien-Schlichting (TS) waves. The stability of these nonlinear solutions is also investigated, showing a low-frequency main unstable mode whose growth rate decreases with increasing permeability and with the Reynolds number, following a power law Re(-ρ), where the value of ρ depends on the permeability coefficient K̂. The nonlinear dynamics of the flow in the vicinity of the computed finite-amplitude solutions is finally investigated by direct numerical simulations, providing a viable scenario for

  16. Vortex lift augmentation by suction on a 60 deg swept Gothic wing

    Science.gov (United States)

    Taylor, A. H.; Jackson, L. R.; Huffman, J. K.

    1982-01-01

    An experimental investigation was conducted in the Langley high-speed 7- by 10-foot wind tunnel to determine the aerodynamic performance of suction applied near the wing tips above the trailing edge of a 60 deg swept Gothic wing. Moveable suction inlets were symmetrically mounted in the proximity of the trailing edge, and the amount of suction was varied to maximize wing lift. Tests were conducted at Mach 0.15, 0.30, and 0.45, and the angle of attack was varied from -4 to 50 deg. The suction augmentation increases the lift coefficient over the entire range of angle of attack. The lift improvement exceeds the unaugmented wing lift by over 20%. Moreover, the augmented lift exceeds the lift predicted by vortex lattice theory to 30 deg angle of attack. Suction augmentation is postulated to strengthen the vortex system by increasing its velocity and making it more concentrated. This causes the vortex breakdown to be delayed to a higher angle of attack

  17. Bio-inspired Miniature Suction Cups Actuated by Shape Memory Alloy

    Directory of Open Access Journals (Sweden)

    Hu Bing-shan

    2010-02-01

    Full Text Available Wall climbing robots using negative pressure suction always employ air pumps which have great noise and large volume. Two prototypes of bio-inspired miniature suction cup actuated by shape memory alloy (SMA are designed based on studying characteristics of biologic suction apparatuses, and the suction cups in this paper can be used as adhesion mechanisms for miniature wall climbing robots without air pumps. The first prototype with a two-way shape memory effect (TWSME extension TiNi spring imitates the piston structure of the stalked sucker; the second one actuated by a one way SMA actuator with a bias has a basic structure of stiff margin, guiding element, leader and elastic element. Analytical model of the second prototype is founded considering the constitutive model of the SMA actuator, the deflection of the thin elastic plate under compound load and the thermo-dynamic model of the sealed air cavity. Experiments are done to test their suction characteristics, and the analytical model of the second prototype is simulated on Matlab/simulink platform and validated by experiments.

  18. Performance of high-area-ratio annular dump diffuser using suction-stabilized-vortex flow control

    Science.gov (United States)

    Juhasz, A. J.; Smith, J. M.

    1977-01-01

    A short annular dump diffuser having a geometry conductive to formation of suction stabilized toroidal vortices in the region of abrupt area change was tested. The overall diffuser area ratio was 4.0 and the length to inlet height ratio was 2.0. Performance data were obtained at near ambient temperature and pressure for inlet Mach numbers of 0.18 and 0.30 with suction rates ranging from 0 to 18 percent of total inlet mass flowrate. Results show that the exit velocity profile could be readily biased toward either wall by adjustment of inner and outer wall suction rates. Symmetric exit velocity profiles were inherently unstable with a tendency to revert to a hub or tip bias. Diffuser effectiveness was increased from about 38 percent without suction to over 85 percent at a total suction rate of 10 to 12 percent. At the same time diffuser total pressure loss was reduced from 3.1 percent to 1.1 percent at an inlet Mach number of 0.3.

  19. Bio-inspired Miniature Suction Cups Actuated by Shape Memory Alloy

    Directory of Open Access Journals (Sweden)

    Hu Bing-Shan

    2009-09-01

    Full Text Available Wall climbing robots using negative pressure suction always employ air pumps which have great noise and large volume. Two prototypes of bio-inspired miniature suction cup actuated by shape memory alloy (SMA are designed based on studying characteristics of biologic suction apparatuses, and the suction cups in this paper can be used as adhesion mechanisms for miniature wall climbing robots without air pumps. The first prototype with a two-way shape memory effect (TWSME extension TiNi spring imitates the piston structure of the stalked sucker; the second one actuated by a one way SMA actuator with a bias has a basic structure of stiff margin, guiding element, leader and elastic element. Analytical model of the second prototype is founded considering the constitutive model of the SMA actuator, the deflection of the thin elastic plate under compound load and the thermo-dynamic model of the sealed air cavity. Experiments are done to test their suction characteristics, and the analytical model of the second prototype is simulated on Matlab/simulink platform and validated by experiments.

  20. Effects of vacuum suctioning and strategic drape tenting on oxygen concentration in a simulated surgical field.

    Science.gov (United States)

    Kung, Theodore A; Kong, Sarah W; Aliu, Oluseyi; Azizi, Jahan; Kai, Salim; Cederna, Paul S

    2016-02-01

    To investigate the isolated and combined effects of vacuum suctioning and strategic drape tenting on oxygen concentration in an experimental setting. Experimental. Clinical simulation center of a university-affiliated hospital. Mannequin simulation of a patient undergoing facial surgery under sedation anesthesia. Supplemental oxygen was delivered via nasal cannula. Vacuum suctioning and strategic drape tenting. The experimental trials entailed measuring oxygen concentration around the nasal cannula continuously either in the presence or absence of a standard operating room vacuum suction system and strategic tenting of surgical drapes. The primary outcome was the time required for oxygen concentration to reach 21%. In the control group (without suction or strategic tenting), a mean time of 180 seconds elapsed until the measured oxygen concentration reached 21% after cessation of oxygen delivery. Use of a vacuum suction device alone (110 seconds; P strategic tenting (110 seconds; P strategic tenting of surgical drapes has a theoretical benefit to decreasing the pooling of oxygen around the surgical site, further investigation is necessary before its routine use is recommended. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Suppression of the secondary flow in a suction channel of a large centrifugal pump

    International Nuclear Information System (INIS)

    Torii, D; Nagahara, T; Okihara, T

    2013-01-01

    The suction channel configuration of a large centrifugal pump with a 90-degree bend was studied in detail to suppress the secondary flow at the impeller inlet for improving suction performance. Design of experiments (DOE) and computational fluid dynamics (CFD) were used to evaluate the sensitivity of several primary design parameters of the suction channel. A DOE is a powerful tool to clarify the sensitivity of objective functions to design parameters with a minimum of trials. An L9 orthogonal array was adopted in this study and nine suction channels were designed, through which the flow was predicted by steady state calculation. The results indicate that a smaller bend radius with a longer straight nozzle, distributed between the bend and the impeller, suppresses the secondary flow at the impeller inlet. An optimum ratio of the cross sectional areas at the bend inlet and outlet was also confirmed in relationship to the contraction rate of the downstream straight nozzle. These findings were obtained by CFD and verified by experiments. The results will aid the design of large centrifugal pumps with better suction performance and higher reliability

  2. Morphology, Kinematics, and Dynamics: The Mechanics of Suction Feeding in Fishes.

    Science.gov (United States)

    Day, Steven W; Higham, Timothy E; Holzman, Roi; Van Wassenbergh, Sam

    2015-07-01

    Suction feeding is pervasive among aquatic vertebrates, and our understanding of the functional morphology and biomechanics of suction feeding has recently been advanced by combining experimental and modeling approaches. Key advances include the visualization of the patterns of flow in front of the mouth of a feeding fish, the measurement of pressure inside their mouth cavity, and the employment of analytical and computational models. Here, we review the key components of the morphology and kinematics of the suction-feeding system of anatomically generalized, adult ray-finned fishes, followed by an overview of the hydrodynamics involved. In the suction-feeding apparatus, a strong mechanistic link among morphology, kinematics, and the capture of prey is manifested through the hydrodynamic interactions between the suction flows and solid surfaces (the mouth cavity and the prey). It is therefore a powerful experimental system in which the ecology and evolution of the capture of prey can be studied based on first principals. © The Author 2015. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  3. Corrosion casting of the subglottis following endotracheal tube intubation injury: a pilot study in Yorkshire piglets

    Science.gov (United States)

    2013-01-01

    Purpose Subglottic stenosis can result from endotracheal tube injury. The mechanism by which this occurs, however, is not well understood. The purpose of this study was to examine the role of angiogenesis, hypoxia and ischemia in subglottic mucosal injury following endotracheal intubation. Methods Six Yorkshire piglets were randomized to either a control group (N=3, ventilated through laryngeal mask airway for corrosion casting) or accelerated subglottic injury group through intubation and induced hypoxia as per a previously described model (N=3). The vasculature of all animals was injected with liquid methyl methacrylate. After polymerization, the surrounding tissue was corroded with potassium hydroxide. The subglottic region was evaluated using scanning electron microscopy looking for angiogenic and hypoxic or degenerative features and groups were compared using Mann–Whitney tests and Friedman’s 2-way ANOVA. Results Animals in the accelerated subglottic injury group had less overall angiogenic features (P=.002) and more overall hypoxic/degenerative features (P=.000) compared with controls. Amongst angiogenic features, there was decreased budding (P=.000) and a trend toward decreased sprouting (P=.037) in the accelerated subglottic injury group with an increase in intussusception (P=.004), possibly representing early attempts at rapid revascularization. Amongst hypoxic/degenerative features, extravasation was the only feature that was significantly higher in the accelerated subglottic injury group (P=.000). Conclusions Subglottic injury due to intubation and hypoxia may lead to decreased angiogenesis and increased blood vessel damage resulting in extravasation of fluid and a decreased propensity toward wound healing in this animal model. PMID:24401165

  4. Reliability of Ultrasonography in Confirming Endotracheal Tube Placement in an Emergency Setting

    Science.gov (United States)

    Thomas, Vimal Koshy; Paul, Cherish; Rajeev, Punchalil Chathappan; Palatty, Babu Urumese

    2017-01-01

    Background and Objectives: Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare it with the traditional clinical methods and the gold standard quantitative waveform capnography. Two primary outcomes were measured in our study. First was the sensitivity and specificity of ultrasonography against the other two methods to confirm endotracheal intubation. The second primary outcome assessed was the time taken for each method to confirm tube placement in an emergency setting. Methods: This is a single-centered, prospective cohort study conducted in an emergency department of a tertiary care hospital. We included 100 patients with indication of emergency intubation by convenient sampling. The intubation was performed as per standard hospital protocol. As part of the study protocol, ultrasonography was used to identify ETT placement simultaneously with the intubation procedure along with quantitative waveform capnography (end-tidal carbon dioxide) and clinical methods. Confirmation of tube placement and time taken for the same were noted by three separate health-care staffs. Results and Discussion: Out of the 100 intubation attempts, five (5%) had esophageal intubations. The sensitivity and specificity of diagnosis using ultrasonography were 97.89% and 100%, respectively. This was statistically comparable with the other two modalities. The time taken to confirm tube placement with ultrasonography was 8.27 ± 1.54 s compared to waveform capnography and clinical methods which were 18.06 ± 2.58 and 20.72 ± 3.21 s, respectively. The time taken by ultrasonography was significantly less. Conclusions: Ultrasonography confirmed tube placement with comparable sensitivity and specificity to quantitative waveform capnography and clinical methods. But then, it yielded results considerably faster than the other two modalities. PMID:28584427

  5. "COMPARISON OF HEMODYNAMIC CHANGES AFTER INSERTION OF LARYNGEAL MASK AIRWAY, FACEMASK AND ENDOTRACHEAL INTUBATION"

    Directory of Open Access Journals (Sweden)

    K. Montazari

    2004-11-01

    Full Text Available Hemodynamic changes are major hazards of general anesthesia and are probably generated by direct laryngoscopy and endotracheal intubation. We designed this prospective randomised study to assess the cardiovascular changes after either laryngeal mask airway (LMA, face mask (FM or endotracheal tube (ETT insertion in the airway management of adult patients anesthetised with nitrous oxide and halothane. A total of 195 healthy normotensive adult patients with normal airways were randomly assigned to one of the three groups according to their airway management (n= 65 each for transurethral lithotripsy procedures. Heart rate (HR, systolic blood pressure (SBP, diastolic blood pressure (DBP and mean arterial blood pressure (MAP values were recorded before the induction of anesthesia, and then every three minutes until 30 min thereafter. The mean maximum HR and MAP values obtained during 15 and 30 minutes after insertion of LMA were 81±13, 73±8 bpm and 82±14, 79 ±11 mmHg, respectively which were significantly smaller compared to those with FM (84±12, 80±6 bpm and 86±10, 83±13 mmHg and ETT (96±8, 88±7 bpm and 91±11, 82±9 mmHg (P< 0.05. Direct stimulation of the trachea appears to be a major cause of the hemodynamic changes associated with tracheal intubation during general anesthesia, but why hemodynamic changes in LMA were smaller than facemask needs further study. In healthy normotensive patients the use of LMA for the airway management during general anesthesia results in a smaller cardiovascular change than FM and ETT.

  6. Isolation of Separate Ureaplasma Species From Endotracheal Secretions of Twin Patients.

    Science.gov (United States)

    Beeton, Michael L; Maxwell, Nicola C; Chalker, Victoria J; Brown, Rebecca J; Aboklaish, Ali F; Spiller, O Brad

    2016-08-01

    Isolation of Ureaplasma spp. from preterm neonates and the association with development of bronchopulmonary dysplasia has been previously investigated. However, few studies have contrasted the nature of infection in twins. In this article, we report that dizygotic twins (1 girl, 1 boy) born at 24 weeks gestation both yielded culturable Ureaplasma from endotracheal secretions. The samples were part of a serial blind collection cohort of ventilated premature neonates, and analysis of repeat cultures showed stable, separate infections over a period of 17 and 21 days, respectively. Immunoblot and probe-specific quantitative polymerase chain reaction analysis determined that Twin 1 was solely infected with Ureaplasma parvum (specifically, serovar 6 by gene sequencing), whereas Twin 2 was solely infected with Ureaplasma urealyticum (specifically, genotype A- serovars 2, 5, and 8 by gene sequencing). Immunoblot analysis found that the major surface antigen (multiple-banded antigen) altered relative mass for both strains during the course of infection. Quantitative polymerase chain reaction analysis of extracted endotracheal aspirates confirmed no evidence of mixed infection for either twin. Failure of sentinel ventilated preterm infants on the same ward to acquire Ureaplasma infection after the first week of birth suggests no cot-to-cot transfer of Ureaplasma infection occurred. This study demonstrated not only a contrasting clinical outcome for a set of twins infected with 2 separate species of Ureaplasma, but also the first real-time demonstration of multiple-banded antigen alteration and evolution of Ureaplasma over the course of a clinical infection. Copyright © 2016 by the American Academy of Pediatrics.

  7. Epistaxis during nasotracheal intubation: a randomized trial of the Parker Flex-Tip™ nasal endotracheal tube with a posterior facing bevel versus a standard nasal RAE endotracheal tube.

    Science.gov (United States)

    Earle, Rosie; Shanahan, Enda; Vaghadia, Himat; Sawka, Andrew; Tang, Raymond

    2017-04-01

    Nasotracheal intubation is a widely performed technique to facilitate anesthesia induction during oral, dental, and maxillofacial surgeries. The technique poses several risks not encountered with oropharyngeal intubation, most commonly epistaxis due to nasal mucosal abrasion. The purpose of this study was to test whether the use of the Parker Flex-Tip™ (PFT) nasal endotracheal tube (ETT) with a posterior facing bevel reduces epistaxis when compared with the standard nasal RAE ETT with a leftward facing bevel. Sixty American Society of Anesthesiologists physical status I and II patients undergoing oral or maxillofacial surgery with nasotracheal intubation were recruited. Patients were randomized to either a standard nasal RAE ETT or a PFT nasal ETT. The ETT was thermosoftened and lubricated for both study groups prior to insertion, and the size of the tube was chosen at the discretion of the attending anesthesiologist. The primary outcome was the incidence of epistaxis, with a secondary outcome of epistaxis severity (scored as none, mild, moderate, or severe). An investigator measured both outcomes five minutes after intubation was completed. Mild or moderate epistaxis was experienced by 22 of 30 (73%) patients in the PFT group compared with 21 of 30 (70%) patients in the standard nasal RAE ETT group (absolute risk reduction, 3%; 95% confidence interval, -19 to 25; P = 0.78). There were no occurrences of severe epistaxis in either group. There was no difference in the incidence or severity of epistaxis following nasal intubation using the Parker Flex-Tip nasal ETT when compared with a standard nasal RAE ETT. This trial was registered at ClinicalTrials.gov, identifier: NCT02315677.

  8. A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions: A randomized, crossover cadaver trial.

    Science.gov (United States)

    Truszewski, Zenon; Krajewski, Paweł; Fudalej, Marcin; Smereka, Jacek; Frass, Michael; Robak, Oliver; Nguyen, Bianka; Ruetzler, Kurt; Szarpak, Lukasz

    2016-11-01

    Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera. To assess if the ETView VivaSight SL can be a superior alternative to a standard endotracheal tube for intubation in an adult cadaver model, both during and without simulated CPR. ETView VivaSight SL tube was investigated via an interventional, randomized, crossover, cadaver study. A total of 52 paramedics participated in the intubation of human cadavers in three different scenarios: a normal airway at rest without concomitant chest compression (CC) (scenario A), a normal airway with uninterrupted CC (scenario B) and manual in-line stabilization (scenario C). Time and rate of success for intubation, the glottic view scale, and ease-of-use of ETView vs. sETT intubation were assessed for each emergency scenario. The median time to intubation using ETView vs. sETT was compared for each of the aforementioned scenarios. For scenario A, time to first ventilation was achieved fastest for ETView, 19.5 [IQR, 16.5-22] sec, when compared to that of sETT at 21.5 [IQR, 20-25] sec (p = .013). In scenario B, the time for intubation using ETView was 21 [IQR, 18.5-24.5] sec (p cadavers and the time to ventilation were improved with the ETView. The time to glottis view, tube insertion, and cuff block were all found to be shorter with the ETView. clinicaltrials.gov Identifier: NCT02733536.

  9. Optimization analysis of the motor cooling method in semi-closed single screw refrigeration compressor

    Science.gov (United States)

    Wang, Z. L.; Shen, Y. F.; Wang, Z. B.; Wang, J.

    2017-08-01

    Semi-closed single screw refrigeration compressors (SSRC) are widely used in refrigeration and air conditioning systems owing to the advantages of simple structure, balanced forces on the rotor, high volumetric efficiency and so on. In semi-closed SSRCs, motor is often cooled by suction gas or injected refrigerant liquid. Motor cooling method will changes the suction gas temperature, this to a certain extent, is an important factor influencing the thermal dynamic performance of a compressor. Thus the effects of motor cooling method on the performance of the compressor must be studied. In this paper mathematical models of motor cooling process by using these two methods were established. Influences of motor cooling parameters such as suction gas temperature, suction gas quantity, temperature of the injected refrigerant liquid and quantity of the injected refrigerant liquid on the thermal dynamic performance of the compressor were analyzed. The performances of the compressor using these two kinds of motor cooling methods were compared. The motor cooling capacity of the injected refrigerant liquid is proved to be better than the suction gas. All analysis results obtained can be useful for optimum design of the motor cooling process to improve the efficiency and the energy efficiency of the compressor.

  10. Present knowledge about Laboratory Testing of Axial Loading on Suction Caissons

    DEFF Research Database (Denmark)

    Manzotti, E.; Vaitkunaite, Evelina; Ibsen, Lars Bo

    Offshore wind turbines are increasing in both efficiency and size. More economical foundations for such light structures are under investigation, and suction caisson was shown to be particularly suitable for this purpose. In multi-pod foundation configuration, the overturning moment given by loads...... on the structure is resisted by push-pull loads on the vertical axis of each suction caisson. Relevant works where this situation is examined by means of laboratory testing are summarized in this article, then different conclusions are followed by discussion and comparison. In the initial theoretical section...

  11. External suction versus water seal after selective pulmonary resection for lung neoplasm: a systematic review.

    Directory of Open Access Journals (Sweden)

    Tong Qiu

    Full Text Available OBJECTIVE: To evaluate whether external suction is more advantageous than water seal in patients undergoing selective pulmonary resection (SPR for lung neoplasm. SUMMARY OF BACKGROUND DATA: Whether external suction should be routinely applied in postoperative chest drainage is still unclear, particularly for lung neoplasm patients. To most surgeons, the decision is based on their clinical experience. METHODS: Randomized control trials were selected. The participants were patients undergoing SPR with lung neoplasm. Lung volume reduction surgery and pneumothorax were excluded. Suction versus non-suction for the intervention. The primary outcome was the incidence of persistent air leak (PAL. The definition of PAL was air leak for more than 3-7 days. The secondary outcomes included air leak duration, time of drainage, postoperative hospital stay and the incidence of postoperative pneumothorax. Studies were identified from literature collections through screening. Bias was analyzed and meta-analysis was used. RESULTS: From the 1824 potentially relevant trials, 6 randomized control trials involving 676 patients were included. There was no difference between external suction and water seal in decreasing the incidence of PAL [95% confidence interval (CI 0.81-2.16; z = 1.10; P = 0.27]. Regarding secondary outcomes, there were no differences in time of drainage (95% CI-0.36-1.56, P = 0.22, postoperative hospital stay (95% CI -.31-.54, P = 0.87 or incidence of postoperative pneumothorax (95% CI 0.18-.02, P = 0.05 between external suction and water seal. CONCLUSIONS: For participants, no differences are identified in terms of PAL incidence, drainage time, length of postoperative hospital stay or incidence of postoperative pneumothorax between external suction and water seal. The bias analysis should be emphasized. To the limitations of the bias and methodological differences among the included studies, we have no recommendation on

  12. Preliminary study of efficacy of cup suction in the correction of typical pectus excavatum.

    Science.gov (United States)

    Lopez, Manuel; Patoir, Arnaud; Costes, Frederic; Varlet, François; Barthelemy, Jean-Claude; Tiffet, Olivier

    2016-01-01

    This preliminary qualitative study evaluates the efficacy of cup suction in the correction of pectus excavatum (PE), and examines the place of this system as a strategic treatment and as an alternative to surgery. Between October 2011 and June 2014, a total of 84 patients (children and adult) presenting with PE were treated by cup suction, in our chest wall deformities unit. On first consultation, the patients with typical PE and with at least partial correction during the first application of cup suction and a maximal suction pressure for correction of less than 300 mbar (millibars) were included in this study. 11 patients were excluded from the present study as they presented with a complex carinatum/excavatum. The remaining 73 patients were divided into two groups: Group I, adult patients ≥ 18 year old, 17 patients. The mean age was 22.8 years old. Group II, pediatric patients cup suction, strengthening exercises, and clinical follow-up every two to three months. The evaluation criteria during, and on the completion of the trial were: depth of the PE, morbidity and treatment compliance. Partial and final results were evaluated by the patients, their parents, and doctor, using a qualitative scoring scale. A total of 73 patients presenting typical PE (symmetric in 52 cases and asymmetric in 21 cases) were treated by cup suction. The mean depth of PE was 23 mm (9-44). Of the 73 patients, one adult abandoned treatment and three children abandoned follow-up. The mean time of use of the device was 4h daily. At six months of treatment, the mean depth of PE was 9 mm (0-30) across all patients. 23 patients completed the treatment and exhibited flattening of the sternum. These patients were considered to have an excellent aesthetic result. The mean treatment duration to normal reshape was achieved at 10 months (4-21). The remaining patients are improving under continuing active treatment. The mean depth of PE in this group was 12 mm (4-30), after a mean treatment

  13. Alternative Shape of Suction Caisson to Reduce Risk of Buckling under high Pressure

    DEFF Research Database (Denmark)

    Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo

    2013-01-01

    Using large suction caissons for offshore wind turbines is an upcoming technology also referred to as bucket foundations. During operation the bucket foundation is loaded by a large overturning moment from the wind turbine and the wave loads. However, during installation the bucket is loaded...... cylindrical monopod foundation made of steel. In this paper, an alternative design/shape of the suction caisson, having a smaller risk of buckling under high pressure is presented. The risk of structural buckling is addressed using numerical methods to determine the buckling pressures of the re...

  14. Easy come, easy go: a simple and effective orthodontic enamel anchor for endotracheal tube stabilization in a child with extensive facial burns.

    Science.gov (United States)

    Sakata, Shinichiro; Hallett, Kerrod B; Brandon, Matthew S; McBride, Craig A

    2009-11-01

    Endotracheal tube stabilization in patients with facial burns is crucial and often challenging. We present a simple method of securing an endotracheal tube using two orthodontic brackets bonded to the maxillary central incisor teeth and a 0.08'' stainless steel ligature wire. Our technique is less traumatic, and is easier to maintain oral hygiene than with previously described methods. This anchorage system takes 5 min to apply and can be removed on the ward without the need for a general anaesthetic.

  15. ProSeal laryngeal mask airway: An alternative to endotracheal intubation in paediatric patients for short duration surgical procedures

    Directory of Open Access Journals (Sweden)

    Jaya Lalwani

    2010-01-01

    Full Text Available The laryngeal mask airway (LMA is a supraglottic airway management device. The LMA is preferred for airway management in paediatric patients for short duration surgical procedures. The recently introduced ProSeal (PLMA, a modification of Classic LMA, has a gastric drainage tube placed lateral to main airway tube which allows the regurgitated gastric contents to bypass the glottis and prevents the pulmonary aspiration. This study was done to compare the efficacy of ProSeal LMA with an endotracheal tube in paediatric patients with respect to number of attempts for placement of devices, haemodynamic responses and perioperative respiratory complications. Sixty children, ASA I and II, weighing 10-20 kg between 2 and 8 years of age group of either sex undergoing elective ophthalmological and lower abdominal surgeries of 30-60 min duration, randomly divided into two groups of 30 patients each were studied. The number of attempts for endotracheal intubation was less than the placement of PLMA. Haemodynamic responses were significantly higher (P<0.05 after endotracheal intubation as compared to the placement of PLMA. There were no significant differences in mean SpO 2 (% and EtCO 2 levels recorded at different time intervals between the two groups. The incidence of post-operative respiratory complications cough and bronchospasm was higher after extubation than after removal of PLMA. The incidence of soft tissue trauma was noted to be higher for PLMA after its removal. There were no incidences of aspiration and hoarseness/sore throat in either group. It is concluded that ProSeal LMA can be safely considered as a suitable and effective alternative to endotracheal intubation in paediatric patients for short duration surgical procedures.

  16. Randomized Pilot Trial of Two Modified Endotracheal Tubes To Prevent Ventilator-associated Pneumonia.

    Science.gov (United States)

    Deem, Steven; Yanez, David; Sissons-Ross, Laura; Broeckel, Jo Ann Elrod; Daniel, Stephen; Treggiari, Miriam

    2016-01-01

    Ventilator-associated pneumonia (VAP) is a prevalent and costly nosocomial infection related to instrumentation of the airway with an endotracheal tube (ETT), enabling microaspiration of contaminated secretions. Modification of the ETT design to reduce microaspiration and/or biofilm formation may play an important role in VAP prevention. However, there is insufficient evidence to provide strong recommendations regarding the use of modified ETT and unaddressed safety concerns. We performed a pilot randomized controlled trial comparing two modified ETTs designed specifically to prevent VAP, with the standard ETT, to test the feasibility of and inform planning for a large, pivotal, randomized trial. This study was conducted with institutional review board approval under exception from informed consent. We randomized in a blinded fashion patients undergoing emergency endotracheal intubation both out of and in hospital to receive one of three different ETT types: (1) a polyurethane-cuffed tube (PUC-ETT), (2) a polyurethane-cuffed tube equipped with a port for continuous aspiration of subglottic secretions (PUC-CASS-ETT), or a (3) standard polyvinylchloride-cuffed tube (PVC-ETT). In addition to investigating feasibility and safety, the study coprimary end points were tracheal bacterial colonization reaching a cfu count >10(6) cfu per milliliter and the incidence of invasively diagnosed VAP. A total of 102 subjects were randomized and met the eligibility criteria. Randomization procedures performed well and integrity of blinding at randomization was maintained. The majority of intubations occurred in the hospital setting (n = 77), and the remainder occurred out of hospital (n = 25). Compared with the PVC-ETT, there were no significant differences in tracheal colonization for PUC-ETT (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.31-3.09) or for PUC-CASS-ETT (OR, 1.26; 95% CI, 0.42-3.76). There were no differences in the risk of invasively diagnosed VAP

  17. Fluoroscopic guidance for placing a double lumen endotracheal tube in adults.

    Science.gov (United States)

    Calenda, Emile; Baste, Jean Marc; Hajjej, Ridha; Rezig, Najiba; Moriceau, Jerome; Diallo, Yaya; Sghaeir, Slim; Danielou, Eric; Peillon, Christophe

    2014-09-01

    The aim of this study was to assess the right placement of the double lumen endotracheal tube with fluoroscopic guidance, which is used in first intention prior to the fiberscope in our institution. This was a prospective observational study. The study was conducted in vascular and thoracic operating rooms. We enrolled 205 patients scheduled for thoracic surgery, with ASA physical statuses of I (n = 37), II (n = 84), III (n = 80), and IV (n = 4). Thoracic procedures were biopsy (n = 20), wedge (n = 34), culminectomy (n = 6), lobectomy (n = 82), pneumonectomy (n = 4), sympathectomy (n = 9), symphysis (n = 47), and thymectomy (n = 3). The intubation with a double lumen tube was performed with the help of a laryngoscope. Tracheal and bronchial balloons were inflated and auscultation was performed after right and left exclusions. One shot was performed to locate the position of the bronchial tube and the hook. Fluoroscopic guidance was used to relocate the tube in case of a wrong position. When the fluoroscopic guidance failed to position the tube, a fiberscope was used. Perioperative collapse of the lung was assessed by the surgeon during the surgery. Correct fluoroscopic image was obtained after the first attempt in 58.5% of patients therefore a misplaced position was encountered in 41.5%. The fluoroscopic guidance allowed an exact repositioning in 99.5% of cases, and the mean duration of the procedure was 8 minutes. A fiberscope was required to move the hook for one patient. We did not notice a moving of the double lumen endotracheal tube during the surgery. The surgeon satisfaction was 100%. The fluoroscopy evidenced the right position of the double lumen tube and allowed a right repositioning in 99.5% of patients with a very simple implementation. Copyright © 2014. Published by Elsevier B.V.

  18. Endotracheal Tube Cuff Pressures in Patients Intubated Prior to Helicopter EMS Transport

    Directory of Open Access Journals (Sweden)

    Joseph Tennyson

    2016-11-01

    Full Text Available Introduction Endotracheal intubation is a common intervention in critical care patients undergoing helicopter emergency medical services (HEMS transportation. Measurement of endotracheal tube (ETT cuff pressures is not common practice in patients referred to our service. Animal studies have demonstrated an association between the pressure of the ETT cuff on the tracheal mucosa and decreased blood flow leading to mucosal ischemia and scarring. Cuff pressures greater than 30 cmH2O impede mucosal capillary blood flow. Multiple prior studies have recommended 30 cmH2O as the maximum safe cuff inflation pressure. This study sought to evaluate the inflation pressures in ETT cuffs of patients presenting to HEMS. Methods We enrolled a convenience sample of patients presenting to UMass Memorial LifeFlight who were intubated by the sending facility or emergency medical services (EMS agency. Flight crews measured the ETT cuff pressures using a commercially available device. Those patients intubated by the flight crew were excluded from this analysis as the cuff was inflated with the manometer to a standardized pressure. Crews logged the results on a research form, and we analyzed the data using Microsoft Excel and an online statistical analysis tool. Results We analyzed data for 55 patients. There was a mean age of 57 years (range 18–90. The mean ETT cuff pressure was 70 (95% CI= [61–80] cmH2O. The mean lies 40 cmH2O above the maximum accepted value of 30 cmH2O (p120 cmH2O, the maximum pressure on the analog gauge. Conclusion Patients presenting to HEMS after intubation by the referral agency (EMS or hospital have ETT cuffs inflated to pressures that are, on average, more than double the recommended maximum. These patients are at risk for tracheal mucosal injury and scarring from decreased mucosal capillary blood flow. Hospital and EMS providers should use ETT cuff manometry to ensure that they inflate ETT cuffs to safe pressures.

  19. Comparison of numerical formulations for the modeling of tensile loaded suction buckets

    DEFF Research Database (Denmark)

    Sørensen, Emil Smed; Clausen, Johan Christian; Damkilde, Lars

    2017-01-01

    The tensile resistance of a suction bucket is investigated using three different numerical formulations. The first formulation utilizes the three-field u-p-U formulation accounting for solid and fluid displacements, u and U, as well as the pore-fluid pressure, p. The two other formulations compri...

  20. Instruction Workbook for Tracheostomy Suctioning and Misting in a School Setting.

    Science.gov (United States)

    Wolf, Karen McKinney; Roach, Antionette Andolfatto

    The handbook presents California guidelines for training school personnel to provide skilled nursing procedures such as tracheostomy suctioning and misting for students with special health needs. The workbook begins with an overview of the anatomy and function of the respiratory system, specifically breathing mechanics. Part 2 considers the…

  1. Influence of saturation degree and role of suction in unsaturated soils behaviour: application to liquefaction

    Directory of Open Access Journals (Sweden)

    Vernay Mathilde

    2016-01-01

    Full Text Available The effect of the pore fluid compressibility on liquefaction has been studied by various authors. But few papers have been published about the role of suction in cyclic behavior of unsaturated soils. Most of these works use Skempton coefficient B as a reference in terms of saturation degree to analyze their results. The use of B in experimental conditions is convenient, but is not accurate when studying liquefaction behavior, since effects of suction are neglected. In this paper, the influence of saturation degree on mechanical behavior of a soil under dynamic loads is studied. Cyclic undrained triaxial tests were performed on sand samples, under various levels of saturation. Soil-water characteristic curve was used, in order to study influence of suction. The first results confirm that when the degree of saturation decreases, the resistance increases. Initial positive suction tends to stiffen the soil. It also appears that the presence of air delays the occurrence of liquefaction, but doesn’t prevent it. Indeed, liquefaction is observed, whether the soil is saturated or not.

  2. On the influence of buoyancy and suction/injection In Heat and Mass ...

    African Journals Online (AJOL)

    In this paper, we examined the influence of buoyancy and suction/injection in the problem of unsteady convection with chemical reaction and radiative heat transfer past a flat porous plate moving through a binary mixture in an optically thin environment is presented. The dimensionless governing equations for this ...

  3. Gravity separation of pericardial fat in cardiotomy suction blood: an in vitro model.

    Science.gov (United States)

    Kinard, M Rhett; Shackelford, Anthony G; Sistino, Joseph J

    2009-06-01

    Fat emboli generated during cardiac surgery have been shown to cause neurologic complications in patients postoperatively. Cardiotomy suction has been known to be a large generator of emboli. This study will examine the efficacy of a separation technique in which the cardiotomy suction blood is stored in a cardiotomy reservoir for various time intervals to allow spontaneous separation of fat from blood by density. Soybean oil was added to heparinized porcine blood to simulate the blood of a patient with hypertriglyceridemia (> 150 mg/dL). Roller pump suction was used to transfer the room temperature blood into the cardiotomy reservoir. Blood was removed from the reservoir in 200-mL aliquots at 0, 15, 30 45, and 60 minutes. Samples were taken at each interval and centrifuged to facilitate further separation of liquid fat. Fat content in each sample was determined by a point-of-care triglyceride analyzer. Three trials were conducted for a total of 30 samples. The 0-minute group was considered a baseline and was compared to the other four times. Fat concentration was reduced significantly in the 45- and 60-minute groups compared to the 0-, 15-, and 30-minute groups (p Gravity separation of cardiotomy suction blood is effective; however, it may require retention of blood for more time than is clinically acceptable during a routing coronary artery bypass graft surgery.

  4. Laboratory determined suction potential of Topopah Spring tuff at high temperatures

    International Nuclear Information System (INIS)

    Daily, W.; Lin, Wunan.

    1991-01-01

    The purpose of this work is to experimentally determine the capillary suction potential of Topopah Spring tuff from Yucca Mountain, Nye County, Nevada. This data can be used to help characterize the unsaturated hydraulic properties of the densely welded tuff at this site. 7 refs., 4 figs., 1 tab

  5. Numerical simulation and analysis of cavitation flows in a double suction centrifugal pump

    International Nuclear Information System (INIS)

    Meng, G; Tan, L; Cao, S L; Jian, W; Liu, W W; Jiang, D J

    2015-01-01

    Cavitation is an unsteady phenomenon, which is nearly inevitable in pumps. It would degrade the pump performance, generate vibrations and noises, and even erode pump flow passage components. The double suction centrifugal pump at design flow rate and large flow rate is numerically simulated using the k-ω turbulence model and the mass transport cavitation model. As a result, the calculated variation of pump head with pump inlet pressure agreed well with the experimental data. The results demonstrate that the numerical model and method can accurately predict the cavitation flows in a double suction centrifugal pump. The cavitation characteristics are analysed in great details. In addition, based on the calculation results, the reason that the plunge of pump head curve is revealed. It is found that the steep fall of pump head happens when the cavity reaches the blade to blade throat and the micro-vortex group appears at the back of the blade suction side. At the same time, this practice can provide guidance for the optimal design of double suction pumps

  6. Bacteremia during adenoidectomy: a comparison of suction diathermy adenoid ablation and adenoid curettage.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2010-08-01

    Transient bacteremia is induced by adenoidectomy when the integrity of the nasopharyngeal membrane is broken. The aim of this study was to determine the incidence of bacteremia in patients undergoing adenoidectomy, to identify the causative organisms, and to compare the incidences of bacteremia between the two techniques suction diathermy and curettage.

  7. Simulation of flow structure in the suction pipe of a hydroturbine by integral characteristics

    DEFF Research Database (Denmark)

    Kuibin, P.A.; Okulov, Valery; Pylev, I.M.

    2006-01-01

    Within the framework of a model of a twisted flow of an inviscid incompressible liquid, we solve the problem of determining the frequency and amplitude of oscillations caused by the precession of a helical vortex core in the suction tube of a hydroturbine from the specified integral characteristics...

  8. Endoscopic en bloc resection of an exophytic gastrointestinal stromal tumor with suction excavation technique

    Science.gov (United States)

    Choi, Hyuk Soon; Chun, Hoon Jai; Kim, Kyoung-Oh; Kim, Eun Sun; Keum, Bora; Jeen, Yoon-Tae; Lee, Hong Sik; Kim, Chang Duck

    2016-01-01

    Here, we report the first successful endoscopic resection of an exophytic gastrointestinal stromal tumor (GIST) using a novel perforation-free suction excavation technique. A 49-year-old woman presented for further management of a gastric subepithelial tumor on the lesser curvature of the lower body, originally detected via routine upper gastrointestinal endoscopy. Abdominal computed tomography and endoscopic ultrasound showed a 4-cm extraluminally protruding mass originating from the muscularis propria layer. The patient firmly refused surgical resection owing to potential cardiac problems, and informed consent was obtained for endoscopic removal. Careful dissection and suction of the tumor was repeated until successful extraction was achieved without serosal injury. We named this procedure the suction excavation technique. The tumor’s dimensions were 3.5 cm × 2.8 cm × 2.5 cm. The tumor was positive for C-KIT and CD34 by immunohistochemical staining. The mitotic count was 6/50 high-power fields. The patient was followed for 5 years without tumor recurrence. This case demonstrated the use of endoscopic resection of an exophytic GIST using the suction excavation technique as a potential therapy without surgical resection. PMID:27340363

  9. Microsatellite marker analysis of peach-potato aphids (Myzus persicae, Homoptera: Aphididae) from Scottish suction traps.

    Science.gov (United States)

    Malloch, G; Highet, F; Kasprowicz, L; Pickup, J; Neilson, R; Fenton, B

    2006-12-01

    The peach-potato aphid Myzus persicae (Sulzer) is an important vector of plant viruses. A network of suction traps collects aerial samples of this aphid in order to monitor and help predict its spatial distribution and likely impact on virus transmission in crops. A suction trap catch is thought to be a good representation of the total aphid pool. Sensitive molecular markers have been developed that determine the genetic composition of the M. persicae population. In Scotland, UK, these were applied to field collections revealing a limited number of clones. Molecular markers are less successful when applied to specimens that have been preserved in an ethanol-based trap fluid designed to preserve morphology. An assessment of different DNA extraction and PCR techniques is presented and the most efficient are used to analyse M. persicae specimens caught in the Dundee suction trap in 2001, a year when exceptionally high numbers were caught. The results reveal that the majority of the M. persicae caught belonged to two highly insecticide resistant clones. In addition, it was possible to compare the relative frequencies of genotypes caught in the trap with those collected at insecticide treated and untreated field sites in the vicinity. These results indicate that, in addition to suction trap data, the ability to sample field sites provides valuable early warning data which have implications for pest control and virus management strategies.

  10. 75 FR 70112 - Medical Devices; General and Plastic Surgery Devices; Classification of Non-Powered Suction...

    Science.gov (United States)

    2010-11-17

    .... FDA-2010-N-0513] Medical Devices; General and Plastic Surgery Devices; Classification of Non-Powered... risks. Adverse tissue reaction Material degradation Improper function of suction apparatus (e.g., reflux.... Material degradation Section 8. Stability and Shelf Life. [[Page 70113

  11. Long term effects of cyclic loading on suction caisson foundations in sand

    NARCIS (Netherlands)

    Lupea, C.; Thijssen, R.; Van Tol, A.F.

    2014-01-01

    Offshore wind turbine projects have been characterised by an increase in costs, sizes and distances from shore, EWEA 2012 This created a need of investigating the adequacy of alternative and more fìnancially attractive foundation types such as suction caissons. Within a multi-footing configuration,

  12. Response of skirted suction caissons to monotonic lateral loading in saturated medium sand

    Science.gov (United States)

    Li, Da-yong; Zhang, Yu-kun; Feng, Ling-yun; Guo, Yan-xue

    2014-08-01

    Monotonic lateral load model tests were carried out on steel skirted suction caissons embedded in the saturated medium sand to study the bearing capacity. A three-dimensional continuum finite element model was developed with Z_SOIL software. The numerical model was calibrated against experimental results. Soil deformation and earth pressures on skirted caissons were investigated by using the finite element model to extend the model tests. It shows that the "skirted" structure can significantly increase the lateral capacity and limit the deflection, especially suitable for offshore wind turbines, compared with regular suction caissons without the "skirted" at the same load level. In addition, appropriate determination of rotation centers plays a crucial role in calculating the lateral capacity by using the analytical method. It was also found that the rotation center is related to dimensions of skirted suction caissons and loading process, i.e. the rotation center moves upwards with the increase of the "skirted" width and length; moreover, the rotation center moves downwards with the increase of loading and keeps constant when all the sand along the caisson's wall yields. It is so complex that we cannot simply determine its position like the regular suction caisson commonly with a specified position to the length ratio of the caisson.

  13. Dispersion of suspended material from an operating sand suction dredge in the Øresund (Denmark)

    DEFF Research Database (Denmark)

    Kiørboe, Thomas; Møhlenberg, F.

    1981-01-01

    The concentration of suspended material in the immediate vicinity of an operating sand suction dredge in the Oresund was 3-5000mg/l. Concentrations > 100 mg/l were restricted to a downstream distance of .apprx. 150m and ambient levels were reached within .apprx. 1 km of the dredge. The natural...

  14. 77 FR 25717 - Proposed Issuance of a General NPDES Permit for Small Suction Dredging

    Science.gov (United States)

    2012-05-01

    ...) General Permit (IDG-37-0000) to placer mining operations in Idaho for small suction dredges (intake nozzle... ENVIRONMENTAL PROTECTION AGENCY [FRL-9666-1] Proposed Issuance of a General NPDES Permit for Small... certifies ``will not, if promulgated, have a significant economic impact on a substantial number of small...

  15. Cyclosporin A levels in suction-blister fluid of patients with psoriasis treated systemically

    NARCIS (Netherlands)

    Meinardi, M. M.; van Eendenburg, J. P.; Oosting, J.; van Boxtel, C. J.; de Rie, M. A.; Bos, J. D.

    1990-01-01

    Oral cyclosporin A (CyA) is highly effective in the treatment of psoriasis. The long-term use is limited by dose-dependent side-effects, and the local concentration of CyA is a determining factor in treatment. The concentration of CyA in suction-blister fluid (SBF) and in whole blood was assessed

  16. Capillary Suction Time. Operational Control Tests for Wastewater Treatment Facilities. Instructor's Manual [and] Student Workbook.

    Science.gov (United States)

    Wooley, John F.

    Capillary suction time is time required for the liquid phase of a treated sludge to travel through 1 centimeter of media (blotter or filter paper). Designed for individuals who have completed National Pollutant Discharge Elimination System (NPDES) level 1 laboratory training skills, this module provides waste water treatment plant operators with…

  17. In situ sampling of small volumes of soil solution using modified micro-suction cups

    NARCIS (Netherlands)

    Shen, Jianbo; Hoffland, E.

    2007-01-01

    Two modified designs of micro-pore-water samplers were tested for their capacity to collect unbiased soil solution samples containing zinc and citrate. The samplers had either ceramic or polyethersulfone (PES) suction cups. Laboratory tests of the micro-samplers were conducted using (a) standard

  18. Suction removal of sediment from between armour blocks. Part 2. Waves

    DEFF Research Database (Denmark)

    Dixen, Figen Hatipoglu; Sumer, B. Mutlu; Fredsøe, Jørgen

    2008-01-01

    When a stone/armor layer on a sand bed is exposed to flow, the sand underneath will be agitated by the flow turbulence. When the flow velocity reaches a critical value, the sand will be sucked (winnowed out) from between the armor blocks. In a previous investigation, we studied suction removal of...

  19. A new suction mask to reduce leak during neonatal resuscitation: a manikin study.

    Science.gov (United States)

    Lorenz, Laila; Maxfield, Dominic A; Dawson, Jennifer A; Kamlin, C Omar F; McGrory, Lorraine; Thio, Marta; Donath, Susan M; Davis, Peter G

    2016-09-01

    Leak around the face mask is a common problem during neonatal resuscitation. A newly designed face mask using a suction system to enhance contact between the mask and the infant's face might reduce leak and improve neonatal resuscitation. The aim of the study is to determine whether leak is reduced using the suction mask (Resusi-sure mask) compared with a conventional mask (Laerdal Silicone mask) in a manikin model. Sixty participants from different professional categories (neonatal consultants, fellows, registrars, nurses, midwives and students) used each face mask in a random order to deliver 2 min of positive pressure ventilation to a manikin. Delivered airway pressures were measured using a pressure line. Inspiratory and expiratory flows were measured using a flow sensor, and expiratory tidal volumes and mask leaks were derived from these values. A median (IQR) leak of 12.1 (0.6-39.0)% was found with the conventional mask compared with 0.7 (0.2-4.6)% using the suction mask (p=0.002). 50% of the participants preferred to use the suction mask and 38% preferred to use the conventional mask. There was no correlation between leak and operator experience. A new neonatal face mask based on the suction system reduced leak in a manikin model. Clinical studies to test the safety and effectiveness of this mask are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The effects of suction and pin/lock suspension systems on transtibial amputees' gait performance.

    Directory of Open Access Journals (Sweden)

    Hossein Gholizadeh

    Full Text Available BACKGROUND: The suction sockets that are commonly prescribed for transtibial amputees are believed to provide a better suspension than the pin/lock systems. Nevertheless, their effect on amputees' gait performance has not yet been fully investigated. The main intention of this study was to understand the potential effects of the Seal-in (suction and the Dermo (pin/lock suspension systems on amputees' gait performance. METHODOLOGY/PRINCIPAL FINDINGS: Ten unilateral transtibial amputees participated in this prospective study, and two prostheses were fabricated for each of them. A three-dimensional motion analysis system was used to evaluate the temporal-spatial, kinematics and kinetics variables during normal walking. We also asked the participants to complete some part of Prosthesis Evaluation Questionnaire (PEQ regarding their satisfaction and problems with both systems. The results revealed that there was more symmetry in temporal-spatial parameters between the prosthetic and sound limbs using the suction system. However, the difference between two systems was not significant (p<0.05. Evaluation of kinetic data and the subjects' feedback showed that the participants had more confidence using the suction socket and the sockets were more fit for walking. Nevertheless, the participants had more complaints with this system due to the difficulty in donning and doffing. CONCLUSION: It can be concluded that even though the suction socket could create better suspension, fit, and gait performance, overall satisfaction was higher with the pin/lock system due to easy donning and doffing of the prosthesis. TRIAL REGISTRATION: irct.ir IRCT2014012816395N1.

  1. Prospective randomized trial compares suction versus water seal for air leaks.

    Science.gov (United States)

    Cerfolio, R J; Bass, C; Katholi, C R

    2001-05-01

    Surgeons treat air leaks differently. Our goal was to evaluate whether it is better to place chest tubes on suction or water seal for stopping air leaks after pulmonary surgery. A second goal was to evaluate a new classification system for air leaks that we developed. Patients were prospectively randomized before surgery to receive suction or water seal to their chest tubes on postoperative day (POD) #2. Air leaks were described and quantified daily by a classification system and a leak meter. The air-leak meter scored leaks from 1 (least) to 7 (greatest). The group randomized to water seal stayed on water seal unless a pneumothorax developed. On POD #2, 33 of 140 patients had an air leak. Eighteen patients had been preoperatively randomized to water seal and 15 to suction. Air leaks resolved in 12 (67%) of the water seal patients by the morning of POD #3. All 6 patients whose air leak did not stop had a leak that was 4/7 or greater (p leak meter. Of the 15 patients randomized to suction, only 1 patient's air leak (7%) resolved by the morning of POD #3. The randomization aspect of the trial was ended and statistical analysis showed water seal was superior (p = 0.001). The remaining 14 patients were then placed to water seal and by the morning of POD #4, 13 patients' leaks had stopped. Of the 32 total patients placed to seal, 7 (22%) developed a pneumothorax and 6 of these 7 patients had leaks that were 4/7 or greater (p = 0.001). Placing chest tubes on water seal seems superior to wall suction for stopping air leaks after pulmonary resection. However, water seal does not stop expiratory leaks that are 4/7 or greater. Pneumothorax may occur when chest tubes are placed on seal with leaks this large.

  2. [Evaluation of pain during mobilization and endotracheal aspiration in critical patients].

    Science.gov (United States)

    Robleda, G; Roche-Campo, F; Membrilla-Martínez, L; Fernández-Lucio, A; Villamor-Vázquez, M; Merten, A; Gich, I; Mancebo, J; Català-Puigbó, E; Baños, J E

    2016-03-01

    1) To assess the prevalence of pain during nursing care procedures, and 2) to evaluate the usefulness of certain vital signs and the bispectral index (BIS) in detecting pain. A prospective, observational analytical study was made of procedures (endotracheal aspiration and mobilization with turning) in critically ill sedated patients on mechanical ventilation. The Behavioral Pain Scale was used to assess pain, with scores of ≥3 indicating pain. Various physiological signs and BIS values were recorded, with changes of >10% being considered clinically relevant. A total of 146 procedures in 70 patients were analyzed. Pain prevalence during the procedures was 94%. Vital signs and BIS values increased significantly during the procedures compared to resting conditions, but only the changes in BIS were considered clinically relevant. In the subgroup of patients receiving preemptive analgesia prior to the procedure, pain decreased significantly compared to the group of patients who received no such analgesia (-2 [IQR: {-5}-0] vs. 3 [IQR: 1-4]; P<.001, respectively). The procedures evaluated in this study are painful. Changes in vital signs are not good indicators of pain. Changes in BIS may provide useful information about pain, but more research is needed. The administration of preemptive analgesia decreases pain during the procedures. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  3. Community analysis of dental plaque and endotracheal tube biofilms from mechanically ventilated patients.

    Science.gov (United States)

    Marino, Poala J; Wise, Matt P; Smith, Ann; Marchesi, Julian R; Riggio, Marcello P; Lewis, Michael A O; Williams, David W

    2017-06-01

    Mechanically ventilated patients are at risk for developing ventilator-associated pneumonia, and it has been reported that dental plaque provides a reservoir of respiratory pathogens that may aspirate to the lungs and endotracheal tube (ETT) biofilms. For the first time, metataxonomics was used to simultaneously characterize the microbiome of dental plaque, ETTs, and non-directed bronchial lavages (NBLs) in mechanically ventilated patients to determine similarities in respective microbial communities and therefore likely associations. Bacterial 16S rRNA gene sequences from 34 samples of dental plaque, NBLs, and ETTs from 12 adult mechanically ventilated patients were analyzed. No significant differences in the microbial communities of these samples were evident. Detected bacteria were primarily oral species (e.g., Fusobacterium nucleatum, Streptococcus salivarius, Prevotella melaninogenica) with respiratory pathogens (Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcuspneumoniae, and Haemophilus influenzae) also in high abundance. The high similarity between the microbiomes of dental plaque, NBLs, and ETTs suggests that the oral cavity is indeed an important site involved in microbial aspiration to the lower airway and ETT. As such, maintenance of good oral hygiene is likely to be highly important in limiting aspiration of bacteria in this vulnerable patient group. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates.

    Science.gov (United States)

    Chowdhry, R; Dangman, B; Pinheiro, J M B

    2015-07-01

    Given the distressingly high incidence of ETT malposition in the neonatal population, patients are exposed to ionizing radiation to confirm endotracheal tube (ETT) position. Our objective is to determine if ultrasound technique is concordant with X-ray in determining whether an ETT is deeply positioned or not. Prospective observational clinical trial. After obtaining informed consent, patients with an ETT who required X-ray for clinical reasons underwent sonographic evaluation of the ETT by an ultrasound technologist or pediatric radiologist, usually within the hour. A total of 56 image pairs were obtained from 29 patients. Ninety-eight percent of the ultrasound/X-ray image pairs were suitable for analysis. The concordance of ultrasound with X-ray to identify deeply and not deeply positioned ETTs was 95% (53/56). The sensitivity of ultrasound to detect deeply positioned ETTs on X-ray was 86% (6/7). The specificity of ultrasound to detect ETTs that were not deeply positioned on X-ray was 96% (47/49). As the largest clinical trial of its kind to date, with the greatest number of ultrasound operators, we have further established US as a feasible imaging modality to determine whether an ETT is deeply positioned or not.

  5. Severed cuff inflation tubing of endotracheal tube: A novel way to prevent cuff deflation.

    Science.gov (United States)

    Rao, Amrut K; Chaudhuri, Souvik; Joseph, Tim T; Kamble, Deependra; Gotur, Gopal; Venkatesh, Sandeep

    2014-01-01

    A well-secured endotracheal tube (ETT) is essential for safe anesthesia. The ETT has to be fixed with the adhesive plasters or with tie along with adhesive plasters appropriately. It is specially required in patients having beard, in intensive care unit (ICU) patients or in oral surgeries. If re-adjustment of the ETT is necessary, we should be cautious while removal of the plasters and tie, as there may be damage to the cuff inflation system. This can be a rare cause of ETT cuff leak, thus making maintenance of adequate ventilation difficult and requiring re-intubation. In a difficult airway scenario, it can be extremely challenging to re-intubate again. We report an incidence where the ETT cuff tubing was severed while attempting to re-adjust and re-fix the ETT and the patient required re-intubation. Retrospectively, we thought of and describe a safe, reliable and novel technique to prevent cuff deflation of the severed inflation tube. The technique can also be used to monitor cuff pressure in such scenarios.

  6. Comparison of endotracheal tube cuff pressure values before and after training seminar.

    Science.gov (United States)

    Özcan, Ayça Tuba Dumanlı; Döğer, Cihan; But, Abdülkadir; Kutlu, Işık; Aksoy, Şemsi Mustafa

    2018-06-01

    It is recommended that endotracheal cuff (ETTc) pressure be between 20 and 30 cm H 2 O. In this present study, we intend to observe average cuff pressure values in our clinic and the change in these values after the training seminar. The cuff pressure values of 200 patients intubated following general anesthesia induction in the operating theatre were measured following intubation. One hundred patients whose values were measured before the training seminar held for all physician assistants, and 100 patients whose values were measured after the training seminar were regarded as Group 1 and Group 2, respectively. Cuff pressures of both groups were recorded, and the difference between them was shown. Moreover, cuff pressure values were explored according to the working period of the physician assistants. There was no significant difference between the groups in terms of age, gender and tube diameters. Statistically significant difference was found between cuff pressure values before and after the training (p values decreased, however no statistically significant different was found (p values and potential complications.

  7. Oral and endotracheal tubes colonization by periodontal bacteria: a case-control ICU study.

    Science.gov (United States)

    Porto, A N; Cortelli, S C; Borges, A H; Matos, F Z; Aquino, D R; Miranda, T B; Oliveira Costa, F; Aranha, A F; Cortelli, J R

    2016-03-01

    Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.

  8. Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Eliandra da Silveira de Lima

    Full Text Available ABSTRACT INTRODUCTION: Acute laryngeal lesions after intubation appear to be precursors of chronic lesions. OBJECTIVE: To describe the incidence and type of acute laryngeal lesions after extubation in a pediatric intensive care unit (PICU. METHODS: A cohort study involving children from birth to <5 years, submitted to intubation for more than 24 h in the PICU of an university hospital. In the first eight hours after extubation, a flexible fiberoptic laryngoscopy (FFL was performed at the bedside. Those with moderate to severe abnormalities underwent a second examination seven to ten days later. RESULTS: 177 patients were included, with a median age of 2.46 months. The mean intubation time was 8.19 days. Seventy-three (41.2% patients had moderate or severe alterations at the FFL, with the remaining showing only minor alterations or normal results. During follow-up, 16 children from the group with moderate to severe lesions developed subglottic stenosis. One patient from the normal FFL group had subglottic stenosis, resulting in an incidence of 9.6% of chronic lesions. CONCLUSION: Most children in the study developed mild acute laryngeal lesions caused by endotracheal intubation, which improved in a few days after extubation.

  9. Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty

    Directory of Open Access Journals (Sweden)

    Daher Rabadi

    2014-12-01

    Full Text Available Background and objective: Prediction of intubation difficulty can save patients from major preoperative morbidity or mortality. The purpose of this paper is to assess the correlation between oro-hypo pharynx position, neck size, and length with endotracheal intubation difficulty. The study also explored the diagnostic value of Friedman Staging System in prediction cases with difficult intubation. Method: The consecutive 500 ASA (I, II adult patients undergoing elective surgery were evaluated for oro and hypopharynx shape and position by modified Mallampati, Cormack and Lehane score as well as Friedman obstructive sleep apnea classification systems. Neck circumference and length were also measured. All cases were intubated by a single anesthesiologist who was uninformed of the above evaluation and graded intubation difficulty in visual analog score. Correlation between these findings and difficulty of intubation was assessed. Sensitivity, Specificity, Positive and Negative Predictive Values were also reported. Results: Cormack-Lehane grade had the strongest correlation with difficulty of intubation followed by Friedman palate position. Friedman palate position was the most sensitive and had higher positive and negative predictive values than modified Mallampati classification. Cormack-Lehane grade was found to be the most specific with the highest negative predictive value among the four studied classifications. Conclusion: Friedman palate position is a more useful, valuable and sensitive test compared to the modified Mallampati screening test for pre-anesthetic prediction of difficult intubation where its involvement in Multivariate model may raise the accuracy and diagnostic value of preoperative assessment of difficult airway.

  10. Factors leading to self-extubation of endotracheal tubes in the intensive care unit.

    Science.gov (United States)

    Huang, Yuan-Ting

    2009-01-01

    To discuss the factors leading to self-extubation of endotracheal tubes (ETTs) and explore the differences between the groups of patients who did and did not self-remove their ETTs. Self-extubation of ETTs has been reported to occur in 4.2% of severely ill patients and is associated with adverse medical effects. A case-control study. One hundred and thirty-nine subjects were recruited from a teaching hospital in southern Taiwan based on purposive sampling. The rate of self-extubation of ETTs was 6.4%. Analysis of the two groups demonstrated that significant variables were identified and fell into three categories: (1) the department to which the patient was admitted (p self-extubation of the ETT. Among the 44 patients who had self-extubation of their ETT, 28 met the criteria to be extubated, 70% and 81.8% of whom were not sedated, and self-extubation of their ETT was conscious of the act. Of the patients who attempted to self-remove their ETT, 80% were successful and 93.2% did not incur any adverse medical effects. The medical doctor and nurse should fully evaluate a patient's oxygenation status, decrease the length of the extubation training session for patients and extubate patients promptly when extubation criteria are met. Adopting a proactive approach to patient extubation will improve the overall quality of care.

  11. Learning endotracheal intubation using a novel videolaryngoscope improves intubation skills of medical students.

    Science.gov (United States)

    Herbstreit, Frank; Fassbender, Philipp; Haberl, Helge; Kehren, Clemens; Peters, Jürgen

    2011-09-01

    Teaching endotracheal intubation to medical students is a task provided by many academic anesthesia departments. We tested the hypothesis that teaching with a novel videolaryngoscope improves students' intubation skills. We prospectively assessed in medical students (2nd clinical year) intubation skills acquired by intubation attempts in adult anesthetized patients during a 60-hour clinical course using, in a randomized fashion, either a conventional Macintosh blade laryngoscope or a videolaryngoscope (C-MAC®). The latter permits direct laryngoscopy with a Macintosh blade and provides a color image on a video screen. Skills were measured before and after the course in a standardized fashion (METI Emergency Care Simulator) using a conventional laryngoscope. All 1-semester medical students (n = 93) were enrolled. The students' performance did not significantly differ between groups before the course. After the course, students trained with the videolaryngoscope had an intubation success rate on a manikin 19% higher (95% CI 1.1%-35.3%; P incidence of "difficult (manikin) laryngoscopy" was less frequent in the group trained with the videolaryngoscope (8% vs 34%; P = 0.005). Education using a video system mounted into a traditional Macintosh blade improves intubation skills in medical students.

  12. Suction forces generated by passive bile bag drainage on a model of post-subdural hematoma evacuation.

    Science.gov (United States)

    Tenny, Steven O; Thorell, William E

    2018-05-05

    Passive drainage systems are commonly used after subdural hematoma evacuation but there is a dearth of published data regarding the suction forces created. We set out to quantify the suction forces generated by a passive drainage system. We created a model of passive drainage after subdural hematoma evacuation. We measured the maximum suction force generated with a bile bag drain for both empty drain tubing and fluid-filled drain tube causing a siphoning effect. We took measurements at varying heights of the bile bag to analyze if bile bag height changed suction forces generated. An empty bile bag with no fluid in the drainage tube connected to a rigid, fluid-filled model creates minimal suction force of 0.9 mmHg (95% CI 0.64-1.16 mmHg). When fluid fills the drain tubing, a siphoning effect is created and can generate suction forces ranging from 18.7 to 30.6 mmHg depending on the relative position of the bile bag and filled amount of the bile bag. The suction forces generated are statistically different if the bile bag is 50 cm below, level with or 50 cm above the experimental model. Passive bile bag drainage does not generate significant suction on a fluid-filled rigid model if the drain tubing is empty. If fluid fills the drain tubing then siphoning occurs and can increase the suction force of a passive bile bag drainage system to levels comparable to partially filled Jackson-Pratt bulb drainage.

  13. Basic life support trained nurses ventilate more efficiently with laryngeal mask supreme than with facemask or laryngeal tube suction-disposable--a prospective, randomized clinical trial.

    Science.gov (United States)

    Gruber, Elisabeth; Oberhammer, Rosmarie; Balkenhol, Karla; Strapazzon, Giacomo; Procter, Emily; Brugger, Hermann; Falk, Markus; Paal, Peter

    2014-04-01

    In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel, especially in rural areas where arrival of advanced life support teams can be delayed. The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel, but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation. In this prospective, randomized clinical single-centre trial we compared airway management and ventilation performed by nurses using facemask, laryngeal mask Supreme (LMA-S) and laryngeal tube suction-disposable (LTS-D). Basic life support trained nurses (n=20) received one-hour practical training with each device. ASA 1-2 patients scheduled for elective surgery were included (n=150). After induction of anaesthesia and neuromuscular block nurses had two 90-second attempts to manage the airway and ventilate the patient with volume-controlled ventilation. Ventilation failed in 34% of patients with facemask, 2% with LMA-S and 22% with LTS-D (P<0.001). In patients who could be ventilated successfully mean tidal volume was 240±210 ml with facemask, 470±120 ml with LMA-S and 470±140 ml with LTS-D (P<0.001). Leak pressure was lower with LMA-S (23.3±10.8 cm H2O, 95% CI 20.2-26.4) than with LTS-D (28.9±13.9 cm·H2O, 95% CI 24.4-33.4; P=0.047). After one hour of introductory training, nurses were able to use LMA-S more effectively than facemask and LTS-D. High ventilation failure rates with facemask and LTS-D may indicate that additional training is required to perform airway management adequately with these devices. High-level trials are needed to confirm these results in cardiac arrest patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. A Constitutive Model for Unsaturated soils based on a Compressibility Framework dependent on Suction and Degree of Saturation

    Directory of Open Access Journals (Sweden)

    Sitarenios Panagiotis

    2016-01-01

    Full Text Available The Modified Cam Clay model is extended to account for the behaviour of unsaturated soils using Bishop’s stress. To describe the Loading – Collapse behaviour, the model incorporates a compressibility framework with suction and degree of saturation dependent compression lines. For simplicity, the present paper describes the model in the triaxial stress space with characteristic simulations of constant suction compression and triaxial tests, as well as wetting tests. The model reproduces an evolving post yield compressibility under constant suction compression, and thus, can adequately describe a maximum of collapse.

  15. Frequency Response of Near-Wall Coherent Structures to Localized Periodic Blowing and Suction in Turbulent Boundary Layer

    International Nuclear Information System (INIS)

    Jian-Hua, Liu; Nan, Jiang

    2008-01-01

    We experimentally investigate the frequency response of near-wall coherent structures to localized periodic blowing and suction through a spanwise slot in a turbulent boundary layer by changing the frequency of periodic disturbance at similar velocities of free stream. The effects of blowing and suction disturbance on energy redistribution, turbulent intensity u' rms + , over y + and waveforms of phase-averaged velocity during sweeping process are respectively discussed under three frequencies of periodic blowing and suction in near-wall region of turbulent boundary layer, compared with those in a standard turbulent boundary layer. The most effective disturbance frequency is figured out in this system. (fundamental areas of phenomenology (including applications))

  16. A COMPARATIVE STUDY OF 2 AGENTS, AIR AND DISTILLED WATER FOR INFLATION OF THE CUFFS OF ENDOTRACHEAL TUBES DURING LAPAROSCOPIC SURGICAL PROCEDURES UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Sistla Gopala Krishna

    2016-03-01

    Full Text Available BACKGROUND & AIM During Nitrous Oxide+ Oxygen anaesthesia and during laparoscopic surgeries using carbon dioxide for creating pneumoperitoneum, if cuff of endotracheal tube is inflated with air, cuff pressure can rise to dangerous limits and it can produce ischemia of tracheal mucosa. Hence distilled water as an alternative agent to air for inflation of cuffs of endotracheal tubes was used for our study. Our aim is to investigate the difference in increase of intra-cuff pressure with time during laparoscopic surgical procedures under general endotracheal anaesthesia with Nitrous oxide+ Oxygen+ relaxant technique when cuffs of endotracheal tube were inflated by air & distilled water. METHODS Fifty patients (n=50 undergoing different laparoscopic surgical procedures under general endotracheal anaesthesia were randomly divided into 2 groups. In group A, air was used & in group D, distilled water was used to inflate the cuffs of endotracheal tubes. General anaesthesia was given with Nitrous oxide+ Oxygen+ relaxant technique. The intra-cuff pressures of endotracheal tube cuffs were recorded in the beginning and at the end of laparoscopic surgical procedures. Increase of pressures with time were recorded and analysed. RESULTS In group in whom we inflated the cuffs with air, there was a significant increase in intra-cuff pressures with time and there was definite diffusion of gases into the cuffs. Increase of pressure with time was statistically highly significant (P=0.00001. But in group in whom we used distilled water to inflate the cuffs, there was no change in the volume of water used for inflation and water came out of cuffs at the end of the laparoscopic surgical procedures. No additional air could be aspirated from the cuffs at the end of laparoscopic surgeries in distilled water group, indicating that there was no diffusion of gases into the cuffs or the gases diffused got dissolved in distilled water. Hence there was no increase of volume

  17. Three-finger tracheal palpation to guide endotracheal tube depth in children.

    Science.gov (United States)

    Gamble, Jonathan J; McKay, William P; Wang, Andrew F; Yip, Kinsha A; O'Brien, Jennifer M; Plewes, Christopher E

    2014-10-01

    Accurate endotracheal tube (ETT) depth is critical, especially in children. The current tools used to guide appropriate ETT depth have significant limitations. To evaluate the utility of tracheal palpation in the neck to guide appropriate ETT placement in children. A prospective observational study with a convenience sample of 50 children was conducted. During intubation, an investigator palpated the trachea with three fingertips side-by-side extending upward from the suprasternal notch. The anesthesiologist advanced the ETT slowly until palpated at the sternal notch. The investigator stated ETT palpation certainty as 'strongly felt', 'weakly felt', or 'not felt.' Final ETT position was determined by bronchoscopy and categorized as 'ETT too shallow' (tip in proximal ¼ of trachea), 'ETT too deep' (tip in distal ¼ of trachea), or 'ETT placement satisfactory' (between those extremes). Thirty boys and 20 girls undergoing dental surgery with nasal intubation were recruited (median age 4.4 years; range 2.0-10.8). The ETT (all ≥4 mm ID) was palpable at the sternal notch in all patients: 46 of 50 strongly palpable and 4 of 50 weakly palpable. The experimental methods led to satisfactory ETT placement in 49 of 50 patients, too deep in 1 of 50 patients. Compared with the Pediatrics Advanced Life Support (PALS) predictive formula, satisfactory placement would have been 41 of 50 patients (P guide ETT placement has excellent clinical performance and better guides appropriate ETT depth than the PALS formula in our study population. © 2014 John Wiley & Sons Ltd.

  18. Incremental change in cross sectional area in small endotracheal tubes: A call for more size options.

    Science.gov (United States)

    Mortelliti, Caroline L; Mortelliti, Anthony J

    2016-08-01

    To elucidate the relatively large incremental percent change (IPC) in cross sectional area (CSA) in currently available small endotracheal tubes (ETTs), and to make recommendation for lesser incremental change in CSA in these smaller ETTs, in order to minimize iatrogenic airway injury. The CSAs of a commercially available line of ETTs were calculated, and the IPC of the CSA between consecutive size ETTs was calculated and graphed. The average IPC in CSA with large ETTs was applied to calculate identical IPC in the CSA for a theoretical, smaller ETT series, and the dimensions of a new theoretical series of proposed small ETTs were defined. The IPC of CSA in the larger (5.0-8.0 mm inner diameter (ID)) ETTs was 17.07%, and the IPC of CSA in the smaller ETTs (2.0-4.0 mm ID) is remarkably larger (38.08%). Applying the relatively smaller IPC of CSA from larger ETTs to a theoretical sequence of small ETTs, starting with the 2.5 mm ID ETT, suggests that intermediate sizes of small ETTs (ID 2.745 mm, 3.254 mm, and 3.859 mm) should exist. We recommend manufacturers produce additional small ETT size options at the intuitive intermediate sizes of 2.75 mm, 3.25 mm, and 3.75 mm ID in order to improve airway management for infants and small children. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Endotracheal tubes and fluid aspiration: an in vitro evaluation of new cuff technologies.

    Science.gov (United States)

    Mariyaselvam, Maryanne Z; Marsh, Lucy L; Bamford, Sarah; Smith, Ann; Wise, Matt P; Williams, David W

    2017-03-04

    Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. ETTs were positioned vertically in 2 cm diameter cylinders. Four ml of a standard microbial suspension was added above inflated cuffs. After 1 h, aspiration was measured and ETTs demonstrating no leakage were subjected to rotational movement and evaluation over 24 h. Collected aspirated fluid was used to inoculate agar media and incubated aerobically at 37 °C for 24 h. The aspiration rate, volume and number of microorganisms that leaked past the cuff was measured. Experiments were repeated (×10) for each type of ETT, with new ETTs used for each repeat. Best performing ETTs were then tested in five different cylinder diameters (1.6, 1.8, 2.0, 2.2 and 2.4 cm). Experiments were repeated as above using sterile water. Volume and time taken for aspiration past the cuff was measured. Experiments were repeated (×10) for each type of ETT. Results were analysed using non-parametric tests for repeated measures. The PneuX ETT prevented aspiration past the cuff in all experiments. All other ETTs allowed aspiration, with considerable variability in performance. The PneuX ETT was statistically superior in reducing aspiration compared to the SealGuard (p aspiration across the range of diameters compared to the SealGuard (p aspiration, relating to cuff material and design. Variability in performance was likely due to the random manner in which involutional folds form in the inflated ETT cuff. The PneuX ETT was the only ETT able to consistently prevent aspiration past the cuff in all experiments.

  20. Resuscitation Prior to Emergency Endotracheal Intubation: Results of a National Survey

    Directory of Open Access Journals (Sweden)

    Robert S. Green

    2016-09-01

    Full Text Available Introduction: Respiratory failure is a common problem in emergency medicine (EM and critical care medicine (CCM. However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI. Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI. Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian Critical Care Trials Group. The questionnaire was distributed to all EM and CCM physician members of three national organizations. Using three clinical scenarios (trauma, pneumonia, congestive heart failure, we assessed physician preferences for use and types of fluid and vasopressor medication in pre-EETI resuscitation of critically ill patients. Results: In total, 1,758 physicians were surveyed (response rate 50.2%, 882/1,758. Overall, physicians would perform pre-EETI resuscitation using either fluids or vasopressors in 54% (1,193/2,203 of cases. Most physicians would “always/often” administer intravenous fluid pre-EETI in the three clinical scenarios (81%, 1,484/1,830. Crystalloids were the most common fluid physicians would “always/often” administer in congestive heart failure (EM 43%; CCM 44%, pneumonia (EM 97%; CCM 95% and trauma (EM 96%; CCM 96%. Pre-EETI resuscitation using vasopressors was uncommon (4.9%. Training in CCM was associated with performing pre-EETI resuscitation (odds ratio, 2.20; 95% CI, [1.44-3.36], p<0.001. Conclusion: Pre-EETI resuscitation is common among Canadian EM and CCM physicians. Most physicians use crystalloids pre-EETI as a resuscitation fluid, while few would give vasopressors. Physicians with CCM training were more likely to perform pre-EETI resuscitation.

  1. Apneic oxygenation reduces hypoxemia during endotracheal intubation in the pediatric emergency department.

    Science.gov (United States)

    Vukovic, Adam A; Hanson, Holly R; Murphy, Shelley L; Mercurio, Danielle; Sheedy, Craig A; Arnold, Donald H

    2018-04-18

    Apneic oxygenation (AO) has been evaluated in adult patients as a means of reducing hypoxemia during endotracheal intubation (ETI). While less studied in pediatric patients, its practice has been largely adopted. Determine association between AO and hypoxemia in pediatric patients undergoing ETI. Observational study at an urban, tertiary children's hospital emergency department. Pediatric patients undergoing ETI were examined during eras without (January 2011-June 2011) and with (August 2014-March 2017) apneic oxygenation. The primary outcome was hypoxemia, defined as pulse oximetry (SpO 2 ) < 90%. The χ 2 and Wilcoxon rank-sum tests examined differences between cohorts. Multivariable regression models examined adjusted associations between covariates and hypoxemia. 149 patients were included. Cohorts were similar except for greater incidence of altered mental status in those receiving AO (26% vs. 7%, p = 0.03). Nearly 50% of the pre-AO cohort experienced hypoxemia during ETI, versus <25% in the AO cohort. Median [IQR] lowest SpO 2 during ETI was 93 (69, 99) for pre-AO and 100 [95, 100] for the AO cohort (p < 0.001). In a multivariable logistic regression model, hypoxemia during ETI was associated with AO (aOR 0.3, 95% confidence interval [CI] 0.1-0.8), increased age (for 1 year, aOR 0.8, 95% CI 0.7-1.0), lowest SpO 2 before ETI (for 1% increase, aOR 0.9, 95% CI 0.8-1.0), and each additional intubation attempt (aOR 4.0, 95% CI 2.2-7.2). Apneic oxygenation is an easily-applied intervention associated with decreases in hypoxemia during pediatric ETI. Nearly 50% of children not receiving AO experienced hypoxemia. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Reduction of the suction pressure of a liquid ring vacuum pump with a supersonic gas ejector

    Directory of Open Access Journals (Sweden)

    Olšiak Róbert

    2018-01-01

    Full Text Available A supersonic gas ejector in conjunction with a liquid ring vacuum pump is used for creating and maintaining vacuum in a chamber for technological purposes. In this paper the authors submit an overview about the problematics of suction pressure reduction with a supersonic gas ejector used as a pre-stage of a liquid ring vacuum pump. This system has also the function of a cavitation protection due to the higher pressure present at the suction throat of the vacuum pump. A part of this paper is devoted to the governing equations used at the definition of the flow through an ejector. The experimental studies are then carried out in or own laboratory for verification purposes.

  3. Suppression of secondary flows in a double suction centrifugal pump with different loading distributions

    International Nuclear Information System (INIS)

    Leng, H F; Wang, F J; Zhang, Z C; Yao, Z F; Zhou, P J

    2013-01-01

    Secondary flow is one of the main reasons for low efficiency in double suction centrifugal pump. In a 3-D inverse design method, the pump blade could be designed by a specified loading distribution to control the flow field in pump. In order to study the influence of loading distribution on secondary flow of a double suction centrifugal pump, the external characteristics and the internal flow field of the pump with three kinds of loading distributions are analysed by using CFD approach. According to the simulation results, it is found that the form of fore-loading distribution at shroud and aft-loading distribution at hub could improve the optimal efficiency and broaden the high efficiency area of the pump. Furthermore, the secondary flow in impeller exit region and volute could be significantly suppressed if the slope of loading distribution curve of shroud is set to be −0.7

  4. Fabricating Zr-Based Bulk Metallic Glass Microcomponent by Suction Casting Using Silicon Micromold

    Directory of Open Access Journals (Sweden)

    Zhijing Zhu

    2014-08-01

    Full Text Available A suction casting process for fabricating Zr55Cu30Al10Ni5 bulk metallic glass microcomponent using silicon micromold has been studied. A complicated BMG microgear with 50 μm in module has been cast successfully. Observed by scanning electron microscopy and laser scanning confocal microscopy, we find that the cast microgear duplicates the silicon micromold including the microstructure on the surface. The amorphous state of the microgear is confirmed by transmission election microscopy. The nanoindentation hardness and elasticity modulus of the microgear reach 6.5 GPa and 94.5 GPa. The simulation and experimental results prove that the suction casting process with the silicon micromold is a promising one-step method to fabricate bulk metallic glass microcomponents with high performance for applications in microelectromechanical system.

  5. Fluid Model of Sliding Suction Cup of Wall-climbing Robots

    Directory of Open Access Journals (Sweden)

    Fu Zhuang

    2008-11-01

    Full Text Available The adhering capability, one of the most important performance indexes of wall-climbing robots(WCRs, should be taken into account when a WCR is designed. This paper proposes a novel approach for investigating the adhering characteristics of the sliding suction cup (SSCs using fluid network theory to enhance the adhering capability of WCRs. The fluid models of the SSCs of two WCRs are developed and equivalent circuits in three cases are presented. The dynamic responses of negative pressure in SSCs are obtained and validated by a set of experiments. It indicated that the theoretical analysis is reasonable and can give some valuable design criteria on the structure parameters of SSCs and control strategies of suction force of SSCs.

  6. Active Flow Control in a Radial Vaned Diffuser for Surge Margin Improvement: A Multislot Suction Strategy

    Directory of Open Access Journals (Sweden)

    Aurélien Marsan

    2017-01-01

    Full Text Available This work is the final step of a research project that aims at evaluating the possibility of delaying the surge of a centrifugal compressor stage using a boundary-layer suction technique. It is based on Reynolds-Averaged Navier-Stokes numerical simulations. Boundary-layer suction is applied within the radial vaned diffuser. Previous work has shown the necessity to take into account the unsteady behavior of the flow when designing the active flow control technique. In this paper, a multislot strategy is designed according to the characteristics of the unsteady pressure field. Its implementation results in a significant increase of the stable operating range predicted by the unsteady RANS numerical model. A hub-corner separation still exists further downstream in the diffuser passage but does not compromise the stability of the compressor stage.

  7. Analysis Of Primary Coolant Suction Side Pressure In The Delay Chamber Of The RSG-GAS

    International Nuclear Information System (INIS)

    Dibyo, Sukmanto

    2000-01-01

    Delay chamber is a tank to delay flow that located in the primary cooling suction side of RSG-GAS. A void occurred when operation reactor caused by too high the delta P at inlet suction pump. The condition may be avoided by using one line mode of the cooling flow. The analysis show that void volume in the delay chamber is occurred because the coolant negative pressure lowers the saturation pressure should be avoided though decreasing the delta P until about 0.1 bar at about 45 exp 0 C. Solution suggested are to use bypass flow from the spent fuel to the delay chamber. Coolant temperature can be also decreased by decreasing the power level of the reactor as well as improving the heat exchanger and cooling tower performances

  8. Air suctioning during colon biopsy forceps removal reduces bacterial air contamination in the endoscopy suite.

    Science.gov (United States)

    Vavricka, S R; Tutuian, R; Imhof, A; Wildi, S; Gubler, C; Fruehauf, H; Ruef, C; Schoepfer, A M; Fried, M

    2010-09-01

    Bacterial contamination of endoscopy suites is of concern; however studies evaluating bacterial aerosols are lacking. We aimed to determine the effectiveness of air suctioning during removal of biopsy forceps in reducing bacterial air contamination. This was a prospective single-blinded trial involving 50 patients who were undergoing elective nontherapeutic colonoscopy. During colonoscopy, endoscopists removed the biopsy forceps first without and then with suctioning following contact with the sigmoid mucosa. A total of 50 L of air was collected continuously for 30 seconds at 30-cm distance from the biopsy channel valve of the colonoscope, with time starting at forceps removal. Airborne bacteria were collected by an impactor air sampler (MAS-100). Standard Petri dishes with CNA blood agar were used to culture Gram-positive bacteria. Main outcome measure was the bacterial load in endoscopy room air. At the beginning and end of the daily colonoscopy program, the median (and interquartile [IQR] range) bioaerosol burden was 4 colony forming units (CFU)/m (3) (IQR 3 - 6) and 16 CFU/m (3) (IQR 13 - 18), respectively. Air suctioning during removal of the biopsy forceps reduced the bioaerosol burden from a median of 14 CFU/m (3) (IQR 11 - 29) to a median of 7 CFU/m (3) (IQR 4 - 16) ( P = 0.0001). Predominantly enterococci were identified on the agar plates. The bacterial aerosol burden during handling of biopsy forceps can be reduced by applying air suction while removing the forceps. This simple method may reduce transmission of infectious agents during gastrointestinal endoscopies. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  9. Exact solution for flow in a porous pipe with unsteady wall suction and/or injection

    Science.gov (United States)

    Tsangaris, S.; Kondaxakis, D.; Vlachakis, N. W.

    2007-10-01

    This paper presents an extension of the exact solution of the steady laminar axisymmetric flow in a straight pipe of circular cross section with porous wall, given by R.M. Terrill, to the case of unsteady wall injection and/or suction. The cases of the pulsating parabolic profile and of the developed pulsating flow are investigated as examples. The pulsating flow in porous ducts has many applications in biomedical engineering and in other engineering areas.

  10. Measuring lip force by oral screens Part 2: The importance of screen design, instruction and suction.

    Science.gov (United States)

    Wertsén, Madeleine; Stenberg, Manne

    2017-10-01

    The aim of this study was to find a reliable method for measuring lip force and to find the most important factors that influence the measurements in terms of magnitude and variability. The hypothesis tested was that suction is involved and thus the instruction and the design of the oral screen are of importance when measuring lip force. This is a methodological study in a healthy population. This study was conducted in a general community. The designs of the screens were soft and hard prefabricated screens and 2 semi-individually made with a tube allowing air to pass. The screens and the instructions squeeze or suck were tested on 29 healthy adults, one at a time and on 4 occasions. The test order of the screens was randomized. Data were collected during 4 consecutive days, and the procedure was repeated after 1 month. The participants were 29 healthy adult volunteers. The instruction was an important mean to distinguish between squeezing and sucking. The design of the screen affected the lip force so that it increases in relation to the projected area of the screen. A screen design with a tube allowing air to pass made it possible to avoid suction when squeezing. By measuring with and without allowing air to pass, it was possible to distinguish between suction related and not suction related lip force. The additional screen pressure when sucking was related to the ability to produce a negative intraoral pressure. In conclusion lip force increases in relation to the projected area of the screen, sucking generally increases the measured lip force and the additional screen pressure when sucking is related to the ability to produce a negative intraoral pressure.

  11. Free Convection from a Semi-Infinite Vertical Plate with Discontinuous Blowing or Suction.

    Science.gov (United States)

    1981-03-01

    SCHIESSR UNCLASSIFIED; EhEllllEllEE EE[E]hEEEIllIEllhlEEIl EEEEEIIIEEEEI EEEIIIIIIIIII EIIIEIIEEEEII EEEIIIIIIIIIIE LVEL NAVAL POSTGRADUATE SCHOOL Monterey...the unsteady free convective flow past a simi-infinite porous plate with constant suction were studied through mathematical analysis by Soundalgekar...boundary-layers and; therefore, will often indicate a preferred method of analytical solution. Although there are several possible mathematical techniques

  12. Deep Convolutional Neural Networks for Endotracheal Tube Position and X-ray Image Classification: Challenges and Opportunities.

    Science.gov (United States)

    Lakhani, Paras

    2017-08-01

    The goal of this study is to evaluate the efficacy of deep convolutional neural networks (DCNNs) in differentiating subtle, intermediate, and more obvious image differences in radiography. Three different datasets were created, which included presence/absence of the endotracheal (ET) tube (n = 300), low/normal position of the ET tube (n = 300), and chest/abdominal radiographs (n = 120). The datasets were split into training, validation, and test. Both untrained and pre-trained deep neural networks were employed, including AlexNet and GoogLeNet classifiers, using the Caffe framework. Data augmentation was performed for the presence/absence and low/normal ET tube datasets. Receiver operating characteristic (ROC), area under the curves (AUC), and 95% confidence intervals were calculated. Statistical differences of the AUCs were determined using a non-parametric approach. The pre-trained AlexNet and GoogLeNet classifiers had perfect accuracy (AUC 1.00) in differentiating chest vs. abdominal radiographs, using only 45 training cases. For more difficult datasets, including the presence/absence and low/normal position endotracheal tubes, more training cases, pre-trained networks, and data-augmentation approaches were helpful to increase accuracy. The best-performing network for classifying presence vs. absence of an ET tube was still very accurate with an AUC of 0.99. However, for the most difficult dataset, such as low vs. normal position of the endotracheal tube, DCNNs did not perform as well, but achieved a reasonable AUC of 0.81.

  13. [Pain assessment of tracheal suctioning on brain injury patients by pain behavioral indicator scale (ESCID)].

    Science.gov (United States)

    López-López, C; Murillo-Pérez, M A; Morales-Sánchez, C; Torrente-Vela, S; Orejana-Martín, M; García-Iglesias, M; Cuenca-Solanas, M; Alted-López, E

    2014-01-01

    To assess pain response on patients with moderate to severe head injury before a common nursing procedure: tracheal suctioning. An observational longitudinal pilot study with consecutive sampling performed from September to December of 2012. Pain was assessed by a pain behavioral indicator scale 5 minutes before, meanwhile and 15 minutes after tracheal suctioning the days 1, 3 and 6 of their intensive care unit (ICU) stay, as well as a non-painful procedure: rubbing with gauze the forearm of the patient. Pseudo-analgesia and hemodynamic variables were also recorded. Descriptive analysis of the variables, inferential statistics with t-student and Anova with SPSS 17.0; statistical tests were considered significant if the critical level observed was less than 5% (P.05) were shown. Data for the painless procedure were significantly different on day 6 (P<.05) CONCLUSION: During tracheal suctioning in patients with head injury in the first 6 days in the ICU, objective mild-moderate pain according to ESCID scale has been detected. Copyright © 2013 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  14. A wet-tolerant adhesive patch inspired by protuberances in suction cups of octopi

    Science.gov (United States)

    Baik, Sangyul; Kim, Da Wan; Park, Youngjin; Lee, Tae-Jin; Ho Bhang, Suk; Pang, Changhyun

    2017-06-01

    Adhesion strategies that rely on mechanical interlocking or molecular attractions between surfaces can suffer when coming into contact with liquids. Thus far, artificial wet and dry adhesives have included hierarchical mushroom-shaped or porous structures that allow suction or capillarity, supramolecular structures comprising nanoparticles, and chemistry-based attractants that use various protein polyelectrolytes. However, it is challenging to develop adhesives that are simple to make and also perform well—and repeatedly—under both wet and dry conditions, while avoiding non-chemical contamination on the adhered surfaces. Here we present an artificial, biologically inspired, reversible wet/dry adhesion system that is based on the dome-like protuberances found in the suction cups of octopi. To mimic the architecture of these protuberances, we use a simple, solution-based, air-trap technique that involves fabricating a patterned structure as a polymeric master, and using it to produce a reversed architecture, without any sophisticated chemical syntheses or surface modifications. The micrometre-scale domes in our artificial adhesive enhance the suction stress. This octopus-inspired system exhibits strong, reversible, highly repeatable adhesion to silicon wafers, glass, and rough skin surfaces under various conditions (dry, moist, under water and under oil). To demonstrate a potential application, we also used our adhesive to transport a large silicon wafer in air and under water without any resulting surface contamination.

  15. MHD Boundary Layer Flow of Dilatant Fluid in a Divergent Channel with Suction or Blowing

    International Nuclear Information System (INIS)

    Bhattacharyya, Krishnendu; Layek, G. C.

    2011-01-01

    An analysis is carried out to study a steady magnetohydrodynamic (MHD) boundary layer flow of an electrically conducting incompressible power-law non-Newtonian fluid through a divergent channel. The channel walls are porous and subjected to either suction or blowing of equal magnitude of the same kind of fluid on both walls. The fluid is permeated by a magnetic field produced by electric current along the line of intersection of the channel walls. The governing partial differential equation is transformed into a self-similar nonlinear ordinary differential equation using similarity transformations. The possibility of boundary layer flow in a divergent channel is analyzed with the power-law fluid model. The analysis reveals that the boundary layer flow (without separation) is possible for the case of the dilatant fluid model subjected to suitable suction velocity applied through its porous walls, even in the absence of a magnetic field. Further, it is found that the boundary layer flow is possible even in the presence of blowing for a suitable value of the magnetic parameter. It is found that the velocity increases with increasing values of the power-law index for the case of dilatant fluid. The effects of suction/blowing and magnetic field on the velocity are shown graphically and discussed physically. (fundamental areas of phenomenology(including applications))

  16. LES-based characterization of a suction and oscillatory blowing fluidic actuator

    Science.gov (United States)

    Kim, Jeonglae; Moin, Parviz

    2015-11-01

    Recently, a novel fluidic actuator using steady suction and oscillatory blowing was developed for control of turbulent flows. The suction and oscillatory blowing (SaOB) actuator combines steady suction and pulsed oscillatory blowing into a single device. The actuation is based upon a self-sustained mechanism of confined jets and does not require any moving parts. The control output is determined by a pressure source and the geometric details, and no additional input is needed. While its basic mechanisms have been investigated to some extent, detailed characteristics of internal turbulent flows are not well understood. In this study, internal flows of the SaOB actuator are simulated using large-eddy simulation (LES). Flow characteristics within the actuator are described in detail for a better understanding of the physical mechanisms and improving the actuator design. LES predicts the self-sustained oscillations of the turbulent jet. Switching frequency, maximum velocity at the actuator outlets, and wall pressure distribution are in good agreement with the experimental measurements. The computational results are used to develop simplified boundary conditions for numerical experiments of active flow control. Supported by the Boeing company.

  17. Analysis of Infiltration-Suction Response in Unsaturated Residual Soil Slope in Gelugor, Penang

    Science.gov (United States)

    Ashraf Mohamad Ismail, Mohd; Hasliza Hamzah, Nur; Min, Ng Soon; Hazreek Zainal Abidin, Mohd; Tajudin, Saiful Azhar Ahmad; Madun, Aziman

    2018-04-01

    Rainfall infiltration on residual soil slope may impair slope stability by altering the pore-water pressure in the soil. A study has been carried out on unsaturated residual soil slope in Gelugor, Penang to determine the changes in matric suction of residual soils at different depth due to rainwater infiltration. The sequence of this study includes the site investigation, field instrumentation, laboratory experiment and numerical modeling. Void ratio and porosity of soil were found to be decreasing with depth while the bulk density and dry density of soil increased due to lower porosity of soil at greater depth. Soil infiltration rate and matric suction of all depths decrease with the increase of volumetric water content as well as the degree of saturation. Numerical modeling was used to verify and predict the relationship between infiltration-suction response and degree of saturation. Numerical models can be used to integrate the rainfall scenarios into quantitative landslide hazard assessments. Thus, development plans and mitigation measures can be designed for estimated impacts from hazard assessments based on collected data.

  18. Vortex cavitation and oscillation in a double-suction volute pump

    International Nuclear Information System (INIS)

    Sato, T; Nagahara, T; Tanaka, K; Fuchiwaki, M; Shimizu, F

    2010-01-01

    In recent years, Computational Fluid Dynamics (CFD) codes have been utilized actively in the early part of the product development cycle. Numerical analysis models have also been developed rapidly and have added cavitation flow analysis functions peculiar to hydraulic machines, in which the flow analysis has been developed remarkably with high-precision and high-reliability. On the other hand, it is well known that three kinds of cavitation, such as vortex cavitation, reverse flow cavitation and cloud cavitation appear in a double-suction volute pump. We have much interest in a relationship among the cavitating flows, pump oscillation and noise. In this study, full 3D numerical simulations have been performed using a commercial code inside the pump from the inlet of suction duct to the outlet of delivery duct. The numerical model is based on a combination of multiphase flow equations with the truncated version of the Rayleigh-Plesset model predicting the complicated growth and collapse process of cavity bubbles. This study highlights especially the mechanism of vortex cavitation occurrence from the end of the suction duct in the pump and pump oscillation which causes cavitation noise from the pump. The experimental investigations have also been performed on the cavitating flow with flow visualization to evaluate the numerical results.

  19. MHD flow over a permeable stretching/shrinking sheet of a nanofluid with suction/injection

    Directory of Open Access Journals (Sweden)

    Sandeep Naramgari

    2016-06-01

    Full Text Available In this study we analyzed the influence of thermal radiation and chemical reaction on two dimensional steady magnetohydrodynamic flow of a nanofluid past a permeable stretching/shrinking sheet in the presence of suction/injection. We considered nanofluid volume fraction on the boundary is submissive controlled, which makes the present study entirely different from earlier studies and physically more realistic. The equations governing the flow are solved numerically. Effects of non-dimensional governing parameters on velocity, temperature and concentration profiles are discussed and presented through graphs. Also, coefficient of skin friction and local Nusselt number is investigated for stretching/shrinking and suction/injection cases separately and presented through tables. Comparisons with existed results are presented. Present results have an excellent agreement with the existed studies under some special assumptions. Results indicate that the enhancement in Brownian motion and thermophoresis parameters depreciates the nanoparticle concentration and increases the mass transfer rate. Dual solutions exist only for certain range of stretching/shrinking and suction/injection parameters.

  20. Timer switch to convert suction apparatus for negative pressure wound therapy application

    Directory of Open Access Journals (Sweden)

    Surath Amarnath

    2014-01-01

    Full Text Available Background: Negative pressure wound therapy (NPWT is an established modality in the treatment of chronic wounds, open fractures, and post-operative wound problems. This method has not been widely used due to the high cost of equipment and consumables. This study demonstrates an indigenously developed apparatus which gives comparable results at a fraction of the cost. Readily available materials are used for the air-tight dressing. Materials and Methods: Equipment consists of suction apparatus with adjustable pressure valve set to a pressure 125-150 mmHg. An electronic timer switch with a sequential working time of 5 min and a standby time of 3 min provides the required intermittent negative pressure. Readily available materials such as polyvinyl alcohol sponge, suction drains and steridrapes were used to provide an air tight wound cover. Results: A total of 90 cases underwent 262 NPWT applications from 2009 to 2014. This series, comprised of 30 open fractures, 21 post-operative and 39 chronic wounds. The wound healing rate in our study was comparable to other published studies using NPWT. Conclusion: The addition of electronic timer switch will convert a suction apparatus into NPWT machine, and the results are equally effective compared to more expensive counter parts. The use of indigenous dressing materials reduces the cost significantly.

  1. A Constitutive Model for Unsaturated soils based on a Compressibility Framework dependent on Suction and Degree of Saturation

    OpenAIRE

    Sitarenios Panagiotis; Kavvadas Michael

    2016-01-01

    The Modified Cam Clay model is extended to account for the behaviour of unsaturated soils using Bishop’s stress. To describe the Loading – Collapse behaviour, the model incorporates a compressibility framework with suction and degree of saturation dependent compression lines. For simplicity, the present paper describes the model in the triaxial stress space with characteristic simulations of constant suction compression and triaxial tests, as well as wetting tests. The model reproduces an evo...

  2. Successful Laparoscopically Assisted Transcervical Suction Evacuation of Interstitial Pregnancy following Failed Methotrexate Injection in a Community Hospital Setting

    Directory of Open Access Journals (Sweden)

    Rani B. Fritz

    2014-01-01

    Full Text Available We report on a case of a patient with an early diagnosed cornual ectopic pregnancy following failed methotrexate treatment. The patient was subsequently taken to the operating room for a laparoscopic guided transcervical suction curettage of the cornual ectopic. The surgery was successful and the patient was followed up until her urine pregnancy test was negative. We conclude that in properly selected patients, cornual ectopic pregnancy may be treated with transcervical suction curettage.

  3. The effect of intraoral suction on oxygen-enriched surgical environments: a mechanism for reducing the risk of surgical fires.

    Science.gov (United States)

    VanCleave, Andrea M; Jones, James E; McGlothlin, James D; Saxen, Mark A; Sanders, Brian J; Vinson, LaQuia A

    2014-01-01

    In this study, a mechanical model was applied in order to replicate potential surgical fire conditions in an oxygen-enriched environment with and without high-volume suction typical for dental surgical applications. During 41 trials, 3 combustion events were measured: an audible pop, a visible flash of light, and full ignition. In at least 11 of 21 trials without suction, all 3 conditions were observed, sometimes with an extent of fire that required early termination of the experimental trial. By contrast, in 18 of 20 with-suction trials, ignition did not occur at all, and in the 2 cases where ignition did occur, the fire was qualitatively a much smaller, candle-like flame. Statistically comparing these 3 combustion events in the no-suction versus with-suction trials, ignition (P = .0005), audible pop (P = .0211), and flash (P = .0092) were all significantly more likely in the no-suction condition. These results suggest a possible significant and new element to be added to existing surgical fire safety protocols toward making surgical fires the "never-events" they should be.

  4. Controls on shallow landslide initiation: Diverse hydrologic pathways, 3D failure geometries, and unsaturated soil suctions

    Science.gov (United States)

    Reid, Mark; Iverson, Richard; Brien, Dianne; Iverson, Neal; LaHusen, Richard; Logan, Matthew

    2017-04-01

    Shallow landslides and ensuing debris flows are a common hazard worldwide, yet forecasting their initiation at a specific site is challenging. These challenges arise, in part, from diverse near-surface hydrologic pathways under different wetting conditions, 3D failure geometries, and the effects of suction in partially saturated soils. Simplistic hydrologic models typically used for regional hazard assessment disregard these complexities. As an alterative to field studies where the effects of these governing factors can be difficult to isolate, we used the USGS debris-flow flume to conduct controlled, field-scale landslide initiation experiments. Using overhead sprinklers or groundwater injectors on the flume bed, we triggered failures using three different wetting conditions: groundwater inflow from below, prolonged moderate-intensity precipitation, and bursts of high-intensity precipitation. Failures occurred in 6 m3 (0.65-m thick and 2-m wide) prisms of loamy sand on a 31° slope; these field-scale failures enabled realistic incorporation of nonlinear scale-dependent effects such as soil suction. During the experiments, we monitored soil deformation, variably saturated pore pressures, and moisture changes using ˜50 sensors sampling at 20 Hz. From ancillary laboratory tests, we determined shear strength, saturated hydraulic conductivities, and unsaturated moisture retention characteristics. The three different wetting conditions noted above led to different hydrologic pathways and influenced instrumental responses and failure timing. During groundwater injection, pore-water pressures increased from the bed of the flume upwards into the sediment, whereas prolonged moderate infiltration wet the sediment from the ground surface downward. In both cases, pore pressures acting on the impending failure surface slowly rose until abrupt failure. In contrast, a burst of intense sprinkling caused rapid failure without precursory development of widespread positive pore

  5. Endotracheal intubation in patients with difficult airway: Using laryngeal mask airway with bougie versus video laryngoscopy

    Directory of Open Access Journals (Sweden)

    Hesameddin Modir

    2017-01-01

    Full Text Available Airway management is essential for safe anesthesia and endotracheal intubation is the most important procedure by which critically ill patients can be better managed, especially if done quickly and successfully. This study aimed to compare the techniques of intubation through laryngeal mask airway (LMA using a bougie versus video laryngoscopy (VL regarding to intubation success and the quality of intubation indices in patients with difficult airways. This randomized clinical trial was performed on 96 patients aged 16–76 years with Mallampati class 3 or 4 who underwent elective surgery. Once the demographics were recorded, patients were randomly divided into two groups and the first group intubated with VL, and the second group intubated through laryngeal mask using a bougie. Then vital signs, arterial oxygen saturation, the time required for successful intubation, and ease of intubation were recorded. Here t-tests, chi-square, Fisher exact tests, and analysis of variance for repeated measurement were used to analyze the data in SPSS software. The overall success rates of intubation in VL and LMA groups were 46 (96% and 44 (92%, respectively. The mean duration of intubation for the LMA and VL groups was 18.70 ± 6.73 and 14.21 ± 4.14 seconds, respectively (P < 0.001. Moreover, visual analogue scale score for pain in throat was significantly lower in VL group than LMA (1.65 ± 0.76 vs. 1.33 ± 0.52. Moreover, easy intubation in bougie group was 50%, while the easy intubation in VL was 73% (P = 0.023. In addition, incidence of cough was 31% in the LMA with bougie group and 9% in VL group (P = 0.005. The VL technique is an easier method and has a shorter intubation time than LMA using bougie, and causes a lower incidence of coughing, laryngospasm in patients that need intubation. Moreover, cough and discomfort in the throat tend to be less in VL, and the LMA could be used as replacement of VL in hard situations.

  6. An expiratory assist during spontaneous breathing can compensate for endotracheal tube resistance.

    Science.gov (United States)

    Uchiyama, Akinori; Chang, Cheng; Suzuki, Shinya; Mashimo, Takashi; Fujino, Yuji

    2009-08-01

    Although inspiratory assist of spontaneous breathing in intubated patients is common, expiratory assist functions have rarely been reported. Effective expiratory support (ES) could be used to compensate for endotracheal tube (ETT) resistance during spontaneous breathing. In this study, we examined the performance of a new system designed to provide both inspiratory support (IS) and ES during spontaneous breathing with the goal of reducing the effective resistance of the ETT. The ES system consisted of a ventilator demand valve and a computer-controlled piston cylinder, which aspirated gas from the respiratory circuit during the expiratory phase. The movement of the piston was synchronized with spontaneous breathing. We compared the pressures at the tip of the ETT and in the breathing circuit during spontaneous breathing through an ETT of internal diameter (ID) 5 mm with that of an ETT with ID 8 mm in nine healthy adult male volunteers. The ventilatory mode was set to maintain a continuous airway pressure of 0 cm H(2)O. Three ventilator settings (no support, IS only, and IS plus ES) were compared using ID 5 mm ETT. We monitored pressure in the breathing circuit (P(aw)), ETT tip pressure (P(tip)), and respiratory flow. The P(tip) of the ID 5 mm ETT showed a large negative deflection during inspiration and a positive deflection during expiration without support. IS alone did not improve the respiratory pattern through the small ETT. However, IS plus ES resulted in negative P(aw) during expiration in addition to positive deflection of P(aw) during inspiration, making the pressure characteristics of P(tip) similar to those of ID 8 mm ETT. Moreover, IS plus ES produced a respiratory pattern through the ID 5 mm ETT that was similar to that through the ID 8 mm ETT. In this study of healthy volunteers, IS plus ES compensated for the airway resistance imposed by a ID 5.0 mm ETT to create pressure changes at the tip of the ETT similar to those of an ID 8.0 mm ETT.

  7. CO2 driven endotracheal tube cuff control in critically ill patients: A randomized controlled study.

    Science.gov (United States)

    De Pascale, Gennaro; Pennisi, Mariano Alberto; Vallecoccia, Maria Sole; Bello, Giuseppe; Maviglia, Riccardo; Montini, Luca; Di Gravio, Valentina; Cutuli, Salvatore Lucio; Conti, Giorgio; Antonelli, Massimo

    2017-01-01

    To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard™ 100 system) that continuously monitors and controls the cuff pressure (Pcuff), while facilitating the aspiration of subglottic secretions (SS). This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of the study was the rate of device related adverse events (AE) and serious AE (SAE) as a result of using AnapnoGuard (AG) 100 during mechanical ventilation. Secondary endpoints were: (1) mechanical complications rate (2) ICU staff satisfaction; (3) VAP occurrence; (4) length of mechanical ventilation; (5) length of Intensive Care Unit stay and mortality; (6) volume of evacuated subglottic secretions. Sixty patients were randomized to be intubated with the AG endotracheal-tube (ETT) and connected to the AG 100 system allowing Pcuff adjustment and SS aspiration; or with an ETT combined with SS drainage and Pcuff controlled manually. No difference in adverse events rate was identified between the groups. The use of AG system was associated with a significantly higher incidence of Pcuff determinations in the safety range (97.3% vs. 71%; paspirated SS secretions: (192.0[64-413] ml vs. 150[50-200], p = 0.19 (total)); (57.8[20-88.7] ml vs. 50[18.7-62] ml, p = 0.11 (daily)). No inter-group difference was detected using AG system vs. controls in terms of post-extubation throat pain level (0 [0-2] vs. 0 [0-3]; p = 0.7), hoarseness (42.9% vs. 75%; p = 0.55) and tracheal mucosa oedema (16.7% vs. 10%; p = 0.65). Patients enrolled in the AG group had a trend to reduced VAP risk of ventilator-associated pneumonia(VAP) (14.8% vs. 40%; p = 0.06), which were more frequently monomicrobial (25% vs. 70%; p = 0.03). No statistically significant difference was observed in duration of mechanical ventilation, ICU stay, and mortality. The use AG 100 system and AG tube in critically ill intubated patients is safe and

  8. CO2 driven endotracheal tube cuff control in critically ill patients: A randomized controlled study.

    Directory of Open Access Journals (Sweden)

    Gennaro De Pascale

    Full Text Available To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard™ 100 system that continuously monitors and controls the cuff pressure (Pcuff, while facilitating the aspiration of subglottic secretions (SS.This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of the study was the rate of device related adverse events (AE and serious AE (SAE as a result of using AnapnoGuard (AG 100 during mechanical ventilation. Secondary endpoints were: (1 mechanical complications rate (2 ICU staff satisfaction; (3 VAP occurrence; (4 length of mechanical ventilation; (5 length of Intensive Care Unit stay and mortality; (6 volume of evacuated subglottic secretions. Sixty patients were randomized to be intubated with the AG endotracheal-tube (ETT and connected to the AG 100 system allowing Pcuff adjustment and SS aspiration; or with an ETT combined with SS drainage and Pcuff controlled manually.No difference in adverse events rate was identified between the groups. The use of AG system was associated with a significantly higher incidence of Pcuff determinations in the safety range (97.3% vs. 71%; p<0.01 and a trend to a greater volume of aspirated SS secretions: (192.0[64-413] ml vs. 150[50-200], p = 0.19 (total; (57.8[20-88.7] ml vs. 50[18.7-62] ml, p = 0.11 (daily. No inter-group difference was detected using AG system vs. controls in terms of post-extubation throat pain level (0 [0-2] vs. 0 [0-3]; p = 0.7, hoarseness (42.9% vs. 75%; p = 0.55 and tracheal mucosa oedema (16.7% vs. 10%; p = 0.65. Patients enrolled in the AG group had a trend to reduced VAP risk of ventilator-associated pneumonia(VAP (14.8% vs. 40%; p = 0.06, which were more frequently monomicrobial (25% vs. 70%; p = 0.03. No statistically significant difference was observed in duration of mechanical ventilation, ICU stay, and mortality.The use AG 100 system and AG tube in critically ill

  9. Closing remarks

    International Nuclear Information System (INIS)

    Reig, J.

    2007-01-01

    Good afternoon. Before providing the closing remarks on behalf of the NEA, I would like to take this opportunity and make some personal reflections, if you allow me Mr. Chairman. I have had the opportunity to take part in the three workshops on public communication organised by the NEA. In the first one in Paris in 2000, representing my country, Spain, and in the two last ones in Ottawa in 2004 and Tokyo today, on behalf of the NEA. The topics for the three workshops follow a logical order, first the focus was on investing in trust in a time when public communication was becoming a big challenge for the regulators. Second, maintaining and measuring public confidence to assess how credible regulators are in front of the public; and finally here in Tokyo, transparency, which is a basic element to achieve trust and credibility. In my view, a regulatory decision has three main components, it has to be technically sound. legally correct and well communicated. The emphasis in the early years was in the technical matters, till legal issues became a key element to achieve the political acceptance from governments and local authorities. Finally the public communication aspects resulted into a major effort and challenge to achieve social acceptance. (author)

  10. High-fidelity simulation of lung isolation with double-lumen endotracheal tubes and bronchial blockers in anesthesiology resident training.

    Science.gov (United States)

    Failor, Erin; Bowdle, Andrew; Jelacic, Srdjan; Togashi, Kei

    2014-08-01

    Demonstrate the feasibility of using the AirSim Bronchi airway simulator to teach residents how to manage lung isolation with double-lumen endotracheal tubes and bronchial blockers and evaluate their performance with a detailed checklist. Prospective observational study. University anesthesiology residency training program. Anesthesiology residents taking a cardiothoracic anesthesiology rotation. Residents were instructed in 7 tasks using the AirSim Bronchi: The use of the fiberoptic bronchoscope, methods for placing left and right double-lumen endotracheal tubes and 3 bronchial blockers (Univent, Arndt, and Cohen), and application of continuous positive airway pressure (CPAP) to the unventilated lung. Two to 3 weeks later, checklists and a detailed scoring system were used to assess performance. Residents rated the curriculum and their own confidence in performing the tasks using a 5-point Likert scale. Thirteen residents completed the curriculum. Their median Likert scale ratings of the curriculum based on a questionnaire with 6 items ranged from 4 to 5 of 5. Resident confidence scores for each lung isolation technique improved after the simulation training, with the median gain ranging from 0.5 to 1.5 Likert levels depending on the task. The largest improvement occurred with the bronchial blockers (psimulator in a novel simulation curriculum to teach lung-isolation techniques to anesthesiology residents and evaluated performance using a detailed checklist scoring system. This curriculum is a promising educational tool. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Bedside screen for oral cavity structure, salivary flow, and vocal production over the 14days following endotracheal extubation.

    Science.gov (United States)

    Chen, Cheryl Chia-Hui; Wu, Kuo-Hsiang; Ku, Shih-Chi; Chan, Ding-Cheng; Lee, Jang-Jaer; Wang, Tyng-Guey; Hsiao, Tzu-Yu

    2018-06-01

    To describe the sequelae of oral endotracheal intubation by evaluating prevalence rates of structural injury, hyposalivation, and impaired vocal production over 14days following extubation. Consecutive adults (≥20years, N=114) with prolonged (≥48h) endotracheal intubation were enrolled from medical intensive care units at a university hospital. Participants were assessed by trained nurses at 2, 7, and 14days after extubation, using a standardized bedside screening protocol. Within 48-hour postextubation, structural injuries were common, with 51% having restricted mouth opening. Unstimulated salivary flow was reduced in 43%. For vocal production, 51% had inadequate breathing support for phonation, dysphonia was common (94% had hoarseness and 36% showed reduced efficiency of vocal fold closure), and >40% had impaired articulatory precision. By 14days postextubation, recovery was noted in most conditions, but reduced efficiency of vocal fold closure persisted. Restricted mouth opening (39%) and reduced salivary flow (34%) remained highly prevalent. After extubation, restricted mouth opening, reduced salivary flow, and dysphonia were common and prolonged in recovery. Reduced efficiency of vocal cord closure persisted at 14days postextubation. The extent and duration of these sequelae remind clinicians to screen for them up to 2weeks after extubation. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Time management and nectar flow: flower handling and suction feeding in long-proboscid flies (Nemestrinidae: Prosoeca)

    Science.gov (United States)

    Karolyi, Florian; Morawetz, Linde; Colville, Jonathan F.; Handschuh, Stephan; Metscher, Brian D.; Krenn, Harald W.

    2013-11-01

    A well-developed suction pump in the head represents an important adaptation for nectar-feeding insects, such as Hymenoptera, Lepidoptera and Diptera. This pumping organ creates a pressure gradient along the proboscis, which is responsible for nectar uptake. The extremely elongated proboscis of the genus Prosoeca (Nemestrinidae) evolved as an adaptation to feeding from long, tubular flowers. According to the functional constraint hypothesis, nectar uptake through a disproportionately elongated, straw-like proboscis increases flower handling time and consequently lowers the energy intake rate. Due to the conspicuous length variation of the proboscis of Prosoeca, individuals with longer proboscides are hypothesised to have longer handling times. To test this hypothesis, we used field video analyses of flower-visiting behaviour, detailed examinations of the suction pump morphology and correlations of proboscis length with body length and suction pump dimensions. Using a biomechanical framework described for nectar-feeding Lepidoptera in relation to proboscis length and suction pump musculature, we describe and contrast the system in long-proboscid flies. Flies with longer proboscides spent significantly more time drinking from flowers. In addition, proboscis length and body length showed a positive allometric relationship. Furthermore, adaptations of the suction pump included an allometric relationship between proboscis length and suction pump muscle volume and a combination of two pumping organs. Overall, the study gives detailed insight into the adaptations required for long-proboscid nectar feeding, and comparisons with other nectar-sucking insects allow further considerations of the evolution of the suction pump in insects with sucking mouthparts.

  13. Silent cooling system with a double suction type centrifugal fan with backward blades; Ryosuikomi turbo fan wo mochiita teisoon engine reikyaku system no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Funabashi, S. [Hitachi, Ltd., Tokyo (Japan); Nakamura, K. [Hitachi Construction Machinery Co. Ltd., Tokyo (Japan)

    2000-04-25

    We have developed a new cooling system for the engine of construction machinery. This system produces two different air flow routes by a double suction type centrifugal fan with backward blades. We first measured aerodynamic performance and sound level of the double suction type fan, which consists of two single suction type fans of different design, and compared these measurements to those of single suction type fans. Next, we installed the fan in a scale model of the new cooling system. The performance of this double suction type fan was different to that of a single suction type. It is considered that the effect of interaction of the exit flows from the two different fans caused this performance change. The test model installed in an engine compartment showed that this cooling system reduced the area of air inlets and outlets around the engine and did not cause re-circulation of cooling air. (author)

  14. Short-snouted toothless ichthyosaur from China suggests Late Triassic diversification of suction feeding ichthyosaurs.

    Directory of Open Access Journals (Sweden)

    P Martin Sander

    Full Text Available BACKGROUND: Ichthyosaurs were an important group of Mesozoic marine reptiles and existed from the Early Triassic to the early Late Cretaceous. Despite a great diversity in body shapes and feeding adaptations, all share greatly enlarged eyes, an elongated rostrum with numerous conical teeth, and a streamlined body. METHODOLOGY/PRINCIPAL FINDINGS: Based on new material from China and the restudy of Shastasaurus pacificus, we here reinterpret the classical large-bodied Late Triassic ichthyosaur genus Shastasaurus to differ greatly from the standard ichthyosaurian body plan, indicating much greater morphological diversity and range of feeding adaptations in ichthyosaurs than previously recognized. Phylogenetic analysis indicates a monophyletic clade consisting of the giant Shonisaurus sikanniensis, Guanlingsaurus liangae, and Shastasaurus pacificus to which the genus name Shastasaurus is applied. Shastasaurus liangae comb. nov. is from the Late Triassic (Carnian Xiaowa Formation of Guizhou Province, southwestern China. The species combines a diminutive head with an entirely toothless and greatly reduced snout. The species also has by far the highest vertebral count among ichthyosaurs (86 presacral vertebrae and >110 caudal vertebrae, a count that is also very high for tetrapods in general. A reduced toothless snout and a diminutive head is also apparently present in the giant S. sikanniensis and presumably in S. pacificus. CONCLUSIONS/SIGNIFICANCE: In analogy to many modern odontocetes, Shastasaurus is interpreted as a specialized suction feeder on unshelled cephalopods and fish, suggesting a unique but widespread Late Triassic diversification of toothless, suction-feeding ichthyosaurs. Suction feeding has not been hypothesized for any of the other diverse marine reptiles of the Mesozoic before, but in Shastasaurus may be linked to the Late Triassic minimum in atmospheric oxygen.

  15. A Prospective Randomized Study Comparing Manual and Wall Suction in the Performance of Bronchoalveolar Lavage.

    Science.gov (United States)

    Seijo, Luis M; Flandes, Javier; Somiedo, Maria V; Naya, Alba; Manjón, Josefina; Álvarez, Susana; Fernández-Navamuel, Iker

    2016-01-01

    Bronchoalveolar lavage (BAL) may be performed using a hand-held syringe or wall suction. The aim was to study BAL volume and diagnostic yields based on BAL technique. A total of 220 consecutive patients undergoing BAL at our center were included. Manual aspiration was performed in 115 patients (group 1), and wall suction (<50 mm Hg of negative pressure) was used in 105 patients (group 2). All bronchoscopies were performed under conscious sedation applying topical anesthesia with lidocaine. Three 50-ml sterile saline aliquots were instilled in all patients. The mean total amount of fluid recovered was 67 ± 20 ml in group 1 and 55 ± 22 ml in group 2 (p < 0.001). More patients in the manual aspiration group met American Thoracic Society criteria (recovery of ≥30% of instilled fluid) for an optimal BAL (81 vs. 59%; p < 0.001). The quantity of recovered fluid was also related to BAL location (p < 0.001) and radiologic findings (p = 0.002). Forty-eight (22%) BALs were diagnostic (23 in group 1 and 25 in group 2), including 37 positive bacterial cultures, 6 positive stains for Pneumocystis, and 5 cases of malignancy. No statistically significant difference in diagnostic yield was observed between the two groups. A BAL diagnosis was more likely in patients with certain radiologic (p = 0.033) and endoscopic findings (p = 0.001). When taking into account all bronchoscopic techniques performed during the procedure (e.g. biopsies, brushing, etc.), bronchoscopy was diagnostic in 37% of patients. Manual aspiration is superior to wall suction during BAL yielding a larger quantity of aspirate. Diagnostic yields are similar for both techniques. © 2016 S. Karger AG, Basel.

  16. Suction Buckets

    DEFF Research Database (Denmark)

    Feld, T.

    Friction Model, are implemented as user defined material models in the commercial finite element program ABAQUS. The simulated tests are partly pullout tests, subsequent cyclic loading, partly drained tests on buckets subject to vertical, horizontal and moment loading. The numerical analyses are capable...

  17. Observations on the flight pattern of some Phlaeothripidae (Thysanoptera species by using suction trap in Hungary

    Directory of Open Access Journals (Sweden)

    Orosz Szilvia

    2016-12-01

    Full Text Available In this study, the seasonal flight activity of the Phlaeothripidae (Thysanoptera species was studied by using suction trap, in South-East Hungary, in the years 2000 and 2004 from April to October. The flight period of two dominant species, namely Haplothrips angusticornis Priesner and Haplothrips aculeatus Fabricius (Thysanoptera: Phlaeothripidae, was observed in high number in Europe. Also, it was the first record of mass flight observation of H. angusticornis. In addition, the effect of meteorological factors, such as temperature, sunshine duration, relative humidity, air pressure, and their influences, were evaluated.

  18. 85,000-GPM, single-stage, single-suction LMFBR intermediate centrifugal pump

    International Nuclear Information System (INIS)

    Fair, C.E.; Cook, M.E.; Huber, K.A.; Rohde, R.

    1983-01-01

    The mechanical and hydraulic design features of the 85,000-gpm, single-stage, single-suction pump test article, which is designed to circulate liquid-sodium coolant in the intermediate heat-transport system of a Large-Scale Liquid Metal Fast Breeder Reactor (LS-LMFBR), are described. The design and analytical considerations used to satisfy the pump performance and operability requirements are presented. The validation of pump hydraulic performance using a hydraulic scale-model pump is discussed, as is the featute test for the mechanical-shaft seal system

  19. Effects of mass transfer on MHD flow of casson fluid with chemical reaction and suction

    Directory of Open Access Journals (Sweden)

    S. A. Shehzad

    2013-03-01

    Full Text Available Effect of mass transfer in the magnetohydrodynamic flow of a Casson fluid over a porous stretching sheet is addressed in the presence of a chemical reaction. A series solution for the resulting nonlinear flow is computed. The skin friction coefficient and local Sherwood number are analyzed through numerical values for various parameters of interest. The velocity and concentration fields are illustrated for several pertinent flow parameters. We observed that the Casson parameter and Hartman number have similar effects on the velocity in a qualitative sense. We further analyzed that the concentration profile decreases rapidly in comparison to the fluid velocity when we increased the values of the suction parameter.

  20. Gage for gas flow measurement especially in gas-suction pipes

    International Nuclear Information System (INIS)

    Renner, K.; Stegmanns, W.

    1978-01-01

    The gage utilizes the differential pressure given by a differential pressure producer to generate, in a bypass, a partial gas flow measured by means of a direct-reading anemometer of windmill type. The partial gas flow is generated between pressure pick-up openings in the gas-suction pipe in front of a venturi insert and pressure pick-up openings at the bottleneck of the venturi insert. The reading of the anemometer is proportional to the main gas flow and independent of the variables of state and the properties of the gases to be measured. (RW) [de

  1. Unsteady flow of an incompressible fluid in a horizontal porous medium with suction

    International Nuclear Information System (INIS)

    Bestman, A.R.

    1988-04-01

    A theoretical analysis of two-dimensional unsteady flow in a porous medium bounded by a horizontal wall is presented as a perturbation on a basic flow. It is assumed that the perturbation is occasioned by a sudden suction at the wall. Even for a highly permeable medium the characteristic Reynolds number in porous media flow is usually small and asymptotic solutions are developed by the Laplace transform technique. It is observed that the perturbed shear stress at the wall decays exponentially with time. (author). 5 refs

  2. A comparison between the v-gel supraglottic airway device and the cuffed endotracheal tube for airway management in spontaneously breathing cats during isoflurane anaesthesia

    NARCIS (Netherlands)

    van Oostrom, H.; Krauss, M.W.; Sap, R.

    2013-01-01

    Abstract OBJECTIVE: To compare airway management using the v-gel supraglottic airway device (v-gel SGAD) to that using an endotracheal tube (ETT), with respect to practicability, leakage of volatile anaesthetics and upper airway discomfort in cats. STUDY DESIGN: Prospective, randomized clinical

  3. The Effect of Progressive Muscle Relaxation Exercises After Endotracheal Extubation on Vital Signs and Anxiety Level in Open Heart Surgery Patients

    Directory of Open Access Journals (Sweden)

    Özlem İbrahimoğlu

    2017-12-01

    Full Text Available Objective: The purpose of this study was to examine the effects of the exercises of progressive muscle relaxation (PMR on vital signs and anxiety level after endotracheal extubation in open heart surgery. Materials and Methods: This study was carried out as quasi-experimental, pre-test, and post-test with a control group. The study recruited 30 experimental and 30 control group open heart surgery patients, who met the inclusion criteria, from a cardiac and vascular surgery clinic of a university hospital. PMR exercises, which were taught before the surgery, were implemented after the surgery in the intensive care unit simultaneously with endotracheal extubation. The vital signs of the patients were monitored for the first 30 min. The anxiety levels were measured after 30 min of extubation with state anxiety inventory. Results: The lower rates of heartbeat, breathing, arterial blood pressure, and anxiety were observed in the experimental group in all measurements (first 30 min after endotracheal extubation, and the differences were statistically significant in favor of the experimental group (p<0.05. Conclusion: The study showed that the relaxation exercises after endotracheal extubation in open heart surgery patients was effective in improving vital signs and reducing anxiety level.

  4. Thopaz Portable Suction Systems in Thoracic Surgery: An end user assessment and feedback in a tertiary unit

    Directory of Open Access Journals (Sweden)

    Cantlin Teresa

    2011-04-01

    Full Text Available Abstract Background Thoracic surgical patients have chest drains inserted to enable re-expansion of lungs, to clear contents from the pleural cavity which sometimes require negative suction. Suction impedes mobility, may have variable suction delivery and increases risk of infection. Assessment of air-leak in conventional drains is not scientific and is subjective. Thopaz chest drain system is a portable suction unit which allows mobilization of the patient, with scientific digital flow recordings and an in built alarm system. Methods We evaluated the utility, staff and patient feedback of this device in a pilot evaluation in a regional thoracic unit in a structured format over a period of two months. Staff responses were graded on a scale of 1 to 6 [1 Excellent to 6 Poor]. Results 120 patients who underwent elective bullectomy/pleurectomy, VATS lung biopsies, VATS metastectomy and lung resections were evaluated. The staff feedback forms were positive. The staff liked the system as it was more scientific and accurately recordable. It made nursing and physiotherapy easier as they could mobilise patients early. The patients liked the compact design, weightlessness and the silence. It enabled mobilisation of the patients and scientific removal of chest drain. Conclusions Thopaz digital suction units were found to be user friendly and were liked by the staff and patients. The staff feedback stated the devices to be objective and scientific in making decisions about removal and enabled mobilisation.

  5. Numerical Investigation of Wall Cooling and Suction Effects on Supersonic Flat-Plate Boundary Layer Transition Using Large Eddy Simulation

    Directory of Open Access Journals (Sweden)

    Suozhu Wang

    2015-02-01

    Full Text Available Reducing friction resistance and aerodynamic heating has important engineering significance to improve the performances of super/hypersonic aircraft, so the purpose of transition control and turbulent drag reduction becomes one of the cutting edges in turbulence research. In order to investigate the influences of wall cooling and suction on the transition process and fully developed turbulence, the large eddy simulation of spatially evolving supersonic boundary layer transition over a flat-plate with freestream Mach number 4.5 at different wall temperature and suction intensity is performed in the present work. It is found that the wall cooling and suction are capable of changing the mean velocity profile within the boundary layer and improving the stability of the flow field, thus delaying the onset of the spatial transition process. The transition control will become more effective as the wall temperature decreases, while there is an optimal wall suction intensity under the given conditions. Moreover, the development of large-scale coherent structures can be suppressed effectively via wall cooling, but wall suction has no influence.

  6. Endobronchial intubation detected by insertion depth of endotracheal tube, bilateral auscultation, or observation of chest movements: randomised trial.

    Science.gov (United States)

    Sitzwohl, Christian; Langheinrich, Angelika; Schober, Andreas; Krafft, Peter; Sessler, Daniel I; Herkner, Harald; Gonano, Christopher; Weinstabl, Christian; Kettner, Stephan C

    2010-11-09

    To determine which bedside method of detecting inadvertent endobronchial intubation in adults has the highest sensitivity and specificity. Prospective randomised blinded study. Department of anaesthesia in tertiary academic hospital. 160 consecutive patients (American Society of Anesthesiologists category I or II) aged 19-75 scheduled for elective gynaecological or urological surgery. Patients were randomly assigned to eight study groups. In four groups, an endotracheal tube was fibreoptically positioned 2.5-4.0 cm above the carina, whereas in the other four groups the tube was positioned in the right mainstem bronchus. The four groups differed in the bedside test used to verify the position of the endotracheal tube. To determine whether the tube was properly positioned in the trachea, in each patient first year residents and experienced anaesthetists were randomly assigned to independently perform bilateral auscultation of the chest (auscultation); observation and palpation of symmetrical chest movements (observation); estimation of the position of the tube by the insertion depth (tube depth); or a combination of all three (all three). Correct and incorrect judgments of endotracheal tube position. 160 patients underwent 320 observations by experienced and inexperienced anaesthetists. First year residents missed endobronchial intubation by auscultation in 55% of cases and performed significantly worse than experienced anaesthetists with this bedside test (odds ratio 10.0, 95% confidence interval 1.4 to 434). With a sensitivity of 88% (95% confidence interval 75% to 100%) and 100%, respectively, tube depth and the three tests combined were significantly more sensitive for detecting endobronchial intubation than auscultation (65%, 49% to 81%) or observation(43%, 25% to 60%) (Pauscultation to detect inadvertent endobronchial intubation. But even experienced physicians will benefit from inserting tubes to 20-21 cm in women and 22-23 cm in men, especially when high

  7. Boundary layer on a flat plate with suction; Couche limite sur paroi plane poreuse avec aspiration

    Energy Technology Data Exchange (ETDEWEB)

    Favre, A; Dumas, R; Verollet, E [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Institut de Mecanique Statistique de la Turbulence, Faculte des Sciences de Marseille, 13 (France)

    1961-07-01

    This research done in wind tunnel concerns the turbulent boundary layer of a porous flat plate with suction. The porous wall is 1 m long and begins 1 m downstream of the leading edge. The Reynolds number based on the boundary layer thickness is of the order of 16.300. The suction rate defined as the ratio of the velocity perpendicular to the wall to the external flow velocity ranges from 0 to 2 per cent. The pressure gradient can be controlled. The mean velocity profiles have been determined for various positions and suction rates by means of total pressure probes together with the intensities of the turbulent velocity fluctuations components, energy spectra and correlations by means of hot wire anemometers, spectral analyser and correlator. The stream lines, the values of the viscous and turbulent shear stresses, of the local wall friction, of the turbulent energy production term, with some information on the dissipation of the energy have been derived from these measurements. For these data the integral of equation of continuity in boundary layer have been drawn. The suction effects on the boundary layer are important. The suction thoroughly alters the mean velocity profiles by increasing the viscous shear stresses near the wall and decreasing them far from the wall, it diminishes the longitudinal and transversal turbulence intensities, the turbulent shear stresses, and the production of energy of turbulence. These effects are much stressed in the inner part of the boundary layer. On the other hand the energy spectra show that the turbulence scale is little modified, the boundary layer thickness being not much diminished by the suction. The suction effects can be appreciated by comparing twice the suction rate to the wall friction coefficient (assumed airtight), quite noticeable as soon as the rate is about unity, they become very important when it reaches ten. (author) [French] Ces recherches, effectuees en soufflerie, concernent la couche limite turbulente d

  8. Aphids of the genus Diuraphis caught by Johnson suction trap in Poznań, Poland

    Directory of Open Access Journals (Sweden)

    Strażyński Przemysław

    2016-12-01

    Full Text Available In 1973-2011 in Poznań, aphid catches were carried out using Johnson’s suction trap. Since then the suction trap located at the Institute of Plant Protection - National Research Institute in Poznań has continuously recorded the daily and seasonal dynamics of aphid flights. The collected results has been used to establish one of the largest databases of this type in Europe. The data also allow tracking changes in aphid biodiversity under the changing climatic conditions. Three aphid species of Diuraphis spp. were identified: D. muehlei (Börner, 1950 - in 1974, D. bromicola (Hille Ris Lambers, 1959 - in 1988, D. noxia (Kurdjumov, 1913 - in 2003 as a result of systematic and long-term aphid collections. The occurrence of D. noxia presents a particular risk to cereal crops in Poland. This expansive aphid species that originates from Asia and the Mediterranean is a vector of Barley yellow dwarf viruses (BYDV, and has become one of the most important pest of wheat and barley in the world. Changes in climatic conditions that have been observed in recent years in Poland such as hot summer, long and warm autumn, mild winter seem to be optimal for occurrence and development of aphid species from warmer parts of Europe.

  9. Set-up and Test Procedure for Suction Installation and Uninstallation of Bucket Foundation

    DEFF Research Database (Denmark)

    Koteras, Aleksandra Katarzyna

    This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use of......) and loading frame used for those tests have been already used for axially static and cyclic loading of piles (Thomassen, 2015a) and for axially static and cyclic loading of bucket foundation (Vaitkunaite et al., 2015).......This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use...... of suction under the bucket lid or by applying additional force through the hydraulic piston, forcing the bucket to penetrate into the soil. Tests for uninstallation are performed also with the use of water pressure, as a reverse process to the suction installation. Both installation and uninstallation tests...

  10. Comparison of ProSeal laryngeal mask airway (PLMA with cuffed and uncuffed endotracheal tubes in infants

    Directory of Open Access Journals (Sweden)

    Eyyup Sabri Ozden

    2016-11-01

    Full Text Available We aimed to compare cuffed and uncuffed endotracheal tubes (ETTs with ProSealTM laryngeal mask airway (PLMA in terms of airway security and extubation, starting out from the hypothesis that PLMA will provide alternative airway safety to the endotracheal tubes, and that airway complications will be less observed. After obtaining approval from the local Ethics Committee and parental informed consent, 120 pediatric patients 1-24 months old, American Society of Anesthesiologists physical status I-II, requiring general anesthesia for elective lower abdominal surgery, were randomized into PLMA (Group P, n = 40, cuffed ETT (Group C, n = 40, and uncuffed ETT (Group UC, n = 40 groups. The number of intubation or PLMA insertion attempts was recorded. Each patient’s epigastrium was auscultated for gastric insufflation, leak volumes and air leak fractions (leak volume/inspiratory volume were recorded. Post-operative adverse events related to airway management were also followed up during the first post-operative hour. Demographic and surgical data were similar among the groups. There were significantly fewer airway manipulations in the Group P than in the other groups (p < 0.01, and leak volume and air leak fractions were greater in the Group UC than in the other two groups (p < 0.01. Laryngospasm was significantly lower in the Group P during extubation and within the first minute of post-extubation than in the other groups (p < 0.01. Based on this study, PLMA may be a good alternative to cuffed and uncuffed ETTs for airway management of infants due to the ease of manipulation and lower incidence of laryngospasm.

  11. Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients.

    Science.gov (United States)

    Ghoochani Khorasani, Ahmad; Shadnia, Shahin; Mashayekhian, Mohammad; Rahimi, Mitra; Aghabiklooei, Abbas

    2016-01-01

    Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU. Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expected duration of mechanical ventilation of more than 48 hours were recruited and randomly assigned into two groups: (1) subglottic secretion drainage (SSD) group who were intubated by Evac ETT (n = 43) and (2) control group who were intubated by C-ETT (n = 48). Results. Of the 91 eligible patients, 56 (61.5%) were male. VAP was detected in 24 of 43 (55.8%) patients in the case group and 23 of 48 (47.9%) patients in the control group (P = 0.45). The most frequently isolated microorganisms were S. aureus (54.10%) and Acinetobacter spp. (19.68%). The incidence of VAP and ICU length of stay were not significantly different between the two groups, but duration of intubation was statistically different and was longer in the SSD group. Mortality rate was less in SSD group but without a significant difference (P = 0.68). Conclusion. The SSD procedure was performed intermittently with one-hour intervals using 10 mL syringe. Subglottic secretion drainage does not significantly reduce the incidence of VAP in patients receiving MV. This strategy appears to be ineffective in preventing VAP among ICU patients.

  12. Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients

    Directory of Open Access Journals (Sweden)

    Ahmad Ghoochani Khorasani

    2016-01-01

    Full Text Available Background. Ventilator-associated pneumonia (VAP is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT in our toxicology ICU. Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expected duration of mechanical ventilation of more than 48 hours were recruited and randomly assigned into two groups: (1 subglottic secretion drainage (SSD group who were intubated by Evac ETT (n=43 and (2 control group who were intubated by C-ETT (n=48. Results. Of the 91 eligible patients, 56 (61.5% were male. VAP was detected in 24 of 43 (55.8% patients in the case group and 23 of 48 (47.9% patients in the control group (P=0.45. The most frequently isolated microorganisms were S. aureus (54.10% and Acinetobacter spp. (19.68%. The incidence of VAP and ICU length of stay were not significantly different between the two groups, but duration of intubation was statistically different and was longer in the SSD group. Mortality rate was less in SSD group but without a significant difference (P=0.68. Conclusion. The SSD procedure was performed intermittently with one-hour intervals using 10 mL syringe. Subglottic secretion drainage does not significantly reduce the incidence of VAP in patients receiving MV. This strategy appears to be ineffective in preventing VAP among ICU patients.

  13. Is the Venner-PneuX Endotracheal Tube System A Cost-Effective Option For Post Cardiac Surgery Care?

    Science.gov (United States)

    Andronis, Lazaros; Oppong, Raymond A; Manga, Na'ngono; Senanayake, Eshan; Gopal, Shameer; Charman, Susan; Giri, Ramesh; Luckraz, Heyman

    2018-04-27

    Ventilator-associated pneumonia (VAP) is common and costly. In a recent randomized controlled trial, the Venner-PneuX (VPX) endotracheal tube system was found to be superior to standard endotracheal tubes (SET) in preventing VAP. However, VPX is considerably more expensive. We evaluated the costs and benefits of VPX to determine whether replacing SET with VPX is a cost-effective option for intensive care units. We developed a decision analytic model to compare intubation with VPX or SET for patients requiring mechanical ventilation post cardiac surgery. The model was populated with existing evidence on costs, effectiveness and quality of life. Cost-effectiveness and cost-utility analyses were conducted from an NHS hospital perspective. Uncertainty was assessed through deterministic and probabilistic sensitivity analyses. Compared to SET, VPX is associated with an expected cost saving of £738 per patient. VPX led to a small increase in quality-adjusted life years (QALYs), indicating that the device is overall less costly and more effective than SET. The probability of VPX being cost-effective at £30,000 per QALY is 97%. VPX would cease to be cost-effective if (i) it led to a risk reduction smaller than 0.02 compared to SET, (ii) the acquisition cost of VPX was as high as £890 or, (iii) the cost of treating a case of VAP was lower than £1,450. VPX resulted in improved outcomes and savings which far offset the cost of the device, suggesting that replacing SET with VPX is overall beneficial. Findings were robust to extreme values of key parameters. Copyright © 2018. Published by Elsevier Inc.

  14. Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients.

    Science.gov (United States)

    Bruder, Eric A; Ball, Ian M; Ridi, Stacy; Pickett, William; Hohl, Corinne

    2015-01-08

    trials in patients undergoing emergency endotracheal intubation for critical illness, including but not limited to trauma, stroke, myocardial infarction, arrhythmia, septic shock, hypovolaemic or haemorrhagic shock, and undifferentiated shock states. We included single (bolus) dose etomidate for emergency airway intervention compared to any other rapid-acting intravenous bolus single-dose induction agent. Refinement of our initial search results by title review, and then by abstract review was carried out by three review authors. Full-text review of potential studies was based on their adherence to our inclusion and exclusion criteria. This was decided by three independent review authors. We reported the decisions regarding inclusion and exclusion in accordance with the PRISMA statement.Electronic database searching yielded 1635 potential titles, and our grey literature search yielded an additional 31 potential titles. Duplicate titles were filtered leaving 1395 titles which underwent review of their titles and abstracts by three review authors. Sixty seven titles were judged to be relevant to our review, however only eight met our inclusion criteria and seven were included in our analysis. We included eight studies in the review and seven in the meta-analysis. Of those seven studies, only two were judged to be at low risk of bias. Overall, no strong evidence exists that etomidate increases mortality in critically ill patients when compared to other bolus dose induction agents (odds ratio (OR) 1.17; 95% confidence interval (CI) 0.86 to 1.60, 6 studies, 772 participants, moderate quality evidence). Due to a large number of participants lost to follow-up, we performed a post hoc sensitivity analysis. This gave a similar result (OR 1.15; 95% CI 0.86 to 1.53). There was evidence that the use of etomidate in critically ill patients was associated with a positive adrenocorticotropic hormone (ACTH) stimulation test, and this difference was more pronounced at between 4 to 6

  15. How propeller suction is the dominant factor for ship accidents at shallow water conditions

    Science.gov (United States)

    Acar, Dursun; Alpar, Bedri; Ozeren, Sinan

    2017-04-01

    The laminar flow comes to the fore with the disappearance of the several other directions in the internal displacements in the water current. Due to the dominant speed direction during the straightforward motion of the ship, the underwater hull is associated with the continuous flow of laminar currents. The open marine environment acts as a compressible liquid medium because of the presence of many variables about water volume overflow boundaries where the ship is associated. Layers of water rising over the sea surface due to ship's body and the propeller's water push provides loss of liquid lifting force for the ship. These situations change the well-known sea-floor morphology and reliable depth limits, and lead to probable accidents. If the ship block coefficient for the front side is 0.7 or higher, the "squat" will be more on the bow, because the associated factor "displacement volume" causes to the low-pressure environment due to large and rapid turbulence. Thus, the bow sinks further, which faced with liquid's weaker lift force. The vessels Gerardus Mercator, Queen Elizabeth and Costa Concordia had accidents because of unified reasons of squat, fast water mass displacement by hull push and propeller suction interaction. In the case of water mass displacement from the bow side away, that accident occurred in 2005 by the vessel Gerardus Mercator with excessive longitudinal trim angularity in the shallow water. The vessel Costa Concordia (2012), voluminous water displaced from the rear left side was an important factor because of the sharp manoeuvre of that the captain made before the accident. Observations before the accident indicate that full-speed sharp turn provided listed position for the ship from left (port side) in the direction of travel before colliding and then strike a rock on the sloping side of the seabed. The reason why the ship drifted to the left depends mainly the water discharge occurred at the left side of the hull during left-hand rudder

  16. Continuous versus intermittent endotracheal cuff pressure control for the prevention of ventilator-associated respiratory infections in Vietnam: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dat, Vu Quoc; Geskus, Ronald B; Wolbers, Marcel; Loan, Huynh Thi; Yen, Lam Minh; Binh, Nguyen Thien; Chien, Le Thanh; Mai, Nguyen Thi Hoang; Phu, Nguyen Hoan; Lan, Nguyen Phu Huong; Hao, Nguyen Van; Long, Hoang Bao; Thuy, Tran Phuong; Kinh, Nguyen Van; Trung, Nguyen Vu; Phu, Vu Dinh; Cap, Nguyen Trung; Trinh, Dao Tuyet; Campbell, James; Kestelyn, Evelyne; Wertheim, Heiman F L; Wyncoll, Duncan; Thwaites, Guy Edward; van Doorn, H Rogier; Thwaites, C Louise; Nadjm, Behzad

    2018-04-04

    Ventilator-associated respiratory infection (VARI) comprises ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). Although their diagnostic criteria vary, together these are the most common hospital-acquired infections in intensive care units (ICUs) worldwide, responsible for a large proportion of antibiotic use within ICUs. Evidence-based strategies for the prevention of VARI in resource-limited settings are lacking. Preventing the leakage of oropharyngeal secretions into the lung using continuous endotracheal cuff pressure control is a promising strategy. The aim of this study is to investigate the efficacy of automated, continuous endotracheal cuff pressure control in preventing the development of VARI and reducing antibiotic use in ICUs in Vietnam. This is an open-label randomised controlled multicentre trial. We will enrol 600 adult patients intubated for ≤ 24 h at the time of enrolment. Eligible patients will be stratified according to admission diagnosis (180 tetanus, 420 non-tetanus) and site and will be randomised in a 1:1 ratio to receive either (1) automated, continuous control of endotracheal cuff pressure or (2) intermittent measurement and control of endotracheal cuff pressure using a manual cuff pressure meter. The primary outcome is the occurrence of VARI, defined as either VAP or VAT during the ICU admission up to a maximum of 90 days after randomisation. Patients in both groups who are at risk for VARI will receive a standardised battery of investigations if their treating physician feels a new infection has occurred, the results of which will be used by an endpoint review committee, blinded to the allocated arm and independent of patient care, to determine the primary outcome. All enrolled patients will be followed for mortality and endotracheal tube cuff-related complications at 28 days and 90 days after randomisation. Other secondary outcomes include antibiotic use; days ventilated, in ICU and in hospital

  17. The radontechnical process of the sub-slab suction system in detached, semi-detached and terraced houses; Imupistejaerjestelmaen radontekninen toiminta eri tyyppisissae pien- ja rivitaloissa

    Energy Technology Data Exchange (ETDEWEB)

    Kettunen, A.V.; Rissanen, R.; Viljanen, M. [Helsinki Univ. of Technology, Otaniemi (Finland). Lab. of Structural Engineering and Building Physics; Arvela, H. [Finnish Centre for Radiation and Nuclear Safety, Helsinki (Finland)

    1997-12-31

    The sub-slab suction system is a repair method for decreasing radon transfer from soil to indoor air in houses. The sub-slab suction system changes the flow field with the aim to reduce the radon content under the ground slab or/and changes the flow direction from indoor air to foundation soil. The study is divided into the theoretical and experimental part. The theoretical part concentrates on solving the factors affecting the sub-slab suction system taking into consideration features of old houses. The experimental part uses the results of the theoretical part when the level and the type of the suction point had been chosen. The effect of the sub-slab suction system was tested with pressure difference experiments and the radon content measurements in 26 different, typical Finnish detached, semi-detached and terrace houses.

  18. Rapid solidification of Ni50Nb28Zr22 glass former alloy through suction-casting

    International Nuclear Information System (INIS)

    Miyamoto, M.I.; Santos, F.S.; Bolfarini, C.; Botta Filho, W.J.; Kiminami, C.S.

    2010-01-01

    To select new alloys with high glass forming ability (GFA) to present amorphous structure in millimeter scale, several semi-empirical models have been developed. In the present work, a new alloy, Ni 50 Nb 28 Zr 22 d, was designed based on the combination of topological instability lambda (A) criterion and electronegativity difference (Δe). The alloy was rapidly solidified in a bulk wedge sample by cooper mold suction casting in order to investigate its amorphization. The sample was characterized by the combination of scanning electron microscopy (MEV), X-ray diffraction (XRD) and differential scanning calorimeter (DSC). For the minimum thickness of 200 μm analyzed, it was found that the alloy did not show a totally amorphous structure. Factor such as low cooling rate, existence of oxides on the surface of the elements and presence of oxygen in the atmosphere of equipment did not allowed the achievement of higher amorphous thickness. (author)

  19. Laboratory Setup for Vertically Loaded Suction Caisson Foundation in Sand and Validation of Responses

    DEFF Research Database (Denmark)

    Manzotti, E.; Vaitkunaite, Evelina; Ibsen, Lars Bo

    during the last years and, following this trend, design choice will turn into foundation composed of three or four suction bucket foundations, called respectively tripod and tetrapod. Overturning moment in tripod and tetrapod is carried by vertical loading; therefore vertical pull-out capacity is tested......, in both static and cyclic case of loading. Testing rig and equipment are presented together with procedures. Tests results are presented in order to verify the output of tests. CPT-based methods and beta-methods to evaluate installation and pull-out resistance are then presented and implemented in Matlab...... in order to validate responses. It is demonstrated that kf parameter of CPT-based methods is dependent on the overburden pressure applied. Parameters of beta methods are analyzed and defined. Satisfying results are obtained with methods that are considering a linear increase or decrease with the depth...

  20. Beneficial effects of intermittent suction and pressure treatment in intermittent claudication

    DEFF Research Database (Denmark)

    Mehlsen, J; Himmelstrup, H; Himmelstrup, Bodil

    1993-01-01

    administration. The treatment caused significant increments in the ADP thresholds for platelet aggregation, while the effects on fibrinolysis were uncertain. It is concluded that intermittent suction and pressure treatment offers a new approach for conservative treatment of intermittent claudication....... participated in an open trial investigating the possible effects of the treatment on platelet aggregation and fibrinolysis. Pain-free and maximal walking distances were measured on a treadmill, and systolic blood pressure was measured on the upper limb, the ankle, and the first toe bilaterally. The threshold...... for adenosine diphosphate (ADP)-induced platelet aggregation was tested, and the fibrinolytic activity was estimated from the euglobulin clot lysis time. Active treatment resulted in significant improvements in pain-free and maximal walking distances, whereas no changes could be found during placebo...

  1. FIST/6IB1, BWR/6 System Responses to Intermediate Break in Recirculation Suction Line LINE

    International Nuclear Information System (INIS)

    1993-01-01

    1 - Description of test facility: BWR/6-218 standard plant. A full size bundle with electrically heated rods is used to simulate the reactor core. A scaling ratio of 1/624 is applied in the design of the system components. Key features of the FIST facility include: (1) Full height test vessel and internals; (2) correctly scaled fluid volume distribution; (3) simulation of ECCS, S/RV, and ADS; (4) level trip capability; (5) heated feedwater supply system, which provides the capability for steady state operation. 2 - Description of test: Test 6IB1 investigates system responses to an intermediate break in the recirculation suction line. BWR system licensing evaluations for various size recirculation break LOCA's indicates that a break size of about 0.2 sq.ft., without LPCS operation, is the highest PCT case for the intermediate break LOCA. Test 6IB1 simulates this event

  2. Development in corrosion resistance by microstructural refinement in Zr-16 SS 304 alloy using suction casting technique

    Energy Technology Data Exchange (ETDEWEB)

    Das, N., E-mail: nirupamd@barc.gov.in; Sengupta, P.; Abraham, G.; Arya, A.; Kain, V.; Dey, G.K.

    2016-08-15

    Highlights: • Grain refinement was made in Zr–16 wt.% SS alloy while prepared by suction casting process. • Distribution of Laves phase, e.g., Zr{sub 2}(Fe, Cr) was raised in suction cast (SC) Zr–16 wt.% SS. • Corrosion resistance was improved in SC alloy compared to that of arc-melt-cast alloy. • Grain refinement in SC alloy assisted for an increase in its corrosion resistance. - Abstract: Zirconium (Zr)-stainless steel (SS) hybrid alloys are being considered as baseline alloys for developing metallic-waste-form (MWF) with the motivation of disposing of Zr and SS base nuclear metallic wastes. Zr–16 wt.% SS, a MWF alloy optimized from previous studies, exhibit significant grain refinement and changes in phase assemblages (soft phase: Zr{sub 2}(Fe, Cr)/α-Zr vs. hard phase: Zr{sub 3}(Fe, Ni)) when prepared by suction casting (SC) technique in comparison to arc-cast-melt (AMC) route. Variation in Cr-distribution among different phases are found to be low in suction cast alloy, which along with grain refinement restricted Cr-depletion at the Zr{sub 2}(Fe, Cr)/Zr interfaces, prone to localized attack. Hence, SC alloy, compared to AMC alloy, showed lower current density, higher potential at the breakdown of passivity and higher corrosion potential during polarization experiments (carried out under possible geological repository environments, viz., pH 8, 5 and 1) indicating its superior corrosion resistance.

  3. Conceptual Design of Portable Filtered Air Suction Systems For Prevention of Released Radioactive Gas under Severe Accidents of NPP

    Energy Technology Data Exchange (ETDEWEB)

    Gu, Beom W.; Choi, Su Y.; Yim, Man S.; Rim, Chun T. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2014-05-15

    It becomes evident that severe accidents may occur by unexpected disasters such as tsunami, heavy flood, or terror. Once radioactive material is released from NPP through severe accidents, there are no ways to prevent the released radioactive gas spreading in the air. As a remedy for this problem, the idea on the portable filtered air suction system (PoFASS) for the prevention of released radioactive gas under severe accidents was proposed. In this paper, the conceptual design of a PoFASS focusing on the number of robot fingers and robot arm rods are proposed. In order to design a flexible robot suction nozzle, mathematical models for the gaps which represent the lifted heights of extensible covers for given convex shapes of pipes and for the covered areas are developed. In addition, the system requirements for the design of the robot arms of PoFASS are proposed, which determine the accessible range of leakage points of released radioactive gas. In this paper, the conceptual designs of the flexible robot suction nozzle and robot arm have been conducted. As a result, the minimum number of robot fingers and robot arm rods are defined to be four and three, respectively. For further works, extensible cover designs on the flexible robot suction nozzle and the application of the PoFASS to the inside of NPP should be studied because the radioactive gas may be released from connection pipes between the containment building and auxiliary buildings.

  4. Portable Filtered Air Suction System for Released Radioactive Gases Prevention under a Severe Accident of NPPs

    International Nuclear Information System (INIS)

    Gu, Beom W.; Choi, Su Y.; Rim, Chun T.

    2013-01-01

    In this paper, the portable filtered air suction system (PoFASS) for released radioactive gases prevention under a severe accident of NPP is proposed. This technology can prevent the release of the radioactive gases to the atmosphere and it can be more economical than FVCS because PoFASS can cover many NPPs with its high mobility. The conceptual design of PoFASS, which has the highest cost effectiveness and robustness to the environment condition such as wind velocity and precipitation, is suggested and the related previous research is introduced in this paper. The portable filtered air suction system (PoFASS) for released radioactive gases prevention can play a key role to mitigate the severe accident of NPP with its high cost effectiveness and robustness to the environment conditions. As further works, the detail design of PoFASS to fabricate a prototype for a demonstration will be proceeded. When released radioactive gases from the broken containment building in the severe accident of nuclear power plants (NPPs) such as the Chernobyl and Fukushima accidents occur, there are no ways to prevent the released radioactive gases spreading in the air. In order to solve this problem, several European NPPs have adopted the filtered vented containment system (FVCS), which can avoid the containment failure through a pressure relief capability to protect the containment building against overpressure. However, the installation cost of FVCS for a NPP is more than $10 million and this system has not been widely welcomed by NPP operating companies due to its high cost

  5. A Comparison of delO18 Composition of Water Extracted from Suction Lysimeters, Centrifugation, and Azeotropic Distillation

    Science.gov (United States)

    Figueroa, A.; Tindall, J. A.; Friedel, M. J.

    2005-12-01

    Concentration of delO18 in water samples extracted by suction lysimeters is compared to samples obtained by methods of centrifugation and azeotropic distillation. Intact soil cores (30 cm diameter by 40 cm height) were extracted from two different sites. Site 1 was rapid infiltration basin number 50, near Altamonte Springs in Seminole County, Florida on properties belonging to the Walt Disney World Resort Complex. Site 2 was the Missouri Management System Evaluation Area (MSEA) near Centralia in Boone County, Missouri. The delO18 water was analyzed on a mass spectrophotometer. Potassium Bromide (KBr) was also used as a tracer and analyzed by ion chromatography. A portion of the data obtained was modeled using CXTFIT. Water collected by centrifugation and azeotropic distillation data were about 2-5% more negative than that collected by suction lysimeter values from the Florida (sandy) soil and about 5-7 % more negative from the Missouri (well structured clay) soil. Results indicate that the majority of soil water in well structured soil is strongly bound to soil grain surfaces and is not easily sampled by suction lysimeters. Also, it is plausible that evaporation caused some delO18 enrichment in the suction lysimeters. Suction lysimeters preferentially sampled water held at lower matric potentials, which may not represent total soil water. In cases where a sufficient volume of water has passed through the soil profile and displaced all previous pore water, suction lysimeters will however collect a representative sample of all the water at that depth interval. It is suggested that for stable isotope studies monitoring precipitation and soil water, suction lysimeters be installed at shallow depths (10 cm). Samples should also be coordinated with precipitation events. The CXTFIT program worked well for Florida soils (a more homogeneous sand), but gave poor performance for Missouri soils (well structured clays) except for deeper depths where clay structure was less

  6. Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast-track CABG

    Directory of Open Access Journals (Sweden)

    Menda Ferdi

    2010-01-01

    Full Text Available During induction of general anesthesia hypertension and tachycardia caused by tracheal intubation may lead to cardiac ischemia and arrhythmias. In this prospective, randomized study, dexmedetomidine has been used to attenuate the hemodynamic response to endotracheal intubation with low dose fentanyl and etomidate in patients undergoing myocardial revascularization receiving beta blocker treatment. Thirty patients undergoing myocardial revascularization received in a double blind manner, either a saline placebo or a dexmedetomidine infusion (1 µg/kg before the anesthesia induction. Heart rate (HR and blood pressure (BP were monitored at baseline, after placebo or dexmedetomidine infusion, after induction of general anesthesia, one, three and five minutes after endotracheal intubation. In the dexmedetomidine (DEX group systolic (SAP, diastolic (DAP and mean arterial pressures (MAP were lower at all times in comparison to baseline values; in the placebo (PLA group SAP, DAP and MAP decreased after the induction of general anesthesia and five minutes after the intubation compared to baseline values. This decrease was not significantly different between the groups. After the induction of general anesthesia, the drop in HR was higher in DEX group compared to PLA group. One minute after endotracheal intubation, HR significantly increased in PLA group while, it decreased in the DEX group. The incidence of tachycardia, hypotension and bradycardia was not different between the groups. The incidence of hypertension requiring treatment was significantly greater in the PLA group. It is concluded that dexmedetomidine can safely be used to attenuate the hemodynamic response to endotracheal intubation in patients undergoing myocardial revascularization receiving beta blockers.

  7. Comparison of bolus and continuous infusion of esmolol on hemodynamic response to laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft

    Directory of Open Access Journals (Sweden)

    Esra Mercanooglu Efe

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVE: The aim of this randomized, prospective and double blinded study is to investigate effects of different esmolol use on hemodynamic response of laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft surgery. METHODS: After approval of local ethics committee and patients' written informed consent, 45 patients were randomized into three groups equally. In Infusion Group; from 10 min before intubation up to 5th minute after sternotomy, 0.5 mg/kg/min esmolol infusion, in Bolus Group; 2 min before intubation and sternotomy 1.5 mg/kg esmolol IV bolus and in Control Group; %0.9 NaCl was administered. All demographic parameters were recorded. Heart rate and blood pressure were recorded before infusion up to anesthesia induction in every minute, during endotracheal intubation, every minute for 10 minutes after endotracheal intubation and before, during and after sternotomy at first and fifth minutes. RESULTS: While area under curve (AUC (SAP × time was being found more in Group B and C than Group I, AUC (SAP × T int and T st and AUC (SAP × T2 was found more in Group B and C than Group I (p < 0.05. Moreover AUC (HR × T st was found less in Group B than Group C but no significant difference was found between Group B and Group I. CONCLUSION: This study highlights that esmolol infusion is more effective than esmolol bolus administration on controlling systolic arterial pressure during endotracheal intubation and sternotomy in CABG surgery.

  8. A CLINICAL ASSESSMENT OF MACINTOSH BLADE, MILLER BLADE AND KING VISIONTM VIDEOLARYNGOSCOPE FOR LARYNGEAL EXPOSURE AND DIFFICULTY IN ENDOTRACHEAL INTUBATION

    Directory of Open Access Journals (Sweden)

    Apoorva Mahendera

    2016-03-01

    Full Text Available CONTEXT Previous studies suggest glottic view is better achieved with straight blades while tracheal intubation is easier with curved blades and videolaryngoscope is better than conventional laryngoscope. AIMS Comparison of conventional laryngoscope (Macintosh blade and Miller blade with channelled videolaryngoscope (King Vision TM with respect to laryngeal visualisation and difficulty in endotracheal intubation. SETTINGS AND DESIGN This prospective randomised comparative study was conducted at a tertiary care hospital (in ASA I and ASA II patients after approval from the Institutional Ethics Committee. METHODS We compared Macintosh, Miller, and the King VisionTM videolaryngoscope for glottic visualisation and ease of tracheal intubation. Patients undergoing elective surgeries under general anaesthesia requiring endotracheal intubation were randomly divided into three groups (N=180. After induction of anaesthesia, laryngoscopy was performed and trachea intubated. We recorded visualisation of glottis (Cormack-Lehane grade-CL, ease of intubation, number of attempts, need to change blade, and need for external laryngeal manipulation. STATISTICAL ANALYSIS Demographic data, Mandibular length, Mallampati classification were compared using ANOVA, Chi-square test, Kruskal-Wallis Test, where P value <0.005 is statically significant. RESULTS CL grade 1 was most often observed in King Vision -TM VL group (90% which is followed by Miller (28.33%, and Macintosh group (15%. We found intubation was to be easier (grade 1 with King Vision -TM VL group (73.33%, followed by Macintosh (38.33%, and Miller group (1.67%. External manipulation (BURP was needed more frequently in patients in Miller group (71.67%, followed by Macintosh (28.33% and in King Vision -TM VL group (6.67%. All (100% patients were intubated in the 1 st attempt with King Vision -TM VL group, followed by Macintosh group (90% and Miller group (58.33%. CONCLUSIONS In patients with normal airway

  9. Early antibiotic treatment for BAL-confirmed ventilator-associated pneumonia: a role for routine endotracheal aspirate cultures.

    Science.gov (United States)

    Michel, Fabrice; Franceschini, Bruno; Berger, Pierre; Arnal, Jean-Michel; Gainnier, Marc; Sainty, Jean-Marie; Papazian, Laurent

    2005-02-01

    To test whether routine quantitative cultures of endotracheal aspirates obtained before the onset of ventilator-associated pneumonia (VAP) could help to predict the causative microorganisms and to select early appropriate antimicrobial therapy before obtaining BAL culture results. Prospective observational study. French medical ICU. A total of 299 patients received mechanical ventilation for at least 48 h. Endotracheal aspiration (EA) was performed twice weekly in all mechanically ventilated patients. A diagnosis of VAP was made by BAL culture. Only the EA performed just before the suspicion of VAP (EA-pre) were evaluated. This strategy (ie, the EA-pre-based strategy) was compared with an antibiotic therapy that would have been prescribed if the recommendations of both the American Thoracic Society (ATS) and Trouillet et al (Am J Respir Crit Care Med 1998; 157:531-539) had been applied. VAP was diagnosed (by BAL culture) in 41 of the 75 patients in whom BAL was performed. Among the 41 BAL specimens that were positive for VAP, EA-pre had identified the same microorganisms (with the same antibiotic resistance patterns) in 34 cases (83%). In one case, EA-pre was not available at the time BAL was performed (a case of early-onset VAP), but the empiric antibiotic therapy was adequate. While EA-pre did not give the same results as the BAL culture, the antibiotic therapy based on the results of the EA-pre was adequate in four other cases. Finally, antibiotic therapy was delayed in only two cases. Antibiotic treatment was therefore adequate in 38 of the 40 assessable cases (95%). If the Trouillet-based strategy had been used, the antibiotic treatment would have been adequate in 34 of the 41 cases (83%; p = 0.15 [vs EA-pre strategy]). Based on the ATS classification, the antibiotic treatment would have been adequately prescribed in only 28 of the 41 cases (68%; p = 0.005 [vs EA-pre strategy]). Routine EA performed twice a week makes it possible to prescribe adequate

  10. Comparison of rocuronium at two different doses and succinylcholine for endotracheal intubation in adult patients for elective surgeries.

    Science.gov (United States)

    Chavan, S G; Gangadharan, S; Gopakumar, A K

    2016-01-01

    The effects of rocuronium at two different doses, that is, 0.6 mg/kg (2 × ED95) and 0.9 mg/kg (3 × ED95), were compared with succinylcholine (2 mg/kg) when used for endotracheal intubation in adult patients for elective surgeries under general anesthesia. Ninety patients were divided into three groups of 30 each. Groups A, B received injection rocuronium at 0.6 mg/kg, 0.9 mg/kg respectively and Group C received succinylcholine at 2 mg/kg. Onset of action of relaxant, intubation conditions, time taken to intubate and duration of action were compared. To compare the statistical difference in the age, weight, height of the study subjects, onset of action of relaxant, intubation conditions, time taken to intubate, and duration of action analysis of variance and unpaired t -test were used. The onset time was considerably shorter with rocuronium 0.9 mg/kg than 0.6 mg/kg. The onset time of rocuronium 0.9 mg/kg was found to be significantly longer than succinylcholine 2 mg/kg. Time taken to intubate was shortest with succinylcholine 2 mg/kg. The time taken to intubate with the rocuronium 0.9 mg/kg was found to be comparable to that of rocuronium 0.6 mg/kg. Intubation score of rocuronium 0.9 mg/kg was the best (17.75), which was comparable with succinylcholine. However, the intubation score obtained with rocuronium 0.6 mg/kg was inferior. Duration of action was shortest with succinylcholine. The duration of action is prolonged when the dose of rocuronium is increased from 0.6 to 0.9 mg/kg. Rapid sequence induction of anesthesia with propofol and fentanyl, succinylcholine allowed a more rapid endotracheal intubation sequence and created superior intubation conditions than rocuronium. However, the technique of using a large dose of rocuronium to achieve perfect conditions for tracheal intubation may have application whenever succinylcholine is relatively contraindicated.

  11. Suction/inspiration against resistance or standardized Mueller maneuver: a new breathing technique to improve contrast density within the pulmonary artery: a pilot CT study

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Froehlich, Johannes M.; Weymarn, Constantin von; Goyen, Matthias [Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Waelti, Stephan [Cantonal Hospital St. Gallen, Department of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Roos, Justus E. [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Meissnitzer, Matthias; Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Czell, David [Cantonal Hospital Winterthur, Department of Neurology, Winterthur (Switzerland); Reischauer, Carolin [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland)

    2015-11-15

    Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. (orig.)

  12. Effect of Zr Purity and Oxygen Content on the Structure and Mechanical Properties of Melt-Spun and Suction-Cast Cu46Zr42Al7Y5 Alloy

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    Kozieł T.

    2016-06-01

    Full Text Available The effect of oxygen content in zirconium on the structure and mechanical properties of the Cu46Zr42Al7Y5 alloy, in the form of melt-spun ribbons and suction-cast rods, was investigated. Two types of Zr, rod and crystal bar of different nominal purities and oxygen contents, were used to synthesize the alloy by arc melting. Rapidly solidified ribbons were produced by melt spinning and their amorphous structures were confirmed by X-ray diffractometry (XRD and differential scanning calorimetry (DSC. Bulk samples in the form of rods were cast using a special water-cooled suction casting unit attached to the arc melting system. XRD and DSC studies proved the amorphous structure of the bulk alloy synthesized from low-oxygen Zr and partial crystallization of the same alloy for high-oxygen Zr. In both bulk samples, uniformly distributed crystalline particles were identified as yttrium oxides. Higher mean compressive strength of amorphous alloy was observed. The hardness of amorphous phase was close to 500 HV1 in both bulk alloys, while the hardness of crystalline dendritic areas, observed in the alloy synthesized from high oxygen Zr, was lower by about 50 HV1.

  13. An application of the learning curve-cumulative summation test to evaluate training for endotracheal intubation in emergency medicine.

    Science.gov (United States)

    Je, Sangmo; Cho, Youngsuk; Choi, Hyuk Joong; Kang, Boseung; Lim, Taeho; Kang, Hyunggoo

    2015-04-01

    The learning curve-cumulative summation (LC-CUSUM) test allows for quantitative and individual assessments of the learning process. In this study, we evaluated the process of skill acquisition for performing endotracheal intubation (ETI) in three emergency medicine (EM) residents over a 2 year period in their first 2 years of their EM residency. We evaluated 342 ETI cases performed by three EM residents using the LC-CUSUM test according to their rate of success or failure of ETI. A 90% success rate (SR) was chosen to define adequate performance and an SR of 80% was considered inadequate. After the learning phase, the standard CUSUM test was applied to ensure that performance was maintained. The mean number of ETI cases required to reach the predefined level of performance was 74.7 (95% CI 62.0 to 87.3). CUSUM tests confirmed that performance was maintained after the learning phase. By using the LC-CUSUM test, we were able to quantitatively monitor the acquisition of the skill of ETI by EM residents. The LC-CUSUM could be useful for monitoring the learning process for the training of airway management in the practice of EM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. A comparative study of efficacy of esmolol and fentanyl for pressure attenuation during laryngoscopy and endotracheal intubation

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    Shobhana Gupta

    2011-01-01

    Full Text Available Objective: To compare the effectiveness of single bolus dose of esmolol or fentanyl in attenuating the hemodynamic responses during laryngoscopy and endotracheal intubation. Methods: Ninety adult ASA I and ASA II patients were included in the study who underwent elective surgical procedures. Patients were divided into three groups. Group C (control receiving 10 ml normal saline, group E (esmolol receiving bolus dose of esmolol 2 mg/kg and group F (fentanyl receiving bolus dose of fentanyl 2 μg/kg intravenously slowly. Study drug was injected 3 min before induction of anesthesia. Heart rate, systemic arterial pressure and ECG were recorded as baseline and after administration of study drug at intubation and 15 min thereafter. Results: Reading of heart rate, blood pressure and rate pressure product were compared with baseline and among each group. The rise in heart rate was minimal in esmolol group and was highly significant. Also the rate pressure product at the time of intubation was minimal and was statistically significant rate 15 min thereafter in group E. Conclusion: Esmolol 2 mg/kg as a bolus done proved to be effective in attenuating rises in heart rate following laryngoscopy and intubation while the rise in blood pressure was suppressed but not abolished by bolus dose of esmolol.

  15. [The role of endotracheal aspirate culture in the diagnosis of ventilator-associated pneumonia: a meta analysis].

    Science.gov (United States)

    Wang, Fei; He, Bei

    2013-01-01

    To investigate the role of endotracheal aspirate (EA) culture in the diagnosis and antibiotic management in ventilator-associated pneumonia (VAP). We searched CNKI, Wanfang, PUBMED and EMBASE databases published from January 1990 to December 2011, to find relevant literatures on VAP microbiological diagnostic techniques including EA and bronchoalveolar lavage (BALF). The following key words were used: ventilator associated pneumonia, diagnosis and adult. Meta-analysis was performed and the sensitivity and specificity of EA on VAP diagnosis were calculated. Our literature search identified 1665 potential articles, 8 of which fulfilled our selection criteria including 561 patients with paired cultures. Using BALF quantitative culture as reference standard, the sensitivity and specificity of EA were 72% and 71%. When considering quantitative culture of EA only, the sensitivity and specificity improved to 90% and 65%, while the positive and the negative predictive values were 68% and 89% respectively. However, the sensitivity and specificity of semi-quantitative culture of EA were only 50% and 80%, with a positive predictive value of 77% and a negative predictive value of 58% respectively. EA culture had relatively poor sensitivity and specificity, although quantitative culture of EA only could improve the sensitivity. Initiating therapy on the basis of EA quantitative culture may still result in excessive antibiotic usage. Our data suggested that EA could provide some information for clinical decision but could not replace the role of BALF quantitative culture in VAP diagnosis.

  16. Endotracheal tube and laryngeal mask airway cuff volume changes with altitude: a rule of thumb for aeromedical transport.

    Science.gov (United States)

    Mann, Catherine; Parkinson, Neil; Bleetman, Anthony

    2007-03-01

    Helicopters and light (unpressurised) aircraft are used increasingly for the transport of ventilated patients. Most of these patients are ventilated through endotracheal tubes (ETTs), others through laryngeal mask airways (LMAs). The cuffs of both ETTs and LMAs inflate with increases in altitude as barometric pressure decreases (30 mbar/1000 feet). Tracheal mucosa perfusion becomes compromised at a pressure of approximately 30 cm H2O; critical perfusion pressure is 50 cm H2O. The change in dimensions of the inflated cuffs of a size 8 ETT and a size 5 LMA were measured with digital callipers at 1000 feet intervals in the unpressurised cabin of an Agusta 109 helicopter used by the Warwickshire and Northamptonshire Air Ambulance. A linear expansion in cuff dimensions as a function of altitude increase was identified. For ETTs, a formula for removal of air from the cuff with increasing altitude was calculated and is recommended for use in aeromedical transfers. This is 1/17x1.1 = 0.06 ml/1000 foot ascent/ml initial cuff inflation. The data for LMA cuff expansion failed to show significant correlation with altitude change. Further work is required to determine a similar rule of thumb for LMA cuff deflation.

  17. Ease of intubation: A randomized, double-blind study to compare two doses of rocuronium bromide for endotracheal intubation.

    Science.gov (United States)

    Shukla, Aparna; Misra, Shilpi

    2016-01-01

    Clinical need for a nondepolarizing agent with a rapid onset time and a brief duration of action has led to the development of rocuronium bromide. The aim of this study was to evaluate optimal dose of rocuronium bromide for intubation and to compare the onset time, duration of action, intubating conditions, and hemodynamic effects of two doses of rocuronium bromide. A prospective, randomized, double-blind study. All the patients were divided in a randomized, double-blind fashion into two groups of twenty patients each. Group I patients received rocuronium bromide 0.6 mg/kg intravenously and intubated at 60 s, Group II patients received rocuronium bromide 0.9 mg/kg and intubated at 60 s. The neuromuscular block was assessed using single twitch stimulation of 0.1 Hz at adductor pollicis muscle of hand at every 10 s. The results were compiled and analyzed statistically using Chi-square test for qualitative data and Student's t -test for quantitative data. Time of onset was significantly shorter ( P Rocuronium bromide 0.9 mg/kg is a safer alternative to rocuronium bromide 0.6 mg/kg for endotracheal intubation with shorter time of onset and better intubating conditions.

  18. EFFECT OF INTRACUFF MEDIA-ALKALINISED LIGNOCAINE, SALINE, AND AIR ON ENDOTRACHEAL TUBE INDUCED EMERGENCE PHENOMENA: A RANDOMIZED CONTROLLED STUDY

    Directory of Open Access Journals (Sweden)

    Indu S

    2016-07-01

    Full Text Available CONTEXT Emergence from general anaesthesia is associated with post extubation cough, hoarseness, sore throat, and dysphagia, which may affect the smoothness of extubation. Prophylactic interventions have been studied to reduce these tracheal morbidities with varying results. AIMS To compare the efficacy of air, alkalinised lignocaine and saline in maintaining intracuff pressure and reducing postoperative cough (PEC and sore throat (POST. SETTINGS AND DESIGN A randomised controlled study conducted in a teaching hospital. METHODS AND MATERIALS 105 patients scheduled for elective surgeries were randomly allocated into groups of 35 each. The endotracheal tube (ETT cuffs were inflated with air, alkalinised lignocaine, or saline. The intracuff pressure (ICP was initially set to 25-30 cm of H2O; measured every 30 minutes and before extubation; the minimum volume for occlusion (MOV noted. The incidence PEC and POST were monitored. STATISTICAL ANALYSIS Data analysed using Chi-square test, Fisher’s exact test; Bonferroni method allowed multiple comparisons. A p value <0.05 was considered significant. RESULTS Pre-lubricated ETT cuff inflation with liquid media maintained an acceptable ICP. Saline and alkalinised lignocaine were effective in reducing PEC and POST. Alkalinised lignocaine provided smoother extubation and fared better in the early postoperative period. CONCLUSIONS Pre-lubricated ETT cuffs with liquid media reduced PEC and POST. Alkalinised lignocaine showed better profile than saline. Optimum ICP reduces tracheal morbidity.

  19. Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate.

    Science.gov (United States)

    Scheenstra, Renske J; Muller, Sara H; Vincent, Andrew; Hilgers, Frans J M

    2011-01-01

    The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. We plotted the subglottic temperature and humidity measurements in 10 patients with head and neck cancer with a temporary precautionary tracheotomy during successive 10-minute periods of nose, mouth, and tracheotomy breathing in a randomized sequence. End-inspiratory temperatures of nose, mouth, and tracheotomy breathing were 31.1, 31.3, and 28.3°C, respectively. End-inspiratory humidity measurements of nose, mouth, and tracheotomy breathing were 29.3, 28.6, and 21.1 mgH₂O/L, respectively. There was a trend toward lower end-inspiratory humidity in patients with radiotherapy or with large surgery-induced oropharyngeal mucosal defects, whereas temperatures were similar. This study gives objective information about the HME capacity of the upper respiratory tract in patients with head and neck cancer with precautionary tracheotomy, and thus provides target values for HMEs for laryngectomized and tracheotomized patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.

  20. The effect of laryngoscope handle size on possible endotracheal intubation success in university football, ice hockey, and soccer players.

    Science.gov (United States)

    Delaney, J Scott; Al-Kashmiri, Ammar; Baylis, Penny-Jane; Aljufaili, Mahmood; Correa, José A

    2012-07-01

    To assess the effectiveness of a standard long-handle laryngoscope and a short-handle laryngoscope on ease of possible intubation in football, ice hockey, and soccer players. Prospective crossover study. University Sport Medicine Clinic. Sixty-two university varsity football (62 males), 45 ice hockey (26 males and 19 females), and 39 soccer players (20 males, 19 females). Athletes were assessed for different airway and physical characteristics. Three different physicians then assessed the use of laryngoscopes of different handle sizes in supine athletes who were wearing protective equipment while in-line cervical spine immobilization was maintained. The ease of passage of a laryngoscope blade into the posterior oropharynx of a supine athlete was assessed using both a standard long-handle and a short-handle laryngoscope. Use of a short-handle laryngoscope was easier for all physicians in all sports as compared with a standard-sized laryngoscope. Passage of a laryngoscope blade into the posterior oropharynx of a supine athlete was easiest in soccer players and most difficult in football and ice hockey players for both sizes of laryngoscope. Interference from chest or shoulder pads was a common cause for difficulty in passing the laryngoscope blade into the posterior oropharynx for football and ice hockey players. In the rare instances that an endotracheal intubation is to be attempted on an unconscious athlete, a short-handle laryngoscope may provide the best chance for successful intubation.

  1. Magnetohydrodynamics effect on three-dimensional viscous incompressible flow between two horizontal parallel porous plates and heat transfer with periodic injection/suction

    Directory of Open Access Journals (Sweden)

    R. C. Chaudhary

    2004-11-01

    Full Text Available We investigate the hydromagnetic effect on viscous incompressible flow between two horizontal parallel porous flat plates with transverse sinusoidal injection of the fluid at the stationary plate and its corresponding removal by periodic suction through the plate in uniform motion. The flow becomes three dimensional due to this injection/suction velocity. Approximate solutions are obtained for the flow field, the pressure, the skin-friction, the temperature field, and the rate of heat transfer. The dependence of solution on M (Hartmann number and λ (injection/suction is investigated by the graphs and tables.

  2. Treatment of cellulite with a bipolar radiofrequency, infrared heat, and pulsatile suction device: a pilot study.

    Science.gov (United States)

    Wanitphakdeedecha, Rungsima; Manuskiatti, Woraphong

    2006-12-01

    Very few therapeutic options have proven effective in the treatment of cellulite. To evaluate the effectiveness and adverse effects of a bipolar radiofrequency (RF), infrared (IR) heat and pulsatile suction device for the treatment of cellulite. Twelve subjects were treated with the RF-light-based device. All subjects were treated twice weekly for a total number of eight to nine treatments. Subjects were evaluated using standardized photographs, and measurements of body weight and circumference of treatment sites at baseline, immediately after the last treatment, and four weeks and one year after the last treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = 75% improvement) were judged independently by two non-treating dermatologists after the series of treatment. The average body weights at baseline, immediately after the last treatment, and four weeks and one year after the complete treatment were 56.30, 56.05, 56.23, and 56.53 kg, respectively. The average circumferential reductions of the abdomen and thigh at the last treatment visit were 5.17 +/- 1.04 cm (6.32%+/- 1.82%) and 3.50 +/- 2.16 cm (6.23 +/- 3.58%), respectively. At four weeks after the last treatment, the average circumferential reductions of the abdomen and thigh were sustained at 3.17 +/- 2.75 cm (4.04%+/- 3.69%) and 3.50 +/- 2.04 cm (6.26%+/- 3.52%), respectively. At one year follow-up visit, the average circumferential reductions of the abdomen and thigh were maintained at 3.83 +/- 0.76 cm (4.64%+/- 1.15%) and 3.13 +/- 3.54 (5.50%+/- 6.12%), respectively. Average clinical improvement scores of the abdomen and thigh after the series of treatments were 0.75 (corresponding to approximately 25% improvement), and 1.75 (corresponding to approximately 50% improvement), respectively. A bipolar RF, IR heat and pulsatile suction device provides a beneficial effect on reduction of abdomen and thigh circumference, and smoothening of the cellulite.

  3. Application of the time dependent suction to free convection laminar flow in the presence of transverse magnetic field

    International Nuclear Information System (INIS)

    Agrawal, H.L.; Ram, P.C.

    1980-01-01

    The laminar unsteady free convection and heat transfer of an electrically conducting fluid past a porous vertical flat plate in the presence of uniform transverse magnetic field is investigated when the free stream velocity and suction at the plate are oscillatory functions of time, viscous dissipation term and Joul's dissipation term have been neglected at low velocity. Expressions for velocity and temperature distributions have been obtained in the non-dimensional forms and the skin-friction has been calculated. The skin-friction decreases by increasing Hartmann number. The suction is applied to check the growth of the boundary layer. This study is likely to have bearing on the problem of boundary layer control and transpiration cooling. (author)

  4. Laterally Loaded Single Pile Response Considering the Influence of Suction and Non-Linear Behaviour of Reinforced Concrete Sections

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    Stefano Stacul

    2017-12-01

    Full Text Available A hybrid BEM-p-y curves approach was developed for the single pile analysis with free/fixed head restraint conditions. The method considers the soil non-linear behaviour by means of p-y curves in series to a multi-layered elastic half-space. The non-linearity of reinforced concrete pile sections, also considering the influence of tension-stiffening, has been considered. The model reproduces the influence of suction by increasing the stress state and hence the stiffness of shallow soil-layers. Suction is modeled using the Modified-Kovacs model. The hybrid BEM-py curves method was validated by comparing results from data of 22 load tests on single piles. In addition, a detailed comparison is presented between measured and computed data on a large-diameter reinforced concrete bored single pile.

  5. Influence of fluid viscosity on vortex cavitation at a suction pipe inlet

    International Nuclear Information System (INIS)

    Ezure, Toshiki; Ito, Kei; Kamide, Hideki; Kameyama, Yuri; Kunugi, Tomoaki

    2016-01-01

    Cavitation is a highly important issue in various fluid machineries. In the design of an advanced loop-type sodium-cooled fast reactor in Japan, vortex cavitation is also a significant issue for the integrity of the reactor structure. Thus, an evaluation method for vortex cavitation is required. In this study, vortex cavitation at a single suction pipe inlet was studied under several different viscosity conditions including its transient behavior. The intermittent occurrence behaviors of vortex cavitation were grasped by visualization measurements. The experimental results showed that the influence of the kinematic viscosity was obvious under a high kinematic viscosity. However, the influence became smaller with decreasing kinematic viscosity. From these results, the non-dimensional circulation, which was defined as the ratio of the local circulation to the kinematic viscosity, was deduced as an evaluation parameter to estimate the influence of the kinematic viscosity. Cavitation factors at transition points from continuous occurrence to intermittent occurrences were also evaluated as representative points where vortex cavitation occurs. Then, the occurrences of vortex cavitation were expressed as a relation between the cavitation factor at transition points and the non-dimensional circulation. As a result, it was clarified that the cavitation factor at transition points increased linearly in relatively small non-dimensional circulation, while it was nearly constant in relatively large non-dimensional circulation. (author)

  6. Improved upper bounds on energy dissipation rates in plane Couette flow with boundary injection and suction

    Science.gov (United States)

    Lee, Harry; Wen, Baole; Doering, Charles

    2017-11-01

    The rate of viscous energy dissipation ɛ in incompressible Newtonian planar Couette flow (a horizontal shear layer) imposed with uniform boundary injection and suction is studied numerically. Specifically, fluid is steadily injected through the top plate with a constant rate at a constant angle of injection, and the same amount of fluid is sucked out vertically through the bottom plate at the same rate. This set-up leads to two control parameters, namely the angle of injection, θ, and the Reynolds number of the horizontal shear flow, Re . We numerically implement the `background field' variational problem formulated by Constantin and Doering with a one-dimensional unidirectional background field ϕ(z) , where z aligns with the distance between the plates. Computation is carried out at various levels of Re with θ = 0 , 0 .1° ,1° and 2°, respectively. The computed upper bounds on ɛ scale like Re0 as Re > 20 , 000 for each fixed θ, this agrees with Kolmogorov's hypothesis on isotropic turbulence. The outcome provides new upper bounds to ɛ among any solution to the underlying Navier-Stokes equations, and they are sharper than the analytical bounds presented in Doering et al. (2000). This research was partially supported by the NSF Award DMS-1515161, and the University of Michigan's Rackham Graduate Student Research Grant.

  7. Thermodynamic analysis of a refrigeration cycle using regenerative heat exchanger - suction/liquid line

    Energy Technology Data Exchange (ETDEWEB)

    Tebchirani, Tarik Linhares; Matos, Rudmar Serafim [Pos graduate Programme in Mechanical Engineering (PGMEC), Universidade Federal do Parana, Curitiba, PR (Brazil)], e-mails: tarik@utfpr.edu.br, rudmar@demec.ufpr.br

    2010-07-01

    This paper presents results from thermodynamic comparison of a conventional compression cycle and a steam cycle that uses a heat exchanger countercurrent (liquid line/suction line) in an air conditioning system split. The main objective is to study the relationship between the COP and the mass variation of refrigerant to the effectiveness of the heat exchanger. The papers presented in the literature discuss the matter in a theoretical way, are summarized in tables of rare loss statements without specification of methods. The methodology of work is based on testing of an air conditioner operating conventionally and also with the heat exchanger for the determination of values and parameters of interest. The tests were performed in a thermal chamber with temperature controlled and equipped with a data acquisition system for reading and storage results. The refrigerant was R22. Besides making possible an assessment of the feasibility of cost-benefit thermodynamics, it is suggested a different method for installing the equipment type split. (author)

  8. Composite Behavior of Insulated Concrete Sandwich Wall Panels Subjected to Wind Pressure and Suction

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    Insub Choi

    2015-03-01

    Full Text Available A full-scale experimental test was conducted to analyze the composite behavior of insulated concrete sandwich wall panels (ICSWPs subjected to wind pressure and suction. The experimental program was composed of three groups of ICSWP specimens, each with a different type of insulation and number of glass-fiber-reinforced polymer (GFRP shear grids. The degree of composite action of each specimen was analyzed according to the load direction, type of the insulation, and number of GFRP shear grids by comparing the theoretical and experimental values. The failure modes of the ICSWPs were compared to investigate the effect of bonds according to the load direction and type of insulation. Bonds based on insulation absorptiveness were effective to result in the composite behavior of ICSWP under positive loading tests only, while bonds based on insulation surface roughness were effective under both positive and negative loading tests. Therefore, the composite behavior based on surface roughness can be applied to the calculation of the design strength of ICSWPs with continuous GFRP shear connectors.

  9. Vortex generation and wave-vortex interaction over a concave plate with roughness and suction

    Science.gov (United States)

    Bertolotti, Fabio

    1993-01-01

    The generation and amplification of vortices by surface homogeneities, both in the form of surface waviness and of wall-normal velocity, is investigated using the nonlinear parabolic stability equations. Transients and issues of algebraic growth are avoided through the use of a similarity solution as initial condition for the vortex. In the absence of curvature, the vortex decays as the square root of 1/x when flowing over streamwise aligned riblets of constant height, and grows as the square root of x when flowing over a corresponding streamwise aligned variation of blowing/suction transpiration velocity. However, in the presence of wall inhomogeneities having both streamwise and spanwise periodicity, the growth of the vortex can be much larger. In the presence of curvature, the vortex develops into a Gortler vortex. The 'direct' and 'indirect' interaction mechanisms possible in wave-vortex interaction are presented. The 'direct' interaction does not lead to strong resonance with the flow conditions investigated. The 'indirect' interaction leads to K-type transition.

  10. AUTOMATIC CONTROL SYSTEM OF THE DIFFERENCE BETWEEN DISCHARGE AND SUCTION PRESSURES OF THE HEAT PUMP STATION COMPRESSOR

    Directory of Open Access Journals (Sweden)

    Sit M.L.

    2009-04-01

    Full Text Available Possibility of realization is shown and the control system of a difference of pressure between an exit and an input of the compressor of the heat pump on carbon dioxide working at variable thermal load, and discharge and suction pressures by means of two control valves connected in series is developed. On an example a flow coefficient calculation procedure of control valves is shown.

  11. Determination of Matric Suction and Saturation Degree for Unsaturated Soils, Comparative Study - Numerical Method versus Analytical Method

    Science.gov (United States)

    Chiorean, Vasile-Florin

    2017-10-01

    Matric suction is a soil parameter which influences the behaviour of unsaturated soils in both terms of shear strength and permeability. It is a necessary aspect to know the variation of matric suction in unsaturated soil zone for solving geotechnical issues like unsaturated soil slopes stability or bearing capacity for unsaturated foundation ground. Mathematical expression of the dependency between soil moisture content and it’s matric suction (soil water characteristic curve) has a powerful character of nonlinearity. This paper presents two methods to determine the variation of matric suction along the depth included between groundwater level and soil level. First method is an analytical approach to emphasize one direction steady state unsaturated infiltration phenomenon that occurs between the groundwater level and the soil level. There were simulated three different situations in terms of border conditions: precipitations (inflow conditions on ground surface), evaporation (outflow conditions on ground surface), and perfect equilibrium (no flow on ground surface). Numerical method is finite element method used for steady state, two-dimensional, unsaturated infiltration calculus. Regarding boundary conditions there were simulated identical situations as in analytical approach. For both methods, was adopted the equation proposed by van Genuchten-Mualen (1980) for mathematical expression of soil water characteristic curve. Also for the unsaturated soil permeability prediction model was adopted the equation proposed by van Genuchten-Mualen. The fitting parameters of these models were adopted according to RETC 6.02 software in function of soil type. The analyses were performed in both methods for three major soil types: clay, silt and sand. For each soil type were concluded analyses for three situations in terms of border conditions applied on soil surface: inflow, outflow, and no flow. The obtained results are presented in order to highlight the differences

  12. Treatment of herniated lumbar disc by percutaneous laser disc decompression combined with synchronous suction technique through syringe

    Institute of Scientific and Technical Information of China (English)

    Dhir B. Gurung; Gaojian Tao; Hongyi Lin; Yanning Qian; Jian Lin

    2007-01-01

    Objective: To compare the outcomes of percutaneous laser disc decompression (PLDD) and PLDD with synchronous suction through syringe in the patients with herniated lumbar disc (HLD). Methods: Forty-two patients with HLD on MRI and those who did not respond to conservative treatment for 6 weeks were randomly divided into group A and group B. In group A, the patients were treated with PLDD and those in group B with PLDD and synchronous suction through syringe. GaAIAS diode laser at 810 nm was used for the ablation in both groups. The treatment effect was evaluated by modified MacNab's criteria on the 7th, 30th and 90th day. Results: Evaluated by modified MacNab's criteria, the percentages of the excellent and good cases in total patients treated for group B and A were 80.95% and 57.14% on the 7th follow-up day, 85.71% and 66.67% on the 30th follow-up day, and 95.24% and 71.43% on the 90th follow-up day, respectively. Conclusion: Synchronous suction technique through syringe during PLDD improves the overall outcome in the treatment of herniated lumbar disc.

  13. Effect of inflow discharges on the development of matric suction and volumetric water content for dike during overtopping tests

    Science.gov (United States)

    Hassan, Marwan A.; Ismail, Mohd A. M.

    2017-10-01

    The point of this review is to depict the impact of various inflow discharge rate releases on the instruments of matric suction and volumetric water content during an experimental test of spatial overtopping failure at school of civil engineering in universiti Sains of Malaysia. A dry sand dike was conducted inside small flume channel with twelve sensors of tensiometer and Time-Domain Reflectometer (TDR). Instruments are installed in the soil at different locations in downstream and upstream slopes of the dike for measuring the response of matric suction and volumetric water content, respectively. Two values of inflow discharge rates of 30 and 40 L/min are utilized as a part of these experiments to simulate the effectiveness of water reservoirs in erosion mechanism. The outcomes demonstrate that the matric suction and volumetric water content are decreased and increased, respectively for both inflow discharges. The higher inflow discharges accelerate the saturation of dike soil and the erosion process faster than that for the lower inflow discharges.

  14. Stability analysis on the flow and heat transfer of nanofluid past a stretching/shrinking cylinder with suction effect

    Science.gov (United States)

    Bakar, Nor Ashikin Abu; Bachok, Norfifah; Arifin, Norihan Md.; Pop, Ioan

    2018-06-01

    The steady boundary layer flow over a stretching/shrinking cylinder with suction effect is numerically studied. Using a similarity transformations, the governing partial differential equations are transformed into a set of nonlinear differential equations and have been solved numerically using a bvp4c code in Matlab software. The nanofluid model used is taking into account the effects of Brownian motion and thermophoresis. The influences of the governing parameters namely the curvature parameter γ, mass suction parameter S, Brownian motion parameter Nb and thermophoresis parameter Nt on the flow, heat and mass transfers characteristics are presented graphically. The numerical results obtained for the skin friction coefficient, local Nusselt number and local Sherwood number are thoroughly determined and presented graphically for several values of the governing parameters. From our investigation, it is found that the non-unique (dual) solutions exist for a certain range of mass suction parameter. It is observed that as curvature parameter increases, the skin friction coefficient and heat transfer rate decrease, meanwhile the mass transfer rates increase. Moreover, the stability analysis showed that the first solution is linearly stable, while the second solution is linearly unstable.

  15. Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    F Behnamfar

    2004-06-01

    Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.

  16. Heat performance resulting from combined effects of radiation and mixed convection in a rectangular cavity ventilated by injection or suction

    Science.gov (United States)

    Ezzaraa, K.; Bahlaoui, A.; Arroub, I.; Raji, A.; Hasnaoui, M.; Naïmi, M.

    2018-05-01

    In this work, we investigated numerically heat transfer by mixed convection coupled to thermal radiation in a vented rectangular enclosure uniformly heated from below with a constant heat flux. The fresh fluid is admitted into the cavity by injection or suction, by means of two openings located on the lower part of both right and left vertical sides. Another opening is placed on the middle of the top wall to ensure the ventilation. Air, a radiatively transparent medium, is considered to be the cooling fluid. The inner surfaces, in contact with the fluid, are assumed to be gray, diffuse emitters and reflectors of radiation with identical emissivities. The effects of some pertinent parameters such as the Reynolds number, 300 ≤ Re ≤ 5000, and the emissivity of the walls, 0 ≤ ɛ ≤ 0.85, on flow and temperature patterns as well as on the heat transfer rate within the enclosure are presented for the two ventilation modes (injection and suction). The results indicate that the flow and thermal structures are affected by the thermal radiation for the two modes of imposed flow. However, the suction mode is found to be more favorable to the heat transfer in comparison with the injection one.

  17. Hydrogenation study of suction-cast Ti{sub 40}Zr{sub 40}Ni{sub 20} quasicrystal

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Huogen; Li, Rong; Yin, Chen; Zheng, Shaotao; Zhang, Pengcheng [National Key Laboratory for Surface Physics and Chemistry, P.O. Box 718-35, Mian Yang 621907, Sichuan (China)

    2008-09-15

    Suction casting was predicted to be an usable method for improving the hydriding kinetics of Ti/Zr-based icosahedral quasicrystals (IQCs) in our previous work. To further determine it, a suction-cast Ti{sub 40}Zr{sub 40}Ni{sub 20} IQC alloy was used for hydrogenation studies by Pressure Composition Isotherm (PCI) and Temperature Programmed Desorption (TPD) techniques. The results showed that, this alloy absorbed hydrogen rapidly with obvious hydrogen pressure plateau and some reversibility, however, displayed very limited hydrogen capacity (about 0.7 wt.%) and low equilibrium pressure. After several hydrogenation/dehydrogenation cycles, the IQC structure transformed into two hydride phases, ZrH{sub 2-x} and one unknown, both of which decomposed at above 600 C, suggesting high thermo-stability for them. On the whole, indeed the suction-casting method can increase the hydrogen absorption rate of Ti/Zr-based IQCs, however, the hydrogenation properties of the Ti{sub 40}Zr{sub 40}Ni{sub 20} IQC alloy still need a mighty advancement. (author)

  18. Auscultation versus Point-of-care Ultrasound to Determine Endotracheal versus Bronchial Intubation: A Diagnostic Accuracy Study.

    Science.gov (United States)

    Ramsingh, Davinder; Frank, Ethan; Haughton, Robert; Schilling, John; Gimenez, Kimberly M; Banh, Esther; Rinehart, Joseph; Cannesson, Maxime

    2016-05-01

    Unrecognized malposition of the endotracheal tube (ETT) can lead to severe complications in patients under general anesthesia. The focus of this double-blinded randomized study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the ETT and to compare it with the accuracy of auscultation. Forty-two adult patients requiring general anesthesia with ETT were consented. Patients were randomized to right main bronchus, left main bronchus, or tracheal intubation. After randomization, the ETT was placed via fiber-optic visualization. Next, the location of the ETT was assessed using auscultation by a separate blinded anesthesiologist, followed by an ultrasound performed by a third blinded anesthesiologist. Ultrasound examination included assessment of tracheal dilation via cuff inflation with air and evaluation of pleural lung sliding. Statistical analysis included sensitivity, specificity, positive predictive value, negative predictive value, and interobserver agreement for the ultrasound examination (95% CI). In differentiating tracheal versus bronchial intubations, auscultation showed a sensitivity of 66% (0.39 to 0.87) and a specificity of 59% (0.39 to 0.77), whereas ultrasound showed a sensitivity of 93% (0.66 to 0.99) and specificity of 96% (0.79 to 1). Identification of tracheal versus bronchial intubation was 62% (26 of 42) in the auscultation group and 95% (40 of 42) in the ultrasound group (P = 0.0005) (CI for difference, 0.15 to 0.52), and the McNemar comparison showed statistically significant improvement with ultrasound (P auscultation in determining the location of ETT.

  19. Colorimetric end-tidal CO2 detector for verification of endotracheal tube placement in out-of-hospital cardiac arrest.

    Science.gov (United States)

    Hayden, S R; Sciammarella, J; Viccellio, P; Thode, H; Delagi, R

    1995-06-01

    To evaluate the ability of a disposable, colorimetric end-tidal CO2 detector to verify proper endotracheal (ET) tube placement in out-of-hospital cardiac arrest, and to correlate semiquantitative CO2 measurements with the rate of return of spontaneous circulation (ROSC). Prospective, observational study using a convenience sample of intubated out-of-hospital cardiac arrest patients. A disposable, colorimetric end-tidal CO2 detector was attached to the ET tube after intubation. In the absence of a colorimetric change, the paramedics reassessed the tube placement and could reintubate the patient. Tube placement was verified at the hospital. Paramedics were instructed to contact the base station and report the colorimetric change upon hospital arrival. ROSC was defined as restoration of a self-sustaining pulse until hospital arrival. Between December 1990 and May 1993, ET tubes were placed in 566 victims of out-of-hospital cardiac arrest. 541 of the 566 intubations (95.6%) were associated with a color change. In one case with a color change and out-of-hospital clinical evidence of proper tube placement, the tube was determined to be in the esophagus at the hospital. Correct placement of the remaining 565 of 566 (99.8%) tubes was verified. Of the 566 patients who had a colorimetric change, 91 (16%) had ROSC vs one of 25 (4%) patients who did not have a color change. In one subgroup (n = 179), the degree of color change was highly associated with ROSC (p = 0.004). A disposable, colorimetric end-tidal CO2 detector appears reliable in verifying proper ET tube placement in victims of out-of-hospital cardiac arrest. The degree of color change correlates with the probability of ROSC.

  20. Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

    Directory of Open Access Journals (Sweden)

    El-Seify Zeinab

    2010-01-01

    Full Text Available Background: Low flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min as compared to endotracheal tube (ETT. Patients and Methods : Fifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO 2 (ETCO 2 , inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications Results : Two patients in the LMA-group developed initial airway leakage (6.9% versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO 2 , uptake of gases, nor difficulty in swallowing. Conclusion : The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

  1. A Multicenter, Randomized Trial of Ramped Position vs Sniffing Position During Endotracheal Intubation of Critically Ill Adults.

    Science.gov (United States)

    Semler, Matthew W; Janz, David R; Russell, Derek W; Casey, Jonathan D; Lentz, Robert J; Zouk, Aline N; deBoisblanc, Bennett P; Santanilla, Jairo I; Khan, Yasin A; Joffe, Aaron M; Stigler, William S; Rice, Todd W

    2017-10-01

    Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. Multicenter, randomized trial comparing the ramped position (head of the bed elevated to 25°) with the sniffing position (torso supine, neck flexed, and head extended) among 260 adults undergoing endotracheal intubation by pulmonary and critical care medicine fellows in four ICUs between July 22, 2015, and July 19, 2016. The primary outcome was lowest arterial oxygen saturation between induction and 2 minutes after intubation. Secondary outcomes included Cormack-Lehane grade of glottic view, difficulty of intubation, and number of laryngoscopy attempts. The median lowest arterial oxygen saturation was 93% (interquartile range [IQR], 84%-99%) with the ramped position vs 92% (IQR, 79%-98%) with the sniffing position (P = .27). The ramped position appeared to increase the incidence of grade III or IV view (25.4% vs 11.5%, P = .01), increase the incidence of difficult intubation (12.3% vs 4.6%, P = .04), and decrease the rate of intubation on the first attempt (76.2% vs 85.4%, P = .02), respectively. In this multicenter trial, the ramped position did not improve oxygenation during endotracheal intubation of critically ill adults compared with the sniffing position. The ramped position may worsen glottic view and increase the number of laryngoscopy attempts required for successful intubation. ClinicalTrials.gov; No.: NCT02497729; URL: www.clinicaltrials.gov. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  2. Suction catheter guided insertion of ProSeal laryngeal mask airway: Experience by untrained physicians

    Directory of Open Access Journals (Sweden)

    Valter Perilli

    2014-01-01

    Full Text Available Background: The use of suction catheter (SC has been shown to improve success rate during ProSeal laryngeal mask airway (PLMA insertion in expert users. Aims: The aim of this study was to compare insertion of PLMA performed by untrained physicians using a SC or the digital technique (DT in anaesthetised non-paralysed patients. Methods: In this prospective randomised double-blind study, conducted in the operating setting, 254 patients (American Society of Anaesthesiologists I-II, aged 18-65 years, undergoing minor surgery were enrolled. Exclusion criteria were body mass index >35 kg/m 2 , laryngeal or oesophageal varices, risk of aspiration or difficult face mask ventilation either referred or suspected (Langeron′s criteria ≥2 and modified Mallampati classification score >2. Participants were randomly allocated to one of the two groups in which PLMA was inserted using DT (DT-group or SC (SC-group. Statistical Analysis: Chi-square test with Yates′ correction, Mann-Whitney U-test or Student′s t-test were carried-out as appropriate. Results: The final insertion success rate was greater in SC-groupcompared with DT-group 90.1% (n = 109 versus 74.4% (n = 99 respectively (P = 0.002. Mean airway leak pressure was higher in SC-group compared to DT-group (23.7 ± 3.9 vs. 21.4 ± 3.2 respectively; (P = 0.001. There were no differences in insertion time, post-operative airway morbidity and complications. Conclusion: The findings of this study suggest that SC-technique improves the success rate of PLMA insertion by untrained physicians.

  3. Investigation on inlet recirculation characteristics of double suction centrifugal compressor with unsymmetrical inlet

    Science.gov (United States)

    Yang, Ce; Wang, Yingjun; Lao, Dazhong; Tong, Ding; Wei, Longyu; Liu, Yixiong

    2016-08-01

    The inlet recirculation characteristics of double suction centrifugal compressor with unsymmetrical inlet structures were studied in numerical method, mainly focused on three issues including the amounts and differences of the inlet recirculation in different working conditions, the circumferential non-uniform distributions of the inlet recirculation, the recirculation velocity distributions of the upstream slot of the rear impeller. The results show that there are some differences between the recirculation of the front impeller and that of the rear impeller in whole working conditions. In design speed, the recirculation flow rate of the rear impeller is larger than that of the front impeller in the large flow range, but in the small flow range, the recirculation flow rate of the rear impeller is smaller than that of the front impeller. In different working conditions, the recirculation velocity distributions of the front and rear impeller are non-uniform along the circumferential direction and their non-uniform extents are quite different. The circumferential non-uniform extent of the recirculation velocity varies with the working conditions change. The circumferential non-uniform extent of the recirculation velocity of front impeller and its distribution are determined by the static pressure distribution of the front impeller, but that of the rear impeller is decided by the coupling effects of the inlet flow distortion of the rear impeller, the circumferential unsymmetrical distribution of the upstream slot and the asymmetric structure of the volute. In the design flow and small flow conditions, the recirculation velocities at different circumferential positions of the mean line of the upstream slot cross-section of the rear impeller are quite different, and the recirculation velocities distribution forms at both sides of the mean line are different. The recirculation velocity distributions in the cross-section of the upstream slot depend on the static pressure

  4. School Closings in Philadelphia

    Science.gov (United States)

    Jack, James; Sludden, John

    2013-01-01

    In 2012, the School District of Philadelphia closed six schools. In 2013, it closed 24. The closure of 30 schools has occurred amid a financial crisis, headlined by the district's $1.35 billion deficit. School closures are one piece of the district's plan to cut expenditures and close its budget gap. The closures are also intended to make…

  5. Impact of chorioamnionitis on exhaled nitric oxide and endotracheal aspirate levels of nitrites-nitrates and interleukin-8 in mechanically ventilated preterm neonates.

    Science.gov (United States)

    Figueras-Aloy, Josep; Salvia-Roiges, Maria Dolors; Rodriguez-Miguélez, J Manuel; Miracle-Echegoyen, Xavier; Botet-Mussons, Francesc; Marín-Soria, J Luís; Carbonell-Estrany, Xavier

    2011-06-01

    To assess the influence of maternal chorioamnionitis on early exhaled nitric oxide (NO) and levels of nitrites-nitrates and interleukin (IL)-8 in endotracheal aspirate fluid in mechanically ventilated preterm neonates. Cross-sectional study. PATIENT-SUBJECT SELECTION: Between September 2007 and August 2009, 54 mechanically ventilated preterm neonates were included. Patients were divided into two groups according to the presence or absence of maternal chorioamnionitis, and those without chorioamnionitis (controls) were further stratified into two subgroups by birth weight nitrates were significantly higher in the chorioamnionitis group than in controls (3.6 vs. 1.07 µmol/L; P = 0.035). Nitrites-nitrates levels were positively correlated with exhaled NO in ppb (ρ = 0.367; P = 0.006). Minute exhaled endogenous NO was significantly higher in the chorioamnionitis group (0.48 vs. 0.27 nl/min/kg; P = 0.021). In mechanically ventilated preterm infants weighing nitrates in endotracheal aspirate fluid. Copyright © 2011 Wiley-Liss, Inc.

  6. Comparative study of the characteristics of some suction devices for gas sampling applications; Etude comparative des caracteristiques de quelques dispositifs d'aspiration a l'usage des prelevements de gaz

    Energy Technology Data Exchange (ETDEWEB)

    Donguy, R.; Drouet, J.

    1959-06-15

    Gas sampling (used to determine the characteristics of dusts or aerosols contained in a gas) needs a suction device. In order to select the right device and the right conditions of use, the characteristics and performances of various suction devices (helicoidal and centrifugal aspirators, air pumps, volumetric pumps) have been experimentally measured: flow rate, head loss, sampling volume and duration, aerosol and dust concentration, gas density, nature of the gas, suction circuit configuration, etc.

  7. Australian fur seals (Arctocephalus pusillus doriferus use raptorial biting and suction feeding when targeting prey in different foraging scenarios.

    Directory of Open Access Journals (Sweden)

    David P Hocking

    Full Text Available Foraging behaviours used by two female Australian fur seals (Arctocephalus pusillus doriferus were documented during controlled feeding trials. During these trials the seals were presented with prey either free-floating in open water or concealed within a mobile ball or a static box feeding device. When targeting free-floating prey both subjects primarily used raptorial biting in combination with suction, which was used to draw prey to within range of the teeth. When targeting prey concealed within either the mobile or static feeding device, the seals were able to use suction to draw out prey items that could not be reached by biting. Suction was followed by lateral water expulsion, where water drawn into the mouth along with the prey item was purged via the sides of the mouth. Vibrissae were used to explore the surface of the feeding devices, especially when locating the openings in which the prey items had been hidden. The mobile ball device was also manipulated by pushing it with the muzzle to knock out concealed prey, which was not possible when using the static feeding device. To knock prey out of this static device one seal used targeted bubble blowing, where a focused stream of bubbles was blown out of the nose into the openings in the device. Once captured in the jaws, prey items were manipulated and re-oriented using further mouth movements or chews so that they could be swallowed head first. While most items were swallowed whole underwater, some were instead taken to the surface and held in the teeth, while being vigorously shaken to break them into smaller pieces before swallowing. The behavioural flexibility displayed by Australian fur seals likely assists in capturing and consuming the extremely wide range of prey types that are targeted in the wild, during both benthic and epipelagic foraging.

  8. Magneto-hydrodynamics of coupled fluid–sheet interface with mass suction and blowing

    International Nuclear Information System (INIS)

    Ahmad, R.

    2016-01-01

    There are large number of studies which prescribe the kinematics of the sheet and ignore the sheet's mechanics. However, the current boundary layer analysis investigates the mechanics of both the electrically conducting fluid and a permeable sheet, which makes it distinct from the other studies in the literature. One of the objectives of the current study is to (i) examine the behaviour of magnetic field effect for both the surface and the electrically conducting fluid (ii) investigate the heat and mass transfer between a permeable sheet and the surrounding electrically conducting fluid across the hydro, thermal and mass boundary layers. Self-similar solutions are obtained by considering the RK45 technique. Analytical solution is also found for the stretching sheet case. The skin friction dual solutions are presented for various types of sheet. The influence of pertinent parameters on the dimensionless velocity, shear stress, temperature, mass concentration, heat and mass transfer rates on the fluid–sheet interface is presented graphically as well as numerically. The obtained results are of potential benefit for studying the electrically conducting flow over various soft surfaces such as synthetic plastics, soft silicone sheet and soft synthetic rubber sheet. These surfaces are easily deformed by thermal fluctuations or thermal stresses. - Highlights: • The momentum equation is modelled for both the surrounding MHD fluid and the sheet with the effects of mass suction and blowing. • The current study further investigates the heat and mass transfer characteristics between a permeable sheet and the surrounding electrically conducting fluid across the thermal and mass boundary layers. • Both the approximated and analytical techniques have been included for the purpose of comparison, and the perfect numerical agreements have been established with the previous studies. • Dual solutions for the skin friction coefficients are found for various categories of

  9. Endovascular thrombectomy for M2 occlusions: comparison between forced arterial suction thrombectomy and stent retriever thrombectomy.

    Science.gov (United States)

    Kim, Yong-Won; Son, Seungnam; Kang, Dong-Hun; Hwang, Yang-Ha; Kim, Yong-Sun

    2017-07-01

    To date there has been no direct comparison of two frequently used endovascular thrombectomy (EVT) methods (forced arterial suction thrombectomy (FAST) and stent retriever thrombectomy) in M2 occlusions. We review our experiences with EVT performed using FAST and stent retriever thrombectomy in such cases. The subjects comprised 41 patients with an M2 occlusion who underwent EVT (25 with FAST, 16 with stent retriever thrombectomy). The patients' data were retrospectively analyzed to evaluate the technical characteristics and angiographic outcome of the two EVT techniques. Thrombolysis In Cerebral Infarction (TICI) grades 2b-3 using the first chosen technique did not differ significantly between the two techniques (FAST 64.0% vs stent retriever thrombectomy 81.2%, p=0.305). Time from groin puncture to reperfusion was significantly shorter for stent retriever thrombectomy (53.0 vs 38.5 min; p=0.045). Distal embolization occurred in three cases (12.0%) in the FAST group and in four (26.7%) in the stent retriever group (p=0.362). However, the two techniques did not differ significantly in the final TICI 2b-3 rate (72.0% vs 87.5%; p=0.441). A frequent angiographic finding regarding the failure of FAST was that the M2 occlusion was located immediately after severe acute angulation between M1 and M2. Stent retriever thrombectomy may provide faster reperfusion than FAST, while the FAST technique might be associated with lower distal embolization and a higher reperfusion rate for the first thrombectomy attempt, but without any significant difference in clinical outcome. When choosing the EVT method for M2 occlusions, consideration of the location of the occlusion and tortuosity between M1 and M2 might be helpful to achieve a better angiographic outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Impeller radial force evolution in a large double-suction centrifugal pump during startup at the shut-off condition

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Zhichao [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Wang, Fujun, E-mail: wangfj@cau.edu.cn [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Beijing Engineering Research Center of Safety and Energy Saving Technology for Water Supply Network System, China Agricultural University, Beijing 100083 (China); Yao, Zhifeng [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Beijing Engineering Research Center of Safety and Energy Saving Technology for Water Supply Network System, China Agricultural University, Beijing 100083 (China); Tao, Ran [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Xiao, Ruofu [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Beijing Engineering Research Center of Safety and Energy Saving Technology for Water Supply Network System, China Agricultural University, Beijing 100083 (China); Li, Huaicheng [Shanghai Liancheng (Group) Co., Ltd., Shanghai 201812 (China)

    2016-12-15

    Highlights: • Conclude the characteristics of transient radial force in the startup process for a large double-suction centrifugal pump. • The overall direction of the radial force during startup process is also confirmed. • A formula used to calculate the transient radial force during startup process is proposed. • A relationship between radial force variation and axial vortex development in blade channel during the startup process is established. The mechanism of the radial force evolution is revealed. - Abstract: Double-suction centrifugal pumps play an important role in the main feedwater systems of nuclear power plant. The impeller radial force in a centrifugal pump varies dramatically during startup at the shut-off condition. In this study, the startup process of a large double-suction centrifugal pump is investigated using CFD. During testing, the impeller speed is accelerated from zero to its rated speed in 1.0 s (marked as t{sub 0}) and is then maintained at the rated speed. The results show that the radial force increase lags behind the impeller speed increase. At 0–0.4t{sub 0}, the radial force is small (approaching zero). At 0.4–1.4t{sub 0}, the radial force increases rapidly. After 1.4t{sub 0}, the average radial force stabilizes and reaches its maximum value of 55,619 N. The observed maximum radial force value during startup is approximately nine times as high as the radial force under rated condition. During startup, the overall radial force direction is proximate to the radial line located 25° from the volute tongue along circumferential direction. A transient radial force formula is proposed to evaluate the changes in radial force during startup. The streamline distribution in impeller passages and the impeller outlet pressure profile varying over time are produced. The relationship between radial force evolution and the varying axial-to-spiral vortex structure is analyzed. The radial force change mechanism is revealed. This research

  11. Effect of boron addition on the magnetic properties of the Fe-Nd-Al alloys prepared by suction casting

    International Nuclear Information System (INIS)

    Bai, Q.; Xu, H.; Tan, X.H.; Zhang, S.Y.

    2007-01-01

    The microstructure and magnetic properties of the Fe-Nd-Al alloys prepared by suction casting with boron addition have been investigated. The increasing boron content in the Fe-Nd-Al alloys significantly increases the intrinsic coercivity ( i H c ) and decreases the proportion of the amorphous phase. The magnetization at the maximum applied field (σ ' s ) of the Fe-Nd-Al-B alloys decreases, while the coercivity increases markedly after annealing. The high intrinsic coercivity is due to the presence of the Nd 2 Fe 14 B phase

  12. A comparison of commercial light-emitting diode baited suction traps for surveillance of Culicoides in northern Europe.

    Science.gov (United States)

    Hope, Andrew; Gubbins, Simon; Sanders, Christopher; Denison, Eric; Barber, James; Stubbins, Francesca; Baylis, Matthew; Carpenter, Simon

    2015-04-22

    The response of Culicoides biting midges (Diptera: Ceratopogonidae) to artificial light sources has led to the use of light-suction traps in surveillance programmes. Recent integration of light emitting diodes (LED) in traps improves flexibility in trapping through reduced power requirements and also allows the wavelength of light used for trapping to be customized. This study investigates the responses of Culicoides to LED light-suction traps emitting different wavelengths of light to make recommendations for use in surveillance. The abundance and diversity of Culicoides collected using commercially available traps fitted with Light Emitting Diode (LED) platforms emitting ultraviolet (UV) (390 nm wavelength), blue (430 nm), green (570 nm), yellow (590 nm), red (660 nm) or white light (425 nm - 750 nm with peaks at 450 nm and 580 nm) were compared. A Centre for Disease Control (CDC) UV light-suction trap was also included within the experimental design which was fitted with a 4 watt UV tube (320-420 nm). Generalised linear models with negative binomial error structure and log-link function were used to compare trap abundance according to LED colour, meteorological conditions and seasonality. The experiment was conducted over 49 nights with 42,766 Culicoides caught in 329 collections. Culicoides obsoletus Meigen and Culicoides scoticus Downes and Kettle responded indiscriminately to all wavelengths of LED used with the exception of red which was significantly less attractive. In contrast, Culicoides dewulfi Goetghebuer and Culicoides pulicaris Linnaeus were found in significantly greater numbers in the green LED trap than in the UV LED trap. The LED traps collected significantly fewer Culicoides than the standard CDC UV light-suction trap. Catches of Culicoides were reduced in LED traps when compared to the standard CDC UV trap, however, their reduced power requirement and small size fulfils a requirement for trapping in logistically challenging areas or where many

  13. Impeller radial force evolution in a large double-suction centrifugal pump during startup at the shut-off condition

    International Nuclear Information System (INIS)

    Zou, Zhichao; Wang, Fujun; Yao, Zhifeng; Tao, Ran; Xiao, Ruofu; Li, Huaicheng

    2016-01-01

    Highlights: • Conclude the characteristics of transient radial force in the startup process for a large double-suction centrifugal pump. • The overall direction of the radial force during startup process is also confirmed. • A formula used to calculate the transient radial force during startup process is proposed. • A relationship between radial force variation and axial vortex development in blade channel during the startup process is established. The mechanism of the radial force evolution is revealed. - Abstract: Double-suction centrifugal pumps play an important role in the main feedwater systems of nuclear power plant. The impeller radial force in a centrifugal pump varies dramatically during startup at the shut-off condition. In this study, the startup process of a large double-suction centrifugal pump is investigated using CFD. During testing, the impeller speed is accelerated from zero to its rated speed in 1.0 s (marked as t_0) and is then maintained at the rated speed. The results show that the radial force increase lags behind the impeller speed increase. At 0–0.4t_0, the radial force is small (approaching zero). At 0.4–1.4t_0, the radial force increases rapidly. After 1.4t_0, the average radial force stabilizes and reaches its maximum value of 55,619 N. The observed maximum radial force value during startup is approximately nine times as high as the radial force under rated condition. During startup, the overall radial force direction is proximate to the radial line located 25° from the volute tongue along circumferential direction. A transient radial force formula is proposed to evaluate the changes in radial force during startup. The streamline distribution in impeller passages and the impeller outlet pressure profile varying over time are produced. The relationship between radial force evolution and the varying axial-to-spiral vortex structure is analyzed. The radial force change mechanism is revealed. This research provides a scientific

  14. Stall margin improvement of an axial flow fan with end wall injection and suction; Hekimen fukidashi suidashi ni yoru han'yo jikuryu sofuki no shissoku kaizen

    Energy Technology Data Exchange (ETDEWEB)

    Nishioka, K.; Kuroda, H.; Obata, S.; Chimura, O. [National Defense Academy, Kanagawa (Japan)

    1999-06-25

    The experimental studies are conducted to reveal the mechanism of stall margin improvement of an axial flow fan by injection or suction from the end wall. In case of injection, the largest improvement is obtained by the injection at about 0. 14 {approx} 0 .21 times axial chord length downstream from leading edge. The reason for large improvement is that stall vortex, shed intermittent separation vortex and tip leakage vortex are dissipated by this injection, and also that this blowing suppresses the separation of boundary layer. In case of suction, the largest improvement is found for the suction from the end wall near leading edge. The amplitude of periodic static pressure after stall inception becomes smaller in comparison with injection cases. These effects are increased with the increase of suction flow rate, because the discharge of the vortex occurs more easily. On the other hand, the suction from the upstream of leading edge reduces the axial velocity near rotor tip, and then it induces stall. Also we tried to visualize the tip region flow, The suppression mechanism is discussed based on the visualization. The suppression of stall is successfully photographed. (author)

  15. Aerosol distribution during open suctioning and long-term surveillance of air quality in a respiratory care center within a medical center.

    Science.gov (United States)

    Chung, Fen-Fang; Lin, Hui-Ling; Liu, Hsueh-Erh; Lien, Angela Shin-Yu; Hsiao, Hsiu-Feng; Chou, Lan-Ti; Wan, Gwo-Hwa

    2015-01-01

    The investigation of hospital air quality has been conducted in wards, ICUs, operating theaters, and public areas. Few studies have assessed air quality in respiratory care centers (RCCs), especially in mechanically ventilated patients with open suctioning. The RCC air quality indices (temperature, relative humidity, levels of CO2, total volatile organic compounds, particulate matter [PM], bacteria, and fungi) were monitored over 1 y. The air around the patient's head was sampled during open suctioning to examine the probability of bioaerosol exposure affecting health-care workers. This investigation found that the levels of indoor air pollutants (CO2, PM, bacteria, and fungi) were below the indoor air quality standard set by the Taiwan Environmental Protection Agency. Meanwhile, the levels of total volatile organic compounds sometimes exceeded the indoor air quality standard, particularly in August. The identified bacterial genera included Micrococcus species, Corynebacterium species, and Staphylococcus species, and the predominant fungal genera included yeast, Aspergillus species, Scopulariopsis species, and Trichoderma species. Additionally, airborne PM2.5, PM1, and bacteria were clearly raised during open suctioning in mechanically ventilated patients. This phenomenon demonstrated that open suctioning may increase the bacterial exposure risk of health-care workers. RCC air quality deserves long-term monitoring and evaluation. Health-care workers must implement self-protection strategies during open suctioning to ensure their occupational health and safety in health-care settings. Copyright © 2015 by Daedalus Enterprises.

  16. Heat-transfer and pressure distributions for laminar separated flows downstream of rearward-facing steps with and without mass suction

    Science.gov (United States)

    Brown, R. D.; Jakubowski, A. K.

    1974-01-01

    Heat-transfer and pressure distributions were measured for laminar separated flows downstream of rearward-facing steps with and without mass suction. The flow conditions were such that the boundary-layer thickness was comparable to or larger than the step height. For both suction and no-suction cases, an increase in the step height resulted in a sharp decrease in the initial heat-transfer rates behind the step. Downstream, however, the heat transfer gradually recovered back to less than or near attached-flow values. Mass suction from the step base area increased the local heat-transfer rates; however, this effect was relatively weak for the laminar flows considered. Even removal of the entire approaching boundary layer raised the post-step heat-transfer rates only about 10 percent above the flatplate values. Post-step pressure distributions were found to depend on the entrainment conditions at separation. In the case of the solid-faced step, a sharp pressure drop behind the step was followed by a very short plateau and relatively fast recompression. For the slotted-step connected to a large plenum but without suction, the pressure drop at the base was much smaller and the downstream recompression more gradual than that for solid-faced step.

  17. Failed endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Sheykhol Islami V

    1995-07-01

    Full Text Available The incidence of failed intubation is higher in obstetric than other surgical patients. Failed intubation was the 2nd commonest cause of mortality during anesthesia. Bearing in mind that failre to intubate may be unavoidable in certain circumstances, it is worth reviewing. The factors, which may contribute to a disastrous out come. Priorities of subsequent management must include maintaining oxygenation and preventing aspiration of gastric contents. Fiber optic intubation is now the technique of choice with a high success rate and with least trauma to the patient.

  18. Effect of Suction Nozzle Pressure Drop on the Performance of an Ejector-Expansion Transcritical CO2 Refrigeration Cycle

    Directory of Open Access Journals (Sweden)

    Zhenying Zhang

    2014-08-01

    Full Text Available The basic transcritical CO2 systems exhibit low energy efficiency due to their large throttling loss. Replacing the throttle valve with an ejector is an effective measure for recovering some of the energy lost in the expansion process. In this paper, a thermodynamic model of the ejector-expansion transcritical CO2 refrigeration cycle is developed. The effect of the suction nozzle pressure drop (SNPD on the cycle performance is discussed. The results indicate that the SNPD has little impact on entrainment ratio. There exists an optimum SNPD which gives a maximum recovered pressure and COP under a specified condition. The value of the optimum SNPD mainly depends on the efficiencies of the motive nozzle and the suction nozzle, but it is essentially independent of evaporating temperature and gas cooler outlet temperature. Through optimizing the value of SNPD, the maximum COP of the ejector-expansion cycle can be up to 45.1% higher than that of the basic cycle. The exergy loss of the ejector-expansion cycle is reduced about 43.0% compared with the basic cycle.

  19. Aero-thermal optimization of film cooling flow parameters on the suction surface of a high pressure turbine blade

    Science.gov (United States)

    El Ayoubi, Carole; Hassan, Ibrahim; Ghaly, Wahid

    2012-11-01

    This paper aims to optimize film coolant flow parameters on the suction surface of a high-pressure gas turbine blade in order to obtain an optimum compromise between a superior cooling performance and a minimum aerodynamic penalty. An optimization algorithm coupled with three-dimensional Reynolds-averaged Navier Stokes analysis is used to determine the optimum film cooling configuration. The VKI blade with two staggered rows of axially oriented, conically flared, film cooling holes on its suction surface is considered. Two design variables are selected; the coolant to mainstream temperature ratio and total pressure ratio. The optimization objective consists of maximizing the spatially averaged film cooling effectiveness and minimizing the aerodynamic penalty produced by film cooling. The effect of varying the coolant flow parameters on the film cooling effectiveness and the aerodynamic loss is analyzed using an optimization method and three dimensional steady CFD simulations. The optimization process consists of a genetic algorithm and a response surface approximation of the artificial neural network type to provide low-fidelity predictions of the objective function. The CFD simulations are performed using the commercial software CFX. The numerical predictions of the aero-thermal performance is validated against a well-established experimental database.

  20. History of Suction-Type Laminar-Flow Control with Emphasis on Flight Resrearch: Monographs in Aerospace History Number 13

    Science.gov (United States)

    Braslow, A. L.

    1999-01-01

    The paper contains the following sections: Foreword; Preface; Laminar-Flow Control Concepts and Scope of Monograph; Early Research on Suction-Type Laminar-Flow Control (Research from the 1930s through the War Years; Research from after World War II to the Mid-1960s); Post X-21 Research on Suction-Type Laminar-Flow Control; Status of Laminar-Flow Control Technology in the Mid-1990s; Glossary; Document 1-Aeronautics Panel, AACB, R&D Review, Report of the Subpanel on Aeronautic Energy Conservation/Fuels; Document 2-Report of Review Group on X-21A Laminar Flow Control Program; Document 3-Langley Research Center Announcement, Establishment of Laminar Flow Control Working Group; Document 4-Intercenter Agreement for Laminar Flow Control Leading Edge Glove Flights, LaRC and DFRC; Document 5-Flight Report NLF-144, of AFTIF-111 Aircraft with the TACT Wing Modified by a Natural Laminar Flow Glove; Document 6-Flight Record, F-16XL Supersonic Laminar Flow Control Aircraft; Index; and About the Author.

  1. Seasonal dynamics of nitrate and ammonium ion concentrations in soil solutions collected using MacroRhizon suction cups.

    Science.gov (United States)

    Kabala, Cezary; Karczewska, Anna; Gałka, Bernard; Cuske, Mateusz; Sowiński, Józef

    2017-07-01

    The aims of the study were to analyse the concentration of nitrate and ammonium ions in soil solutions obtained using MacroRhizon miniaturized composite suction cups under field conditions and to determine potential nitrogen leaching from soil fertilized with three types of fertilizers (standard urea, slow-release urea, and ammonium nitrate) at the doses of 90 and 180 kg ha -1 , applied once or divided into two rates. During a 3-year growing experiment with sugar sorghum, the concentration of nitrate and ammonium ions in soil solutions was the highest with standard urea fertilization and the lowest in variants fertilized with slow-release urea for most of the months of the growing season. Higher concentrations of both nitrogen forms were noted at the fertilizer dose of 180 kg ha -1 . One-time fertilization, at both doses, resulted in higher nitrate concentrations in June and July, while dividing the dose into two rates resulted in higher nitrate concentrations between August and November. The highest potential for nitrate leaching during the growing season was in July. The tests confirmed that the miniaturized suction cups MacroRhizon are highly useful for routine monitoring the concentration of nitrate and ammonium ions in soil solutions under field conditions.

  2. BWR 200 % recirculation pump suction line break LOCA tests, RUNs 942 and 943 at ROSA-III without HPCS

    International Nuclear Information System (INIS)

    Suzuki, Mitsuhiro; Tasaka, Kanji; Anoda, Yoshinari; Kumamaru, Hiroshige; Nakamura, Hideo; Yonomoto, Taisuke; Murata, Hideo; Koizumi, Yasuo

    1986-03-01

    This report presents the experimental results of RUNs 942 and 943 in ROSA-III program, which are 200 % recirculation pump suction line break LOCA tests with assumption of HPCS failure. The ROSA-III test facility simulates a BWR system with volume scale of 1/424 and has four half-length electrically heated fuel bundles, two active recirculation loops, ECCS's, and steam and feedwater systems. Effects of initial core void distribution and other fluid conditions on overall LOCA phenomena with special interest on transient core cooling phenomena were investigated by comparing the present test results with those of RUN 926, a 200 % suction line break test with standard initial fluid conditions. The initial core outlet quality was changed between 5 % and 43 %. As conclusions, (1) the initial lower core flow and higher void fraction affected significantly the core cooling conditions and resulted in earlier and higher PCT. (2) The lower plenum flashing temporarily contributed to cool down the core. (3) Flashing of remained hot water in the feedwater line affected slightly the pressure response and delayed the actuation of LPCI by 11 seconds. (4) The whole core was completely cooled down within 104 seconds after the LPCI actuation in these large break tests. (author)

  3. New fossil insect order Permopsocida elucidates major radiation and evolution of suction feeding in hemimetabolous insects (Hexapoda: Acercaria).

    Science.gov (United States)

    Huang, Di-Ying; Bechly, Günter; Nel, Patricia; Engel, Michael S; Prokop, Jakub; Azar, Dany; Cai, Chen-Yang; van de Kamp, Thomas; Staniczek, Arnold H; Garrouste, Romain; Krogmann, Lars; Dos Santos Rolo, Tomy; Baumbach, Tilo; Ohlhoff, Rainer; Shmakov, Alexey S; Bourgoin, Thierry; Nel, André

    2016-03-10

    With nearly 100,000 species, the Acercaria (lice, plant lices, thrips, bugs) including number of economically important species is one of the most successful insect lineages. However, its phylogeny and evolution of mouthparts among other issues remain debatable. Here new methods of preparation permitted the comprehensive anatomical description of insect inclusions from mid-Cretaceous Burmese amber in astonishing detail. These "missing links" fossils, attributed to a new order Permopsocida, provide crucial evidence for reconstructing the phylogenetic relationships in the Acercaria, supporting its monophyly, and questioning the position of Psocodea as sister group of holometabolans in the most recent phylogenomic study. Permopsocida resolves as sister group of Thripida + Hemiptera and represents an evolutionary link documenting the transition from chewing to piercing mouthparts in relation to suction feeding. Identification of gut contents as angiosperm pollen documents an ecological role of Permopsocida as early pollen feeders with relatively unspecialized mouthparts. This group existed for 185 million years, but has never been diverse and was superseded by new pollenivorous pollinators during the Cretaceous co-evolution of insects and flowers. The key innovation of suction feeding with piercing mouthparts is identified as main event that triggered the huge post-Carboniferous radiation of hemipterans, and facilitated the spreading of pathogenic vectors.

  4. A Numerical Study on the Improvement of Suction Performance and Hydraulic Efficiency for a Mixed-Flow Pump Impeller

    Directory of Open Access Journals (Sweden)

    Sung Kim

    2014-01-01

    Full Text Available This paper describes a numerical study on the improvement of suction performance and hydraulic efficiency of a mixed-flow pump by impellers. The design of these impellers was optimized using a commercial CFD (computational fluid dynamics code and DOE (design of experiments. The design variables of meridional plane and vane plane development were defined for impeller design. In DOE, variables of inlet part were selected as main design variables in meridional plane, and incidence angle was selected in vane plane development. The verification of the experiment sets that were generated by 2k factorial was done by numerical analysis. The objective functions were defined as the NPSHre (net positive suction head required, total efficiency, and total head of the impellers. The importance of the geometric design variables was analyzed using 2k factorial designs. The interaction between the NPSHre and total efficiency, according to the meridional plane and incidence angle, was discussed by analyzing the 2k factorial design results. The performance of optimally designed model was verified by experiments and numerical analysis and the reliability of the model was retained by comparison of numerical analysis and comparative analysis with the reference model.

  5. Cytoskeleton and pericellular matrix organization of pure adult human keratinocytes cultured from suction-blister roof epidermis.

    Science.gov (United States)

    Kariniemi, A L; Lehto, V P; Vartio, T; Virtanen, I

    1982-12-01

    Pure adult human keratinocyte cultures were raised from suction-blister roof epidermis and cultured in MCDB-151 medium. In primary culture the epidermal cells rapidly adhered, spread and began to proliferate on collagen-coated growth substrata but not on uncoated plastic or glass substrata. A fibrillar keratin-specific fluorescence, showing a typical cell-cell arrangement, was seen in all cells in indirect immunofluorescence microscopy, whereas only some cells also showed vimentin-specific staining. A fine fibrillar fibronectin-specific surface staining was seen at the margin of attaching cells and in marginal cells of spreading cell islands, whereas no fluorescence could be seen in epidermal cells, with antibodies against type IV collagen or laminin. Interestingly, the marginal cells also showed intracellular fibronectin. The synthesis of fibronectin in epidermal cell cultures could also be revealed by metabolic labelling experiments with [35S]methionine. In contrast to primary cultures, subcultivated keratinocytes also adhered to uncoated plastic and glass substrata. After subcultivation, keratin and surface fibronectin distribution remained unaltered but after some subcultivations, most of the cells also showed fibrillar vimentin and expressed fibronectin intracellularly. The results show that the suction-blister method provides an easy way to obtain pure epidermal cell cultures without contaminating mesenchymal cells. Our results also suggest a direct role for fibronectin but not for collagen type IV or laminin in adhesion and spreading of epidermal cells in vitro.

  6. The impact analysis of the connecting pipe length and diameter on the operation of a piston hybrid power machine of positive displacement with gas suction capacity

    Science.gov (United States)

    Shcherba, V. E.; Grigoriev, A. V.; Averyanov, G. S.; Surikov, V. I.; Vedruchenko, V. P.; Galdin, N. S.; Trukhanova, D. A.

    2017-08-01

    The article analyzes the impact of the connecting liquid pipe length and diameter on consumables and power characteristics of the piston hybrid power machine with gas suction capacity. The following operating characteristics of the machine were constructed and analyzed: the average height of the liquid column in the jacket space; instantaneous velocity and height of the liquid column in the jacket space; the relative height of the liquid column in the jacket space; volumetric efficiency; indicator isothermal efficiency; flowrate in the pump section; relative pressure losses during suction; relative flowrate. The dependence of the instantaneous pressure in the work space and the suction space of the compressor section on the rotation angle of the crankshaft is determined for different values of the length and diameter of the connecting pipeline.

  7. Restaurants closed over Christmas

    CERN Multimedia

    2011-01-01

    The restaurants will be closed during the Christmas holiday period : please note that all three CERN Restaurants will be closed from 5 p.m. on Wednesday, 21 December until Wednesday, 4 January inclusive. The Restaurants will reopen on Thursday, 5 January 2012.

  8. Effects of radial diffuser hydraulic design on a double-suction centrifugal pump

    Science.gov (United States)

    Hou, H. C.; Zhang, Y. X.; Xu, C.; Zhang, J. Y.; Li, Z. L.

    2016-05-01

    In order to study effects of radial diffuser on hydraulic performance of crude oil pump, the steady CFD numerical method is applied and one large double-suction oil pump running in long-distance pipeline is considered. The research focuses on analysing the influence of its diffuser vane profile on hydraulic performance of oil pump. The four different types of cylindrical vane have been designed by in-house codes mainly including double arcs (DA), triple arcs (TA), equiangular spiral line (ES) and linear variable angle spiral line (LVS). During design process diffuser vane angles at inlet and outlet are tentatively given within a certain range and then the wrapping angle of the four types of diffuser vanes can be calculated automatically. Under the given inlet and outlet angles, the linear variable angle spiral line profile has the biggest wrapping angle and profile length which is good to delay channel diffusion but bring more friction hydraulic loss. Finally the vane camber line is thickened at the certain uniform thickness distribution and the 3D diffuser models are generated. The whole flow passage of oil pump with different types of diffusers under various flow rate conditions are numerically simulated based on RNG k-ɛ turbulent model and SIMPLEC algorithm. The numerical results show that different types of diffusers can bring about great difference on the hydraulic performance of oil pump, of which the ES profile diffuser with its proper setting angle shows the best hydraulic performance and its inner flow field is improved obviously. Compared with the head data from model sample, all designed diffusers can make a certain improvement on head characteristic. At the large flow rate conditions the hydraulic efficiency increases obviously and the best efficiency point shift to the large flow rate range. The ES profile diffuser embodies the better advantages on pump performance which can be explained theoretically that the diffuser actually acts as a diffusion

  9. [A comparison of degree of precision of auscultation, partial pressure of carbon dioxide in end-expiration, and transillumination technique in verifying accurate position of endotracheal tube].

    Science.gov (United States)

    Qi, Le; Liu, Rong; Tang, Enhui; Li, Shouchun; Jin, Jun; He, Xihuan; Lyu, Shaojun; Weng, Hao

    2015-10-01

    To evaluate the effect of auscultation, partial pressure of carbon dioxide in end-expiration (P(ET)CO2), transillumination technique to judge whether the endotracheal tube is misplaced into the esophagus. A blinded randomized controlled trial was conducted. Sixty patients with American Society of Anesthesiology (ASA) grade I - II undergoing endotracheal intubation in Fengxian Central Hospital admitted from September 2014 to February 2015 were enrolled. Two endotracheal tubes with the same size were respectively inserted into the trachea and esophagus for the same depth after general anesthesia by the same person. Two blinded anesthetists with different experience checked the tube position using three methods including auscultation, P(ET)CO2, and transillumination technique, respectively. The order of the tubes tested (trachea or esophagus) and the method used were randomized according to randomise numbers table. The experienced anesthetists conducted the test first, followed by an inexperienced anesthetist conducting the same methods. The numbers of right and wrong determinations with different methods by different anesthetists were recorded. Sixty patients underwent the procedures for 180 times, with intratracheal intubation for 90 times, and esophageal intubation for 90 times. It was shown that the results were not different in two groups [96.7% (174/180) vs. 92.2% (166/180), χ2 = 3.500, P = 0.057]. By using auscultation, the correct rate of experienced anesthetist was higher than that of inexperienced (95.0% vs. 78.3%, χ2 = 5.786, P = 0.013). Using P(ET)CO2, both anesthetists were correct in all cases, and the accuracy was 100%. Using transillumination, the experienced anesthetist was mistaken in 3 cases (accuracy was 95.0%), while the inexperienced mistook in 1 case (accuracy was 98.3%), and no significant difference was found between two groups χ2 = 0.500, P = 0.250). The correct rate of using transillumination was significantly higher than that of using

  10. [Comparison of endotracheal aspiration and mini-BAL culture results in the diagnosis of ventilator-associated pneumonia].

    Science.gov (United States)

    Artuk, Cumhur; Gül, Hanefi Cem; Mert, Gürkan; Karakaş, Ahmet; Bedir, Orhan; Eyigün, Can Polat

    2012-07-01

    The objective of this study was to compare the results of cultures obtained by mini-bronchoalveolar lavage (BAL) and endotracheal aspiration (ETA) techniques, used for rapid and accurate determination of pathogens causing ventilator-associated pneumonia (VAP) in intensive care units. Of the 92 patients on mechanical ventilation followed at the emergency intensive care unit of our hospital between June 2010 and June 2011, 30 (32.2%) patients were diagnosed as VAP and they were included in this study. VAP diagnosis were based on the clinical and radiological findings. Clinical pulmonary infection score (CPIS) of > 6 was accepted as the clinical criteria of VAP. Initially ETA samples were collected from the patients followed by mini-BAL sampling 15 minutes later, together with urine and two blood cultures. Microbiological evaluation and identification were performed by conventional methods and Phoenix 100 (BD Diagnostic Systems, ABD) automated system. In quantitative culture analysis, > 10.000 cfu/ml for BAL and > 100.000 cfu/ml for ETA were accepted as the positive result. The mean ages of VAP-developed (n= 30; 18 were male) and nondeveloped (n= 62; 39 were male) patients were 68.23 ± 16.19 and 52.16 ± 10.41 years, respectively, and the mean durations of mechanical ventilation were 29.57 ± 15.78 and 12.11 ± 6.01 days, respectively. Multivariate logistic regression analysis showed that older age (pVAP development. There was also a statistically significant difference in CPIS values between patients who developed VAP and not (6.8 ± 1.15 and 2.71 ± 1.06, respectively; pVAP diagnosis was found to be useful in patients on mechanical ventilation. In our study, a total of 16 strains (six A.baumannii, three P.aeruginosa, one K.pneumoniae, six S.aureus) were isolated from ETA cultures, while 34 strains (16 A.baumannii, six P.aeruginosa, four K.pneumoniae, two E.coli, six S.aureus) were isolated from mini-BAL cultures of 30 VAP patients. The contamination rate for ETA

  11. Effects of thoracic squeezing on airway secretion removal in mechanically ventilated patients

    Directory of Open Access Journals (Sweden)

    Farkhondeh Yousefnia-Darzi

    2016-01-01

    Conclusions: According to the study findings, endotracheal suction with thoracic squeezing on expiration helps airway secretion discharge more than suction alone in patients on mechanical ventilators and can be used as an effective method.

  12. Controlling the Flow past a Semicircular Airfoil at Zero Angle of Attack Using Slot Suction in One or Two Vortex Cells for Attaining Extremal Lift

    Science.gov (United States)

    Isaev, S. A.; Baranov, P. A.; Sudakov, A. G.; Popov, I. A.; Usachov, A. E.

    2017-12-01

    Calculations using multiblock computational technologies and a model of shear-stress transport modified with allowance for the curvature of streamlines in turbulent airflow were performed at a zero angle of attack for a semicircular airfoil containing one or two surface vortex cells with slot suction. The results showed evidence of stabilization of a nearly undetached flow and attainment of an extremal lift of C y = 5.2 and a lift-to-drag ratio of K = 24 with allowance for energy losses for suction in the vortex cells.

  13. Closed string field theory

    International Nuclear Information System (INIS)

    Strominger, A.

    1987-01-01

    A gauge invariant cubic action describing bosonic closed string field theory is constructed. The gauge symmetries include local spacetime diffeomorphisms. The conventional closed string spectrum and trilinear couplings are reproduced after spontaneous symmetry breaking. The action S is constructed from the usual ''open string'' field of ghost number minus one half. It is given by the associator of the string field product which is non-vanishing because of associativity anomalies. S does not describe open string propagation because open string states associate and can thereby be shifted away. A field theory of closed and open strings can be obtained by adding to S the cubic open string action. (orig.)

  14. Pipe closing device

    International Nuclear Information System (INIS)

    Klahn, F.C.; Nolan, J.H.; Wills, C.

    1979-01-01

    The closing device closes the upper end of a support tube for monitoring samples. It meshes with the upper connecting piece of the monitorung sample capsule, and loads the capsule within the bore of the support tube, so that it is fixed but can be released. The closing device consists of an interlocking component with a chamber and several ratchets which hang down. The interlocking component surrounds the actuating component for positioning the ratchets. The interlocking and actuating components are movable axially relative to each other. (DG) [de

  15. Effectiveness of evacuating combustible gases by two parallel expellers closely coupled at one end of a gas pipeline

    International Nuclear Information System (INIS)

    Hawryluk, A.; Botros, K.K.

    2008-01-01

    Expeller performance has been formulated in terms of its capability to create suction pressure at the throat. This formulation has been used to assess the effectiveness of evacuating combustible gases from a pipeline section from one end using dual expellers mounted in parallel on two adjacent blow-down stacks. A general formulation was derived to address any situation of asymmetry in the stack resistance, asymmetry in the expellers' power as well overall pipeline resistance to suction flow. Solutions of the closed-form equations were obtained and presented on performance graphs showing the ratio of the suction flow using dual expellers to that using either one in a single mode. It was found that there are conditions at which expelling with dual expellers exceed that of either expeller operating alone. It was also shown that when asymmetric expellers are used, where one expeller is more powerful than the other, the benefits of using two expellers is realized up to a limiting degree of asymmetry, beyond which the weaker expeller could be stalled and then reverse flow

  16. A simple method for accurate endotracheal placement of an intubation tube in Guinea pigs to assess lung injury following chemical exposure.

    Science.gov (United States)

    Nambiar, M P; Gordon, R K; Moran, T S; Richards, S M; Sciuto, A M

    2007-01-01

    ABSTRACT Guinea pigs are considered as the animal model of choice for toxicology and medical countermeasure studies against chemical warfare agents (CWAs) and toxic organophosphate pesticides because of the low levels of carboxylesterase compared to rats and mice. However, it is difficult to intubate guinea pigs without damaging the larynx to perform CWA inhalation experiments. We describe an easy technique of intubation of guinea pigs for accurate endotracheal placement of the intubation tube. The technique involves a speculum made by cutting the medium-size ear speculum in the midline leaving behind the intact circular connector to the otoscope. Guinea pigs were anesthetized with Telazol/meditomidine, the tongue was pulled using blunt forceps, and an otoscope attached with the specially prepared speculum was inserted gently. Insertion of the speculum raises the epiglottis and restrains the movements of vocal cord, which allows smooth insertion of the metal stylet-reinforced intubation tube. Accurate endotracheal placement of the intubation tube was achieved by measuring the length from the tracheal bifurcation to vocal cord and vocal cord to the upper front teeth. The average length of the trachea in guinea pigs (275 +/- 25 g) was 5.5 +/- 0.2 cm and the distance from the vocal cord to the front teeth was typically 3 cm. Coinciding an intubation tube marked at 6 cm with the upper front teeth accurately places the intubation tube 2.5 cm above the tracheal bifurcation. This simple method of intubation does not disturb the natural flora of the mouth and causes minimum laryngeal damage. It is rapid and reliable, and will be very valuable in inhalation exposure to chemical/biological warfare agents or toxic chemicals to assess respiratory toxicity and develop medical countermeasures.

  17. Quantitative culture of endotracheal aspirate and BAL fluid samples in the management of patients with ventilator-associated pneumonia: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ricardo de Amorim Corrêa

    2014-12-01

    Full Text Available OBJECTIVE: To compare 28-day mortality rates and clinical outcomes in ICU patients with ventilator-associated pneumonia according to the diagnostic strategy used. METHODS: This was a prospective randomized clinical trial. Of the 73 patients included in the study, 36 and 37 were randomized to undergo BAL or endotracheal aspiration (EA, respectively. Antibiotic therapy was based on guidelines and was adjusted according to the results of quantitative cultures. RESULTS: The 28-day mortality rate was similar in the BAL and EA groups (25.0% and 37.8%, respectively; p = 0.353. There were no differences between the groups regarding the duration of mechanical ventilation, antibiotic therapy, secondary complications, VAP recurrence, or length of ICU and hospital stay. Initial antibiotic therapy was deemed appropriate in 28 (77.8% and 30 (83.3% of the patients in the BAL and EA groups, respectively (p = 0.551. The 28-day mortality rate was not associated with the appropriateness of initial therapy in the BAL and EA groups (appropriate therapy: 35.7% vs. 43.3%; p = 0.553; and inappropriate therapy: 62.5% vs. 50.0%; p = 1.000. Previous use of antibiotics did not affect the culture yield in the EA or BAL group (p = 0.130 and p = 0.484, respectively. CONCLUSIONS: In the context of this study, the management of VAP patients, based on the results of quantitative endotracheal aspirate cultures, led to similar clinical outcomes to those obtained with the results of quantitative BAL fluid cultures.

  18. Reevaluating Musculoskeletal Linkages in Suction-Feeding Fishes with X-Ray Reconstruction of Moving Morphology (XROMM).

    Science.gov (United States)

    Camp, Ariel L; Brainerd, Elizabeth L

    2015-07-01

    Suction-feeding fishes encompass a vast diversity of morphologies and ecologies, but during feeding they all rely on musculoskeletal linkages and levers to transform the shortening of muscle into 3D expansion of the mouth cavity. To relate the shape of these skeletal elements to their function in expansion of the mouth, four-bar linkage models have been developed and widely used in studies of ecology, evolution, and development. However, we have lacked the ability to test the predictions of these 2D linkage models against the actual 3D motions of fishes' skulls. A new imaging method, X-ray Reconstruction of Moving Morphology (XROMM), now makes it possible to measure 3D skeletal motions relative to other bones within the head and relative to the fish's body, and thereby to examine directly the proposed linkages. We used XROMM to examine the opercular linkage, in which shortening of the levator operculi muscle is hypothesized to retract the operculum, and thereby the interoperculum and interoperculomandibular ligament to generate depression of the lower jaw about the quadratomandibular joint. XROMM animations of suction strikes in largemouth bass revealed that the operculum is indeed retracted relative to the suspensorium as the levator operculi muscle shortens and the jaw depresses. However, the four-bar model of this linkage overestimates the depression of the jaw by nearly a factor of two. Therefore, caution should be used in interpreting and applying the predictions of this linkage model. When we measured kinematics relative to the fish's body, we found that the operculum was relatively stable, whereas the suspensorium was elevated along with the neurocranium, pushing the quadratomandibular joint forward to produce depression of the jaw. Thus, it is the epaxial muscles elevating the neurocranium that powers depression of the jaw through the opercular linkage. However, the levator operculi muscle plays a crucial role in stabilizing the operculum to allow elevation

  19. Glioma tissue obtained by modern ultrasonic aspiration with a simple sterile suction trap for primary cell culture and pathological evaluation.

    Science.gov (United States)

    Schroeteler, Juliane; Reeker, Ralf; Suero Molina, Eric; Brokinkel, Benjamin; Holling, Markus; Grauer, Oliver M; Senner, Volker; Stummer, Walter; Ewelt, Christian

    2014-01-01

    Ultrasonic aspiration is widely used in the resection of brain tumors. Nevertheless, tumor tissue fragments obtained by ultrasonic aspiration are usually discarded. In this study, we demonstrate that these fragments are possible sources of material for histopathological study and tissue culture and compare their microscopic features and viability in tissue culture of cavitron ultrasonic surgical aspirator tissue fragments. Brain tumor tissue collected by ultrasonic aspiration (CUSA EXcel®; Integra Radionics Inc.) in a simple sterile suction trap during resection was processed for primary cell culture. Cell viability and immunohistological markers were measured by the WST-1 test, microscopy and immunofluorescent evaluation. Six gliomas are presented to demonstrate that these tissue fragments show good preservation of histological detail and tissue viability in culture. Utilization of this material may facilitate pathological interpretation by providing a more representative sample of tumor histology as well as an adequate and sterile biosource of material for tissue culture studies.

  20. Recirculation pump suction line 2.8% break integral test at ROSA-III with HPCS failure, RUN 984

    International Nuclear Information System (INIS)

    Suzuki, Mitsuhiro; Anoda, Yoshinari; Tasaka, Kanji; Kumamaru, Hiroshige; Nakamura, Hideo; Yonomoto, Taisuke; Murata, Hideo; Shiba, Masayoshi

    1984-06-01

    This report presents the experimental data of 2.8% suction line break test RUN 984 at ROSA-III, which was conducted as one of counterpart tests to FIST program sponsored by GE, EPRI and USNRC. The similarity study between the ROSA-III and FIST tests is on the way. The report also presents the information on the ROSA-III test facility, experiment results and the effects of the ADS flow rate and the MSIV trip level comparing with the previously conducted ROSA-III small break tests, RUNs 920 and 922. Major conclusions obtained are as follows. (1) Change of the MSIV trip level from L2 to L1 gives delay of MSIV closure and longer actuation of pressure control system in a small break LOCA. (2) Larger ADS flow gives faster depressurization rate and earlier ECCS actuation, which results in shorter fuel rod dryout period and lower PCT. (author)

  1. 75 FR 3731 - Proposed Issuance of a General NPDES Permit for Small Suction Dredging-Permit Number IDG-37-0000

    Science.gov (United States)

    2010-01-22

    ... System (NPDES) general permit to placer mining operations in Idaho for small suction dredges (intake... ENVIRONMENTAL PROTECTION AGENCY [FRL-9104-3] Proposed Issuance of a General NPDES Permit for Small... significant economic impact on a substantial number of small entities.'' EPA has concluded that NPDES general...

  2. A Giant Chelonioid Turtle from the Late Cretaceous of Morocco with a Suction Feeding Apparatus Unique among Tetrapods

    Science.gov (United States)

    Bardet, Nathalie; Jalil, Nour-Eddine; de Lapparent de Broin, France; Germain, Damien; Lambert, Olivier; Amaghzaz, Mbarek

    2013-01-01

    Background Secondary adaptation to aquatic life occurred independently in several amniote lineages, including reptiles during the Mesozoic and mammals during the Cenozoic. These evolutionary shifts to aquatic environments imply major morphological modifications, especially of the feeding apparatus. Mesozoic (250–65 Myr) marine reptiles, such as ichthyosaurs, plesiosaurs, mosasaurid squamates, crocodiles, and turtles, exhibit a wide range of adaptations to aquatic feeding and a broad overlap of their tooth morphospaces with those of Cenozoic marine mammals. However, despite these multiple feeding behavior convergences, suction feeding, though being a common feeding strategy in aquatic vertebrates and in marine mammals in particular, has been extremely rarely reported for Mesozoic marine reptiles. Principal Findings A relative of fossil protostegid and dermochelyoid sea turtles, Ocepechelon bouyai gen. et sp. nov. is a new giant chelonioid from the Late Maastrichtian (67 Myr) of Morocco exhibiting remarkable adaptations to marine life (among others, very dorsally and posteriorly located nostrils). The 70-cm-long skull of Ocepechelon not only makes it one of the largest marine turtles ever described, but also deviates significantly from typical turtle cranial morphology. It shares unique convergences with both syngnathid fishes (unique long tubular bony snout ending in a rounded and anteriorly directed mouth) and beaked whales (large size and elongated edentulous jaws). This striking anatomy suggests extreme adaptation for suction feeding unmatched among known turtles. Conclusion/Significance The feeding apparatus of Ocepechelon, a bony pipette-like snout, is unique among tetrapods. This new taxon exemplifies the successful systematic and ecological diversification of chelonioid turtles during the Late Cretaceous. This new evidence for a unique trophic specialization in turtles, along with the abundant marine vertebrate faunas associated to Ocepechelon in the Late

  3. A giant chelonioid turtle from the late Cretaceous of Morocco with a suction feeding apparatus unique among tetrapods.

    Directory of Open Access Journals (Sweden)

    Nathalie Bardet

    Full Text Available BACKGROUND: Secondary adaptation to aquatic life occurred independently in several amniote lineages, including reptiles during the Mesozoic and mammals during the Cenozoic. These evolutionary shifts to aquatic environments imply major morphological modifications, especially of the feeding apparatus. Mesozoic (250-65 Myr marine reptiles, such as ichthyosaurs, plesiosaurs, mosasaurid squamates, crocodiles, and turtles, exhibit a wide range of adaptations to aquatic feeding and a broad overlap of their tooth morphospaces with those of Cenozoic marine mammals. However, despite these multiple feeding behavior convergences, suction feeding, though being a common feeding strategy in aquatic vertebrates and in marine mammals in particular, has been extremely rarely reported for Mesozoic marine reptiles. PRINCIPAL FINDINGS: A relative of fossil protostegid and dermochelyoid sea turtles, Ocepechelon bouyai gen. et sp. nov. is a new giant chelonioid from the Late Maastrichtian (67 Myr of Morocco exhibiting remarkable adaptations to marine life (among others, very dorsally and posteriorly located nostrils. The 70-cm-long skull of Ocepechelon not only makes it one of the largest marine turtles ever described, but also deviates significantly from typical turtle cranial morphology. It shares unique convergences with both syngnathid fishes (unique long tubular bony snout ending in a rounded and anteriorly directed mouth and beaked whales (large size and elongated edentulous jaws. This striking anatomy suggests extreme adaptation for suction feeding unmatched among known turtles. CONCLUSION/SIGNIFICANCE: The feeding apparatus of Ocepechelon, a bony pipette-like snout, is unique among tetrapods. This new taxon exemplifies the successful systematic and ecological diversification of chelonioid turtles during the Late Cretaceous. This new evidence for a unique trophic specialization in turtles, along with the abundant marine vertebrate faunas associated to

  4. A giant chelonioid turtle from the late Cretaceous of Morocco with a suction feeding apparatus unique among tetrapods.

    Science.gov (United States)

    Bardet, Nathalie; Jalil, Nour-Eddine; de Lapparent de Broin, France; Germain, Damien; Lambert, Olivier; Amaghzaz, Mbarek

    2013-01-01

    Secondary adaptation to aquatic life occurred independently in several amniote lineages, including reptiles during the Mesozoic and mammals during the Cenozoic. These evolutionary shifts to aquatic environments imply major morphological modifications, especially of the feeding apparatus. Mesozoic (250-65 Myr) marine reptiles, such as ichthyosaurs, plesiosaurs, mosasaurid squamates, crocodiles, and turtles, exhibit a wide range of adaptations to aquatic feeding and a broad overlap of their tooth morphospaces with those of Cenozoic marine mammals. However, despite these multiple feeding behavior convergences, suction feeding, though being a common feeding strategy in aquatic vertebrates and in marine mammals in particular, has been extremely rarely reported for Mesozoic marine reptiles. A relative of fossil protostegid and dermochelyoid sea turtles, Ocepechelon bouyai gen. et sp. nov. is a new giant chelonioid from the Late Maastrichtian (67 Myr) of Morocco exhibiting remarkable adaptations to marine life (among others, very dorsally and posteriorly located nostrils). The 70-cm-long skull of Ocepechelon not only makes it one of the largest marine turtles ever described, but also deviates significantly from typical turtle cranial morphology. It shares unique convergences with both syngnathid fishes (unique long tubular bony snout ending in a rounded and anteriorly directed mouth) and beaked whales (large size and elongated edentulous jaws). This striking anatomy suggests extreme adaptation for suction feeding unmatched among known turtles. The feeding apparatus of Ocepechelon, a bony pipette-like snout, is unique among tetrapods. This new taxon exemplifies the successful systematic and ecological diversification of chelonioid turtles during the Late Cretaceous. This new evidence for a unique trophic specialization in turtles, along with the abundant marine vertebrate faunas associated to Ocepechelon in the Late Maastrichtian phosphatic beds of Morocco, further

  5. Instability and Transition of Flow at, and Near, an Attachment-line - Including Control by Surface Suction

    Science.gov (United States)

    Smith, A.

    1996-01-01

    Advances in aviation during and following the Second World War led to an enormous improvement in the performance of aircraft. The push for enhanced efficiency brought cruise speeds into the transonic range, where the associated drag rise due to the appearance of shock-waves became a limiting factor. Wing sweep was adopted to delay the onset of this drag rise, but with this development came several new and unforeseen problems. Preliminary theoretical work assumed that the boundary layer transition characteristics of a swept wing would be subject to the independence principle, so the chordwise transition position could be predicted from two-dimensional work Gas turbine development has now reached a point where additional increases in efficiency are both difficult and expensive to achieve. Consequently, aircraft manufacturers are looking elsewhere for ways to reduce Direct Operating Costs (DOC's) or increase military performance. The attention of industry is currently focusing on Hybrid Laminar Flow Control (HLFC) as a possible method of reducing DOC's for civil aircraft. Following this study and discussions with NASA Langley and Boeing a different series of questions have been addressed in the present work. There are five areas of interest: Relaminarisation of the attachment-line boundary layer when the value of R exceeds 600. The effects of large suction levels on transition in the attachment-line boundary layer (ie critical oversuction). The transition characteristics of a relaminarised attachment-line flow which encounters a non-porous surface. The effect of attachment-line suction on the spanwise propagation of gross disturbances emanating from the wing-fuselage junction. The attachment-line transition caused by surface blowing.

  6. Suckermouth armored catfish resolve the paradox of simultaneous respiration and suction attachment: a kinematic study of Pterygoplichthys disjunctivus.

    Science.gov (United States)

    Geerinckx, Tom; Herrel, Anthony; Adriaens, Dominique

    2011-03-01

    Suckermouth armored catfishes (Loricariidae) use their suckermouth for inspiration, feeding, and attachment to substrates. The sucker consists of a pre-valvular cavity, formed by a modified lip disc, and is separated from the larger post-valvular buccal cavity by a muscular oral valve. The combination of respiration and suction attachment seems paradoxal, as a properly functioning suction device would need a sucker without leakage (yet inspiration must occur via the sucker), and continuous subambient pressure in the sucker cavity (even during expiratory mouth floor elevation). In the loricariid Pterygoplichthys disjunctivus, the anatomy of the suckermouth structures was examined, and a kinematic analysis was performed to acquire insights into how respiration and attachment are combined. High-speed external and X-ray recordings show that suckermouth attachment influences respiratory parameters such as decreasing excursion amplitudes of mouth floor elements, and the way water enters the mouth via furrows in the lip disc. Respiration, however, continues during attachment and is not blocked. Our data show that the muscular oral valve actively separates the post-valvular buccal cavity from the pre-valvular sucker cavity. Volume changes of this pre-valvular cavity are opposite to those of the post-valvular cavity and assure sucker function even during expiration. These volume changes are caused by movements of the lower lip, the lower jaws, and the oral valve. The lateral inflow furrow openings, controlled by the maxillary barbels, can occur unilaterally. Morphological and kinematic data also show that the opercle is anatomically and functionally decoupled from the gill opening. Copyright © 2010 Wiley-Liss, Inc., A Wiley Company.

  7. Minding the close relationship.

    Science.gov (United States)

    Harvey, J H; Omarzu, J

    1997-01-01

    In this theoretical analysis, we argue that a process referred to as minding is essential for a couple to feel mutually close and satisfied in a close relationship over a long period Minding represents a package of mutual self-disclosure, other forms of goal-oriented behavior aimed at facilitating the relationship, and attributions about self's and other's motivations, intentions, and Mort in the relationship. Self-disclosure and attribution activities in minding are aimed at getting to know the other, trying to understand the other's motivations and deeper disposition as they pertain to the relationship, and showing respect and acceptance for knowledge gained about other. We link the concept of minding to other major ideas and literatures about how couples achieve closeness: self-disclosure and social penetration, intimacy, empathy and empathic accuracy, and love and self-expansion. We argue that the minding process articulated here has not previously been delineated and that it is a useful composite notion about essential steps in bonding among humans. We also argue that the minding concept stretches our understanding of the interface of attribution and close relationships. We present research possibilities and implications and consider possible alternative positions and counter arguments about the merits of the minding idea for close relationship satisfaction.

  8. Close binary stars

    International Nuclear Information System (INIS)

    Larsson-Leander, G.

    1979-01-01

    Studies of close binary stars are being persued more vigorously than ever, with about 3000 research papers and notes pertaining to the field being published during the triennium 1976-1978. Many major advances and spectacular discoveries were made, mostly due to increased observational efficiency and precision, especially in the X-ray, radio, and ultraviolet domains. Progress reports are presented in the following areas: observational techniques, methods of analyzing light curves, observational data, physical data, structure and models of close binaries, statistical investigations, and origin and evolution of close binaries. Reports from the Coordinates Programs Committee, the Committee for Extra-Terrestrial Observations and the Working Group on RS CVn binaries are included. (Auth./C.F.)

  9. Close-loop Dynamic Stall Control on a Pitching Airfoil

    Science.gov (United States)

    Giles, Ian; Corke, Thomas

    2017-11-01

    A closed-loop control scheme utilizing a plasma actuator to control dynamic stall is presented. The plasma actuator is located at the leading-edge of a pitching airfoil. It initially pulses at an unsteady frequency that perturbs the boundary layer flow over the suction surface of the airfoil. As the airfoil approaches and enters stall, the amplification of the unsteady disturbance is detected by an onboard pressure sensor also located near the leading edge. Once detected, the actuator is switched to a higher voltage control state that in static airfoil experiments would reattach the flow. The threshold level of the detection is a parameter in the control scheme. Three stall regimes were examined: light, medium, and deep stall, that were defined by their stall penetration angles. The results showed that in general, the closed-loop control scheme was effective at controlling dynamic stall. The cycle-integrated lift improved in all cases, and increased by as much as 15% at the lowest stall penetration angle. As important, the cycle-integrated aerodynamic damping coefficient also increased in all cases, and was made to be positive at the light stall regime where it traditionally is negative. The latter is important in applications where negative damping can lead to stall flutter.

  10. NRC closing remarks

    International Nuclear Information System (INIS)

    Coffman, F.

    1994-01-01

    This section contains the edited transcript of the NRC closing remarks made by Mr. Franklin Coffman (Chief, Human Factors Branch, Office of Nuclear Regulatory Research) and Dr. Cecil Thomas (Deputy Director, Division of Reactor Controls and Human Factors, Office of Nuclear Reactor Regulation). This editing consisted of minimal editing to correct grammar and remove extraneous references to microphone volume, etc

  11. Hands-Off Time for Endotracheal Intubation during CPR Is Not Altered by the Use of the C-MAC Video-Laryngoscope Compared to Conventional Direct Laryngoscopy. A Randomized Crossover Manikin Study.

    Directory of Open Access Journals (Sweden)

    Philipp Schuerner

    Full Text Available Sufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR. Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success. Therefore, we aimed to compare hands-off time and intubation success of direct laryngoscopy with videolaryngoscopy (C-MAC, Karl Storz, Tuttlingen, Germany in a randomized, cross-over manikin study.Twenty-six anesthesia residents and twelve anesthesia consultants of the University Hospital Zurich were recruited through a voluntary enrolment. All participants performed endotracheal intubation using direct laryngoscopy and C-MAC in a random order during ongoing chest compressions. Participants were strictly advised to stop chest compression only if necessary.The median hands-off time was 1.9 seconds in direct laryngoscopy, compared to 3 seconds in the C-MAC group. In direct laryngoscopy 39 intubation attempts were recorded, resulting in an overall first intubation attempt success rate of 97%, compared to 38 intubation attempts and 100% overall first intubation attempt success rate in the C-MAC group.As a conclusion, the results of our manikin-study demonstrate that video laryngoscopes might not be beneficial compared to conventional, direct laryngoscopy in easily accessible airways under CPR conditions and in experienced hands. The benefits of video laryngoscopes are of course more distinct in overcoming difficult airways, as it converts a potential "blind intubation" into an intubation under visual control.

  12. Hands-Off Time for Endotracheal Intubation during CPR Is Not Altered by the Use of the C-MAC Video-Laryngoscope Compared to Conventional Direct Laryngoscopy. A Randomized Crossover Manikin Study.

    Science.gov (United States)

    Schuerner, Philipp; Grande, Bastian; Piegeler, Tobias; Schlaepfer, Martin; Saager, Leif; Hutcherson, Matthew T; Spahn, Donat R; Ruetzler, Kurt

    2016-01-01

    Sufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR). Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success. Therefore, we aimed to compare hands-off time and intubation success of direct laryngoscopy with videolaryngoscopy (C-MAC, Karl Storz, Tuttlingen, Germany) in a randomized, cross-over manikin study. Twenty-six anesthesia residents and twelve anesthesia consultants of the University Hospital Zurich were recruited through a voluntary enrolment. All participants performed endotracheal intubation using direct laryngoscopy and C-MAC in a random order during ongoing chest compressions. Participants were strictly advised to stop chest compression only if necessary. The median hands-off time was 1.9 seconds in direct laryngoscopy, compared to 3 seconds in the C-MAC group. In direct laryngoscopy 39 intubation attempts were recorded, resulting in an overall first intubation attempt success rate of 97%, compared to 38 intubation attempts and 100% overall first intubation attempt success rate in the C-MAC group. As a conclusion, the results of our manikin-study demonstrate that video laryngoscopes might not be beneficial compared to conventional, direct laryngoscopy in easily accessible airways under CPR conditions and in experienced hands. The benefits of video laryngoscopes are of course more distinct in overcoming difficult airways, as it converts a potential "blind intubation" into an intubation under visual control.

  13. Closing the loop.

    Science.gov (United States)

    Dassau, E; Atlas, E; Phillip, M

    2010-02-01

    The dream of closing the loop is actually the dream of creating an artificial pancreas and freeing the patients from being involved with the care of their own diabetes. Insulin-dependent diabetes (type 1) is a chronic incurable disease which requires constant therapy without the possibility of any 'holidays' or insulin-free days. It means that patients have to inject insulin every day of their life, several times per day, and in order to do it safely they also have to measure their blood glucose levels several times per day. Patients need to plan their meals, their physical activities and their insulin regime - there is only very small room for spontaneous activities. This is why the desire for an artificial pancreas is so strong despite the fact that it will not cure the diabetic patients. Attempts to develop a closed-loop system started in the 1960s but never got to a clinical practical stage of development. In recent years the availability of continuous glucose sensors revived those efforts and stimulated the clinician and researchers to believe that closing the loop might be possible nowadays. Many papers have been published over the years describing several different ideas on how to close the loop. Most of the suggested systems have a sensing arm that measures the blood glucose repeatedly or continuously, an insulin delivery arm that injects insulin upon command and a computer that makes the decisions of when and how much insulin to deliver. The differences between the various published systems in the literature are mainly in their control algorithms. However, there are also differences related to the method and site of glucose measurement and insulin delivery. SC glucose measurements and insulin delivery are the most studied option but other combinations of insulin measurements and glucose delivery including intravascular and intraperitoneal (IP) are explored. We tried to select recent publications that we believe had influenced and inspired people interested

  14. Endotracheal intubation with airtraq® versus storz® videolaryngoscope in children younger than two years - a randomized pilot-study

    Directory of Open Access Journals (Sweden)

    Sørensen Martin

    2012-04-01

    Full Text Available Abstract Background New laryngoscopes have become available for use in small children. The aim of the study was to compare the Storz® videolaryngoscope (SVL to the Airtraq® Optical laryngoscope (AOL for tracheal intubation in children younger than two years of age who had a normal airway assessment. Our hypothesis was that the SVL would have a better success rate than the AOL. Methods Ten children aged 2 years or younger scheduled for elective cleft lip/palate surgery were included. The anesthesia was standardized and a Cormack-Lehane (CL-score was obtained using a Macintosh laryngoscope. After randomization CL-score and endotracheal tube positioning in front of the glottis was performed with one device, followed by the same procedure and intubation with the other device. The video-feed was recorded along with real-time audio. The primary endpoint was the success rate, defined as intubation in first attempt. Secondary endpoints were the time from start of laryngoscopy to CL-score, tube positioning in front of the glottis, and intubation. Results Two intubation attempts were needed in two of five patients randomized to the SVL. The difference in time (SVL vs. AOL to CL-score was 4.5 sec (p = 0.0449. The difference in time (SVL vs. AOL to tube positioning was 11.6 sec (p = 0.0015. Time to intubation was 29.0 sec for SVL and 15.8 sec for AOL. Conclusion No difference in the success rate of endotracheal intubation could be established in this ten patient sample of children younger than two years with a normal airway assessment scheduled for elective cleft lip/palate surgery. However, the Airtraq® Optical videolaryngoscope showed a number of time related advantages over the Storz® videolaryngoscope. Because of the small sample size a larger trial is needed to confirm these findings. Both devices were considered safe in all intubations. Trial registration ClinicalTrials.gov; Identifier NCT01090726.

  15. Closing the gasoline system

    International Nuclear Information System (INIS)

    Hutcheson, R.C.

    1992-01-01

    In this paper, a representative of the Oil Companies' European Organization for Environmental and Health Protection (CONCAWE), argues the advantages of closing the gasoline system. Because this decouples the product from the environment, health risks and environmental damage are reduced. It is also more effective than changing the composition of gasoline because it offers better cost effectiveness, energy efficiency and the minimization of carbon dioxide release into the environment. However it will take time and political will to change until all European vehicles are fitted with three way catalysts and carbon canisters: control systems to monitor such systems will also need to be set up. However CONCAWE still recommends its adoption. (UK)

  16. Closing the fuel cycle

    International Nuclear Information System (INIS)

    Wolfe, B.; Judson, B.F.

    1984-01-01

    The possibilities for closing the fuel cycle in today's nuclear climate in the US are compared with those envisioned in 1977. Reprocessing, the fast breeder reactor program, and the uranium supply are discussed. The conclusion drawn is that the nuclear world is less healthy and less stable than the one previously envisioned and that the major task before the international nuclear community is to develop technologies, institutions, and accepted procedures that will allow to economically provide the huge store of energy from reprocessing and the breeder that it appears the world will desperately need

  17. Negative Suction Drain Through a Mini Periareolar Incision for the Treatment of Lactational Breast Abscess Shortens Hospital Stay and Increases Breastfeeding Rates.

    Science.gov (United States)

    Wei, Jinli; Zhang, Jiaxin; Fu, Deyuan

    2016-06-01

    Although breast abscess is a serious uncommon complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments. We reported a novel way of applying negative suction drain through a mini periareolar incision. We retrospectively analyzed and compared the clinical characteristics of 62 patients with lactational breast abscess in our department from August 2012 to April 2015. Thirty-two patients went through traditional incision and drainage (Group A) and 30 patients were placed on negative suction drain through mini periareolar incision (Group B). There is no significant difference between the two groups in terms of age, white blood cell (WBC) count, size of the abscess cavity, and positive rate of Staphylococcus aureus (SA) or methicillin-resistant Staphylococcus aureus (MRSA). Patients in Group B had a shorter hospitalized stay (p = 0.003) and had a higher rate of continuation of breastfeeding (p breast abscess and maintaining breastfeeding.

  18. Unsteady three dimensional flow of Casson liquid film over a porous stretching sheet in the presence of uniform transverse magnetic field and suction/injection

    Energy Technology Data Exchange (ETDEWEB)

    Maity, S., E-mail: susantamaiti@gmail.com [Department of Mathematics, National Institute of Technology, Arunachal Pradesh, Yupia, Papumpare 791112 (India); Singh, S.K. [Engineering Mechanics Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Bangalore 560064 (India); Kumar, A.V. [Department of Mathematics, National Institute of Technology, Arunachal Pradesh, Yupia, Papumpare 791112 (India)

    2016-12-01

    Three dimensional flow of thin Casson liquid film over a porous unsteady stretching sheet is investigated under assumption of initial uniform film thickness. The effects of the uniform transverse magnetic field, suction and injection are also considered for investigation. The nonlinear governing set of equations and film evolution equation are solved analytically by using singular perturbation technique. It is found that the film thickness decreases with the increasing values of the Casson parameter. The Hartmann number and porosity parameter resist the film thinning process. It is also observed that the film thickness increases with the increasing values of the suction velocity whereas it decreases for increasing values of the injection velocity at the stretching surface.

  19. Effect of thermal radiation and suction on convective heat transfer of nanofluid along a wedge in the presence of heat generation/absorption

    Energy Technology Data Exchange (ETDEWEB)

    Kasmani, Ruhaila Md; Bhuvaneswari, M. [Centre for Foundation Studies in Science, University of Malaya, 50603 Kuala Lumpur (Malaysia); Sivasankaran, S.; Siri, Zailan [Institute of Mathematical Science, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2015-10-22

    An analysis is presented to find the effects of thermal radiation and heat generation/absorption on convection heat transfer of nanofluid past a wedge in the presence of wall suction. The governing partial differential equations are transformed into a system of ordinary differential equations using similarity transformation. The resulting system is solved numerically using a fourth-order Runge–Kutta method with shooting technique. Numerical computations are carried out for different values of dimensionless parameters to predict the effects of wedge angle, thermophoresis, Brownian motion, heat generation/absorption, thermal radiation and suction. It is found that the temperature increases significantly when the value of the heat generation/absorption parameter increases. But the opposite observation is found for the effect of thermal radiation.

  20. Comparison in processing routes by copper mold casting injection and suction in the Cu46Zr42Al7Y5 vitreous alloy

    International Nuclear Information System (INIS)

    Batalha, W.; Aliaga, L.C.R.; Bolfarini, C.; Botta, W.J.; Kiminami, C.S.

    2014-01-01

    To expand the application of glassy metals, the development of processing routes and compositions that allow the production of parts with dimensions of millimeters or even centimeters, is very important. The present work aims the contribution to the technological development of processing routes for the production of Cu-based bulk metallic glasses. Wedge-shaped samples of Cu 46 Zr 42 Al 7 Y 5 (atom percent) chemical composition were processed using copper mold casting by suction and injection. Characterization was made combining scanning electron microscopy, x-ray diffraction and differential scanning calorimetry. The critical amorphous thickness obtained by those two different routes was carefully observed. The suction route allow obtaining the best results with critical amorphous thickness about 8 mm. This result was analyzed considering the different extrinsic parameters to the glass forming ability of the alloy. (author)

  1. Some Exact Solutions of Boundary Layer Flows along a Vertical Plate with Buoyancy Forces Combined with Lorentz Forces under Uniform Suction

    Directory of Open Access Journals (Sweden)

    Asterios Pantokratoras

    2008-01-01

    Full Text Available Exact analytical solutions of boundary layer flows along a vertical porous plate with uniform suction are derived and presented in this paper. The solutions concern the Blasius, Sakiadis, and Blasius-Sakiadis flows with buoyancy forces combined with either MHD Lorentz or EMHD Lorentz forces. In addition, some exact solutions are presented specifically for water in the temperature range of 0∘C≤≤8∘C, where water density is nearly parabolic. Except for their use as benchmarking means for testing the numerical solution of the Navier-Stokes equations, the presented exact solutions with EMHD forces have use in flow separation control in aeronautics and hydronautics, whereas the MHD results have applications in process metallurgy and fusion technology. These analytical solutions are valid for flows with strong suction.

  2. The radiation and variable viscosity effects on electrically conducting fluid over a vertically moving plate subjected to suction and heat flux

    Energy Technology Data Exchange (ETDEWEB)

    Malekzadeh, P., E-mail: malekzadeh@pgu.ac.i [Department of Mechanical Engineering, Persian Gulf University, Bushehr 75168 (Iran, Islamic Republic of); Center of Excellence for Computational Mechanics, Shiraz University, Shiraz (Iran, Islamic Republic of); Moghimi, M.A. [Department of Mechanical Engineering, School of Engineering, Shaid Bahonar University, Kerman (Iran, Islamic Republic of); Nickaeen, M. [K.N. Toosi University of Technology, Tehran (Iran, Islamic Republic of)

    2011-05-15

    Research highlights: {yields} A new application of the differential quadrature method in thermo-fluid fields. {yields} Moving vertical plate with suction and heat flux is considered. {yields} Fluid with variable viscosity subjected to thermal radiation is studied. -- Abstract: In this paper, firstly, the applicability of the differential quadrature method (DQM) as an efficient and accurate numerical method for solving the problem of variable viscosity and thermally radiative unsteady magneto-hydrodynamic (MHD) flow over a moving vertical plate with suction and heat flux is investigated. The spatial as well as the temporal domains are discretized using the DQM. The fast rate of convergence of the method is demonstrated and for the cases that a solution is available, comparison is done. Then, effects of the temperature dependence of viscosity and different fluid parameters on the velocity and temperature of transient MHD flow subjected to the above mentioned boundary condition are studied.

  3. A similar solution for an unsteady free convection flow past an impulsively started vertical plate with mass transfer and suction or injection

    International Nuclear Information System (INIS)

    Sattar, M.A.

    1990-12-01

    A similar solution for the flow past a vertical plate started impulsively in its own plane in a viscous incompressible fluid is presented on taking into account the effects of variable suction and/or injection and mass transfer. To solve the momentum, energy and concentration equations, a time dependent length scale is introduced, which leads to the driving parameters γ(=G r /R σ 2 ) and γ*(=G r */R σ 2 ), where G r and G r * are respectively the Grashof and modified Grashof numbers while R σ is the Reynolds number. The resulting locally similar momentum equation is then solved by the method of superposition. The effects of the parameters and that of suction/injection on the flow and on the wall shear-stress of the plate are shown graphically for different values of Schmidt number and transpiration parameter. (author). 24 refs, 11 figs

  4. Closed Strings From Nothing

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, Albion

    2001-07-25

    We study the physics of open strings in bosonic and type II string theories in the presence of unstable D-branes. When the potential energy of the open string tachyon is at its minimum, Sen has argued that only closed strings remain in the perturbative spectrum. We explore the scenario of Yi and of Bergman, Hori and Yi, who argue that the open string degrees of freedom are strongly coupled and disappear through confinement. We discuss arguments using open string field theory and worldsheet boundary RG flows, which seem to indicate otherwise. We then describe a solitonic excitation of the open string tachyon and gauge field with the charge and tension of a fundamental closed string. This requires a double scaling limit where the tachyon is taken to its minimal value and the electric field is taken to its maximum value. The resulting flux tube has an unconstrained spatial profile; and for large fundamental string charge, it appears to have light, weakly coupled open strings living in the core. We argue that the flux tube acquires a size or order {alpha}' through sigma model and string coupling effects; and we argue that confinement effects make the light degrees of freedom heavy and strongly interacting.

  5. Closed Strings From Nothing

    International Nuclear Information System (INIS)

    Lawrence, Albion

    2001-01-01

    We study the physics of open strings in bosonic and type II string theories in the presence of unstable D-branes. When the potential energy of the open string tachyon is at its minimum, Sen has argued that only closed strings remain in the perturbative spectrum. We explore the scenario of Yi and of Bergman, Hori and Yi, who argue that the open string degrees of freedom are strongly coupled and disappear through confinement. We discuss arguments using open string field theory and worldsheet boundary RG flows, which seem to indicate otherwise. We then describe a solitonic excitation of the open string tachyon and gauge field with the charge and tension of a fundamental closed string. This requires a double scaling limit where the tachyon is taken to its minimal value and the electric field is taken to its maximum value. The resulting flux tube has an unconstrained spatial profile; and for large fundamental string charge, it appears to have light, weakly coupled open strings living in the core. We argue that the flux tube acquires a size or order α' through sigma model and string coupling effects; and we argue that confinement effects make the light degrees of freedom heavy and strongly interacting

  6. The effects of preemptive pregabalin on attenuation of stress response to endotracheal intubation and opioid- sparing effect in patients undergoing off-pump coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Ayya Syama Sundar

    2012-01-01

    Full Text Available The clinical study was designed to evaluate and compare single preoperative dose of pregabalin to a placebo regarding hemodynamic responses to laryngoscopy and endotracheal intubation, to assess perioperative fentanyl requirement and any side-effects. It was a randomized, double-blind, placebo-controlled, parallel assignment, efficacy study. The study was done at a tertiary university hospital. This study was a comparison between two groups of 30 adult patients scheduled for elective off pump coronary artery bypass surgery. In the control group, the patients were given placebo capsules, and in the pregabalin group, the patients were given pregabalin 150 mg capsule orally 1 h before surgery. The patients were compared for hemodynamic changes before the start of the surgery, after induction, 1, 3, and 5 min after intubation. Additionally, fentanyl requirement during surgery and the first postoperative day was also compared. The present study shows that a single oral dose of 150 mg pregabalin given 1 h before surgery attenuated the pressor response to tracheal intubation in adults, but the drug did not show any effect on perioperative opioid consumption and was devoid of side-effects in the given dose.

  7. Direct analysis of bacterial viability in endotracheal tube biofilm from a pig model of methicillin-resistant Staphylococcus aureus pneumonia following antimicrobial therapy.

    Science.gov (United States)

    Fernández-Barat, Laia; Li Bassi, Gianluigi; Ferrer, Miquel; Bosch, Anna; Calvo, Maria; Vila, Jordi; Gabarrús, Albert; Martínez-Olondris, Pilar; Rigol, Montse; Esperatti, Mariano; Luque, Néstor; Torres, Antoni

    2012-07-01

    Confocal laser scanning microscopy (CLSM) helps to observe the biofilms formed in the endotracheal tube (ETT) of ventilated subjects and to determine its structure and bacterial viability using specific dyes. We compared the effect of three different treatments (placebo, linezolid, and vancomycin) on the bacterial biofilm viability captured by CLSM. Eight pigs with pneumonia induced by methicillin-resistant Staphylococcus aureus (MRSA) were ventilated up to 96 h and treated with linezolid, vancomycin, or placebo (controls). ETT images were microscopically examined after staining with the live/dead(®) BacLight(™) Kit (Invitrogen, Barcelona, Spain) with a confocal laser scanning microscope. We analyzed 127 images obtained by CLSM. The median ratio of live/dead bacteria was 0.51, 0.74, and 1 for the linezolid, vancomycin, and control groups, respectively (P = 0.002 for the three groups); this ratio was significantly lower for the linezolid group, compared with the control group (P = 0.001). Images showed bacterial biofilm attached and non-attached to the ETT surface but growing within secretions accumulated inside ETT. Systemic treatment with linezolid is associated with a higher proportion of dead bacteria in the ETT biofilm of animals with MRSA pneumonia. Biofilm clusters not necessarily attach to the ETT surface. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  8. A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

    Directory of Open Access Journals (Sweden)

    Tomasz Gaszynski

    2014-01-01

    Full Text Available Introduction. The use of videolaryngoscopes is recommended for morbidly obese patients. The aim of the study was to evaluate the Levitan FPS optical stylet (Levitan vs Lafy-Flex videolaryngoscope (Lary-Flex in a group of MO patients. Methods. Seventy-nine MO (BMI>40 kg m−2 patients scheduled for bariatric surgery were included in the study and randomly allocated to the Levitan FPS or Lary-Flex group. The primary endpoint was time to intubation and evaluation laryngoscopic of glottic view. Anesthesiologists were asked to evaluate the glottic view first under direct laryngoscopy using the videolaryngoscope as a standard laryngoscope (monitor display was excluded from use and then using devices. The secondary endpoint was the cardiovascular response to intubation and the participant’s evaluation of such devices. Results. The time to intubation was 8.572.66 sec. versus 5.790.2 sec. for Levitan and Lary-Flex, respectively (P1 under direct laryngoscopy, the study devices improved CL grade to 1. The Levitan FPS produced a greater cardiovascular response than the Lary-Flex videolaryngoscope. Conclusion. The Lary-Flex videolaryngoscope and the Levitan FPS optical stylet improve the laryngeal visualization in morbidly obese patients, allowing for fast endotracheal intubation, but Lary-Flex produces less cardiovascular response to intubation attempt.

  9. A comparison of performance of endotracheal intubation using the Levitan FPS optical stylet or Lary-Flex videolaryngoscope in morbidly obese patients.

    Science.gov (United States)

    Gaszynski, Tomasz; Pietrzyk, Monika; Szewczyk, Tomasz; Gaszynska, Ewelina

    2014-01-01

    The use of videolaryngoscopes is recommended for morbidly obese patients. The aim of the study was to evaluate the Levitan FPS optical stylet (Levitan) vs Lafy-Flex videolaryngoscope (Lary-Flex) in a group of MO patients. Seventy-nine MO (BMI > 40 kg m(-2)) patients scheduled for bariatric surgery were included in the study and randomly allocated to the Levitan FPS or Lary-Flex group. The primary endpoint was time to intubation and evaluation laryngoscopic of glottic view. Anesthesiologists were asked to evaluate the glottic view first under direct laryngoscopy using the videolaryngoscope as a standard laryngoscope (monitor display was excluded from use) and then using devices. The secondary endpoint was the cardiovascular response to intubation and the participant's evaluation of such devices. The time to intubation was 8.572.66 sec. versus 5.790.2 sec. for Levitan and Lary-Flex, respectively (P 1 under direct laryngoscopy, the study devices improved CL grade to 1. The Levitan FPS produced a greater cardiovascular response than the Lary-Flex videolaryngoscope. The Lary-Flex videolaryngoscope and the Levitan FPS optical stylet improve the laryngeal visualization in morbidly obese patients, allowing for fast endotracheal intubation, but Lary-Flex produces less cardiovascular response to intubation attempt.

  10. A Comparative Study of Cuffed Pharyngeal Tube (CPR with Endotracheal Tube in Airway Management and Ventilation of Spontaneously Breathing Patients Undergoing General Anesthesia

    Directory of Open Access Journals (Sweden)

    F Mir Mohammad Sadeghi

    2002-09-01

    Full Text Available Background: Cuffed pharyngeal tube is a device designed for ventilation of anesthetized patients. CPT has advantages over face mask including: maintaining of face mask can be difficult and boring after several minutes and mobility of the practitioner is reduced due to involvement of hands. Mask pressure can cause soft tissue and nerve damage around the nose. Anesthetic gas leakage from the mask adds to the operation room pollution. In difficult intubation CPT can be life-saving. Materials and Methods: In our study CPT was compared with endotracheal tube (ET in anesthetized patients. A scoring system for evaluating ventilation of patients was designed using symmetric chest wall motion during ventilation with anesthesia bag and sensing lung compliance through it, auscultation of breathing sounds, oscilation of bag with breathing and peripheral oxygen saturation by pulse oxymetry. Respiratory complications (pulmonary aspiration, Iaryngospasm and bronchospasm, nausea and vomiting were looked for during anesthesia. Results: The results showed that CPT was successful as ET in ventilation of spontaneously breathing patients and incidence of respiratory complications with CPT was no more than ET. Airway resistance was significantly greater with CPT than ET (P<0.05. Patients with ET had significantly greater incidence of sore throat than with CPT (P<0.05. Conclusion: Thus we concluded that CPT can be used for ventilation of anesthetized patients not predisposed to pulmonary aspiration and whose peak airway pressure does not exceed 20-25 CmH2O.

  11. The incidence of ventilator-associated pneumonia using the PneuX System with or without elective endotracheal tube exchange: A pilot study

    Directory of Open Access Journals (Sweden)

    Blunt Mark

    2011-03-01

    Full Text Available Abstract Background The PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. We aimed to determine the incidence of ventilator-associated pneumonia (VAP in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System. Findings In this retrospective observational study, data was collected from 53 sequential patients. Nine (17% patients were initially intubated with the PneuX System and 44 (83% patients underwent elective exchange to the PneuX System. There were no episodes of VAP while the PneuX System was in situ. On an intention to treat basis, the incidence VAP was 1.8%. There were no complications from, or failure of, subglottic secretion drainage during the study. Conclusions Our study demonstrates that a low incidence of VAP is possible using the PneuX System. Our study also demonstrates that elective exchange and intermittent subglottic secretion drainage can be performed reliably and safely using the PneuX System.

  12. Comparison of endotracheal aspirate and non-bronchoscopic bronchoalveolar lavage in the diagnosis of ventilator-associated pneumonia in a pediatric intensive care unit.

    Science.gov (United States)

    Yıldız-Atıkan, Başak; Karapınar, Bülent; Aydemir, Şöhret; Vardar, Fadıl

    2015-01-01

    Ventilator-associated pneumonia (VAP) is defined as pneumonia occuring in any period of mechanical ventilation. There is no optimal diagnostic method in current use and in this study we aimed to compare two non-invasive diagnostic methods used in diagnosis of VAP in children. This prospective study was conducted in 8 bedded Pediatric Intensive Care Unit at Ege University Children´s Hospital. Endotracheal aspiration (ETA) and non-bronchoscopic bronchoalveolar lavage (BAL) were performed in case of developing VIP after 48 hours of ventilation. Quantitative cultures were examined in Ege University Department of Diagnostic Microbiology, Bacteriology Laboratory. Fourty-one patients were enrolled in the study. The mean age of study subjects was 47.2±53.6 months. A total of 28 in 82 specimens taken with both methods were negative/negative; 28 had positive result with ETA and a negative result with non-bronchoscopic BAL and both results were negative in 26 specimens. There were no patients whose respiratory specimen culture was negative with ETA and positive with non-bronchoscopic BAL. These results imply that there is a significant difference between two diagnostic methods (p VAP; therefore, ETA results were compared with this method. ETA's sensitivity, specificity, negative and positive predictive values were 100%, 50%, 100% and 48% respectively. The study revealed the ease of usability and the sensitivity of non-bronchoscopic BAL, in comparison with ETA.

  13. Effects of stellate ganglion block on cardiovascular reaction and heart rate variability in elderly patients during anesthesia induction and endotracheal intubation.

    Science.gov (United States)

    Chen, Yong-Quan; Jin, Xiao-Ju; Liu, Zhao-Fang; Zhu, Mei-Fang

    2015-03-01

    To investigate the effects of stellate ganglion block (SGB) on cardiovascular response and heart rate (HR) variability in elderly patients during anesthesia induction and endotracheal intubation. A randomized, double-blinded, and placebo-controlled study. University-affiliated teaching hospital. Eighty elderly patients (American Society of Anesthesiologists grades I and II) receiving elective surgery during general anesthesia. Right stellate ganglion injection (SGB) was performed in all patients using 10 mL of 1% lidocaine or normal saline. Systolic blood pressure (BP), diastolic BP, HR, and calculated rate pressure product. HR variability at the following time points: conscious status before induction (T0); immediately before intubation (T1); immediately after intubation (T2); and 1, 3, and 5 minutes postintubation (T3, T4, and T5). No significant differences in BP and HR were observed between the 2 groups. Rate pressure product values significantly increased in the control group compared with baseline and SGB group values. Low-frequency power (LF) and LF/high-frequency power (HF) significantly increased, and HF and normalized units of HF significantly decreased in the control group compared with baseline values. LF, normalized units of LF, and LF/HF in the SGB group significantly decreased compared with those of the control group. SGB protects the myocardium and effectively suppresses stress responses during anesthesia induction and tracheal intubation in elderly patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Morphological findings in the tracheal epithelium of dogs exposed to the inhalation of poorly conditioned gases under use of an endotracheal tube or laryngeal mask airway.

    Science.gov (United States)

    Dias, Norimar Hernandes; Braz, José Reinaldo Cerqueira; Defaveri, Júlio; Carvalho, Lídia Raquel; Martins, Regina Helena Garcia

    2011-10-01

    To study morphological findings in the tracheal epithelium of dogs exposed to the inhalation of poorly conditioned gases under use of an endotracheal tube (ET) or laryngeal mask airway (LMA). Twelve dogs randomly were allocated to two groups: ET group (n-6) and LMA group (n-6), anaesthetized and mechanically ventilated, without CO(2) reabsorption. Haemodynamic and ventilatory parameters, tympanic temperature, temperature, relative and absolute humidity of the ambient and inhaled gases were analyzed during three hours. The animals were submitted to euthanasia and biopsies were carried out along the tracheal segment to morphological study. Three healthy dogs were used to morphological control. Inhaled gas temperature was maintained between 24ºC and 26ºC, relative humidity between 10% and 12%, and absolute humidity between 2 - 3 mg H(2)O.L(-1) with no significant differences between groups. In both groups, histological analysis showed epithelial inflammation and congestion in the corion and scanning electron microscopy showed ciliary grouping and disorganization. Transmission electron microscopy showed higher alterations in ET group than LMA group as widening of cell junctions, ciliary disorientation, cytoplasmic vacuolization, nuclear abnormalities, picnosis and chromatin condensation. LMA determined less pronounced changes in the tracheal epithelium in dogs exposed to the inhalation of poorly conditioned gases.

  15. Microstructure analysis of cofebsinb metallic glasses with a various geometry prepared by planar flow casting and suction casting methods

    International Nuclear Information System (INIS)

    Hosko, J.; Janotova, J.; Svec, P.; Matko, I.; Janickovic, D.; Svec, P. Sr.

    2012-01-01

    In this paper we have studied the structure of as-cast Co_4_7Fe_2_0_._9B_2_1_._2Si_4_._6Nb_6_._3 ribbon, bilayer and bulk samples in form of rods up to 5 mm diameter. Amorphous structure of the ribbons and bilayer prepared by PFC was confirmed by XRD characterization. XRD analysis of the bulk sample with 5 mm diameter indicated the presence of crystalline phases. However, XRD analysis of the bulk sample with 4 mm diameter indicated no significant crystalline peaks. From TEM analysis it was found that in-situ BMG composite was obtained in bulk sample. The edge of bulk sample with 4 mm diameter was fully amorphous, however, the center of this sample contains crystalline particles of micron sizes dispersed in the amorphous matrix. Our results suggest that the system Co_4_7Fe_2_0_._9B_2_1_._2Si_4_._6Nb_6_._3 has high GFA because we have prepared various amorphous materials with different shape and thickness using the techniques of suction casting, modified PFC and PFC. The critical diameter of bulk samples with chemical composition Co_4_7Fe_2_0_._9B_2_1_._2Si_4_._6Nb_6_._3 for emergence amorphous phase is 4 mm. (authors)

  16. Right vs. left sensorimotor cortex suction-ablation in the rat: no difference in beam-walking recovery.

    Science.gov (United States)

    Goldstein, L B

    1995-03-13

    The ability of rats to traverse a narrow elevated beam has been used to quantitate recovery of hindlimb motor function after unilateral injury to the sensorimotor cortex. We tested the hypothesis that the rate of spontaneous beam-walking recovery varies with the side of the cortex lesion. Groups of rats that were trained at the beam-walking task underwent suction-ablation of either the right or left hindlimb sensorimotor cortex. There was no difference in hindlimb motor function between the groups on the first post-operative beam-waking trial carried out the day after cortex ablation and no difference between the groups in overall recovery rates over the next two weeks. Subsequent analyses of lesion surface parameters showed no differences in lesion size or extent. Regardless of the side of the lesion, there were also no differences between the right and left hemispheres in norepinephrine content of the lesioned or contralateral cortex. We conclude that the side of sensorimotor cortex ablation injury does not differentially affect the rate of spontaneous motor recovery as measured with the beam-walking task.

  17. On exact solutions for disturbances to the asymptotic suction boundary layer: transformation of Barnes integrals to convolution integrals

    Science.gov (United States)

    Russell, John

    2000-11-01

    A modified Orr-Sommerfeld equation that applies to the asymptotic suction boundary layer was reported by Bussmann & Münz in a wartime report dated 1942 and by Hughes & Reid in J.F.M. ( 23, 1965, p715). Fundamental systems of exact solutions of the Orr-Sommerfeld equation for this mean velocity distribution were reported by D. Grohne in an unpublished typescript dated 1950. Exact solutions of the equation of Bussmann, Münz, Hughes, & Reid were reported by P. Baldwin in Mathematika ( 17, 1970, p206). Grohne and Baldwin noticed that these exact solutions may be expressed either as Barnes integrals or as convolution integrals. In a later paper (Phil. Trans. Roy. Soc. A, 399, 1985, p321), Baldwin applied the convolution integrals in the contruction of large-Reynolds number asymptotic approximations that hold uniformly. The present talk discusses the subtleties that arise in the construction of such convolution integrals, including several not reported by Grohne or Baldwin. The aim is to recover the full set of seven solutions (one well balanced, three balanced, and three dominant-recessive) postulated by W.H. Reid in various works on the uniformly valid solutions.

  18. Microstructure, mechanical property and corrosion behavior of interpenetrating (HA + β-TCP)/MgCa composite fabricated by suction casting

    International Nuclear Information System (INIS)

    Wang, X.; Dong, L.H.; Li, J.T.; Li, X.L.; Ma, X.L.; Zheng, Y.F.

    2013-01-01

    The novel interpenetrating (HA + β-TCP)/MgCa composites were fabricated by infiltrating MgCa alloy into porous HA + β-TCP using suction casting technique. The microstructure, mechanical properties and corrosion behaviors of the composites have been evaluated by means of scanning electron microscopy (SEM), X-ray diffraction (XRD), mechanical testing, electrochemical and immersion tests. It was shown that the composites had compact structure and the interfacial bonding between MgCa alloy and HA + β-TCP scaffolds was very well. The ultimate compressive strength of the composites was about 500–1000 fold higher than that of the original porous scaffolds, and it still retained quarter-half of the strength of the bulk MgCa alloy. The electrochemical and immersion tests indicated that the corrosion resistance of the composites was better than that of the MgCa matrix alloy, and the corrosion products of the composite surface were mainly Mg(OH) 2 , HA and Ca 3 (PO 4 ) 2 . Meanwhile, the mechanical and corrosive properties of the (HA + β-TCP)/MgCa composites were adjustable by the choice of HA content. - Highlights: • The composites were fabricated by infiltrating MgCa alloy into porous HA + β-TCP. • The microstructure, mechanical and corrosion properties were investigated. • It showed composites had compact structures and good interfacial bonding. • The mechanical and corrosive properties can be adjustable by the HA content. • The corrosion mechanism of the composite has been explained

  19. H-M bearing capacity of a modified suction caisson determined by using load-/displacement-controlled methods

    Science.gov (United States)

    Zhang, Yu-kun; Gao, Yu-feng; Li, Da-yong; Mahfouz, Ali H.

    2016-12-01

    This paper presents a series of monotonically combined lateral loading tests to investigate the bearing capacity of the MSCs (modified suction caissons) in the saturated marine fine sand. The lateral loads were applied under load- and displacement-controlled methods at the loading eccentricity ratios of 1.5, 2.0 and 2.5. Results show that, in the displacement-controlled test, the deflection-softening behavior of load-deflection curves for MSCs was observed, and the softening degree of the load-deflection response increased with the increasing external skirt length or the decreasing loading eccentricity. It was also found that the rotation center of the MSC at failure determined by the load-controlled method is slightly lower than that by the displacement-controlled method. The calculated MSC capacity based on the rotation center position in serviceability limit state is relatively conservative, compared with the calculated capacity based on the rotation center position in the ultimate limit state. In the limit state, the passive earth pressures opposite the loading direction under load- and displacement-controlled methods decrease by 46% and 74% corresponding to peak values, respectively; however, the passive earth pressures in the loading direction at failure only decrease by approximately 3% and 7%, compared with their peak values.

  20. Parametric study of a capillary tube-suction line heat exchanger in a transcritical CO2 heat pump cycle

    International Nuclear Information System (INIS)

    Agrawal, Neeraj; Bhattacharyya, Souvik

    2008-01-01

    The capillary tube in a transcritical CO 2 system behaves differently as temperature and pressure are two independent parameters unlike those in a sub-critical cycle. A capillary tube-suction line heat exchanger (CL-SLHX) in a transcritical vapour compression cycle considering homogeneous two-phase flow is modelled in this study based on mass, energy and momentum equations. Effects of gas cooler temperature, evaporator temperature and internal diameter of capillary tube are investigated. Heat transfer rate is observed to be influenced by refrigerant quality, mass flow rate and the prevailing temperature difference. Heat transfer rate variation with gas cooler temperature is unique, recording an initial increase followed by a decrease. Frictional pressure drop influences the heat transfer; consequently, chances of re-condensation of refrigerant vapour are very marginal. Larger diameter of capillary tube leads to increase in refrigerant mass flow rate and increase in heat transfer rate as well. Shorter inlet adiabatic capillary length with larger heat exchanger length is better for heat transfer. This study is an attempt to dispel the scepticism prevailing in transcritical CO 2 system community overemphasising the need for a throttle valve to control the optimum discharge pressure

  1. Filter for underground mining for suction of preferably full cut and part cut machines, to be provided with preheated air, to avoid dropping below the dew point

    Energy Technology Data Exchange (ETDEWEB)

    Hoelter, H.

    1976-10-28

    Particularly when cutting hard rock, the cutting room to be provided with suction is wetted with water from nozzles, which, when sucking out air containing dust with high humidity leads to encrustation in the filter cloth. In order to avoid this, it is proposed that the air should be heated, using heat from the motor driving the ventilator, so that one avoids dropping below the dew point in the filter.

  2. A biorobotic model of the suction-feeding system in largemouth bass: the roles of motor program speed and hyoid kinematics

    OpenAIRE

    Kenaley, Christopher P.; Lauder, George V.

    2016-01-01

    The vast majority of ray-finned fishes capture prey through suction feeding. The basis of this behavior is the generation of subambient pressure through rapid expansion of a highly kinetic skull. Over the last four decades, results from in vivo experiments have elucidated the general relationships between morphological parameters and subambient pressure generation. Until now, however, researchers have been unable to tease apart the discrete contributions of, and complex relationships among, t...

  3. Analgesic efficacy of lidocaine for suction-assisted lipectomy with tumescent technique under general anesthesia: a randomized, double-masked, controlled trial.

    Science.gov (United States)

    Danilla, Stefan; Fontbona, Montserrat; de Valdés, Victoria Diaz; Dagnino, Bruno; Sorolla, Juan Pablo; Israel, Guillermo; Searle, Susana; Norambuena, Hernán; Cabello, Rodrigo

    2013-08-01

    Suction-assisted lipectomy is one of the most common procedures performed in plastic surgery. To minimize blood loss and to obtain adequate analgesia, a liquid solution is infiltrated into the subcutaneous plane before suction. The objective of this study was to determine whether the use of lidocaine in the infiltration solution reduces postoperative pain. A prospective, randomized, double-masked, clinical trial was designed. Each side of patients' body zones to be treated with suction-assisted lipectomy was randomized to receive infiltration solution with or without lidocaine. Treatment allocation was performed using computer-generated random numbers in permuted blocks of eight. Pain was assessed using the visual analogue scale and registered 1, 6, 12, 18, and 24 hours after the procedure. The trial was stopped after a first interim analysis. The use of lidocaine in the dilute solution reduced pain by 0.5 point on the visual analogue scale (95 percent CI, 0.3 to 0.8; p<0.001). The effect was independent of the suctioned body zone (p=0.756), and lasted until 18 hours after surgery. Its analgesic effect was lost at the 24-hour postoperative control. Pain increased an average of 0.018 point on the visual analogue scale per hour (95 percent CI, 0.001 to 0.036; p=0.043). The use of lidocaine in the infiltration solution is effective in postoperative pain control until 18 hours after surgery. Nevertheless, its clinical effect is limited and clinically irrelevant, and therefore it is no longer used by the authors. Therapeutic, I.

  4. High negative pressure subcutaneous suction drain for managing debilitating subcutaneous emphysema secondary to tube thoracostomy for an iatrogenic post computed tomography guided transthoracic needle biopsy pneumothorax: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Zeeshan Ahmed

    2016-01-01

    Conclusion: Debilitating subcutaneous emphysema which causes distress, anxiety, palpebral closure, dyspnoea or dysphagia requires intervention. High negative pressure subcutaneous suction drain provides immediate and sustained relief in extensive and debilitating SE.

  5. Numerical simulation of effects of a non-ionized fluid injection and suction on the MHD flow in a circular channel

    International Nuclear Information System (INIS)

    Rahimi Eosboee, M.; Pourmahmoud, N.; Mirzaie, I.; Mohajeri Khameneh, P.; Majidyfar, S.

    2012-01-01

    Control of a fluid flow velocity profile by injection and suction of a non-ionized fluid in presence of a uniform steady magnetic field has important technical applications. In this paper, the unsteady incompressible and viscous conducting fluid flow has been investigated in a circular channel. The channel walls are assumed to be non-conducting and porous. They are subjected to a uniform steady magnetic field which is perpendicular to the axis of channel, then and suction and injection are applied at the walls. The well known equations of Magnetohydrodynamics are governed to the motion of an electrically conducting fluid flow that is subjected to magnetic field. The numerical solution is carried out by finite difference approach. The results of present numerical simulation shown that the flow injection and suction through the wall can be controlled effectively, the main flow in channel especially in industrial purposes. The results are obtained for different values of the injected and sucked non-ionized flow rate and the effect of Hartman number on the velocity profile is investigated. Finally, a good agreement is seen between the presented results and the corresponding data of finite element method.

  6. Fastest predators in the plant kingdom: functional morphology and biomechanics of suction traps found in the largest genus of carnivorous plants

    Science.gov (United States)

    Poppinga, Simon; Weisskopf, Carmen; Westermeier, Anna Sophia; Masselter, Tom; Speck, Thomas

    2016-01-01

    Understanding the physics of plant movements, which describe the interplay between plant architecture, movement speed and actuation principles, is essential for the comprehension of important processes like plant morphogenesis. Recent investigations especially on rapid plant movements at the interface of biology, physics and engineering sciences highlight how such fast motions can be achieved without the presence of muscles, nerves and technical hinge analogies. The suction traps (bladders) of carnivorous bladderworts (Utricularia spp., Lentibulariaceae, Lamiales) are considered as some of the most elaborate moving structures in the plant kingdom. A complex interplay of morphological and physiological adaptations allows the traps to pump water out of their body and to store elastic energy in the deformed bladder walls. Mechanical stimulation by prey entails opening of the otherwise watertight trapdoor, followed by trap wall relaxation, sucking in of water and prey, and consecutive trapdoor closure. Suction can also occur spontaneously in non-stimulated traps. We review the current state of knowledge about the suction trap mechanism with a focus on architectonically homogeneous traps of aquatic bladderwort species from section Utricularia (the so-called ‘Utricularia vulgaris trap type’). The functional morphology and biomechanics of the traps are described in detail. We discuss open questions and propose promising aspects for future studies on these sophisticated ultra-fast trapping devices. PMID:26602984

  7. An Iterative Method to Derive the Equivalent Centrifugal Compressor Performance at Various Operating Conditions: Part I: Modelling of Suction Parameters Impact

    Directory of Open Access Journals (Sweden)

    Waleed Albusaidi

    2015-08-01

    Full Text Available This paper introduces a new iterative method to predict the equivalent centrifugal compressor performance at various operating conditions. The presented theoretical analysis and empirical correlations provide a novel approach to derive the entire compressor map corresponding to various suction conditions without a prior knowledge of the detailed geometry. The efficiency model was derived to reflect the impact of physical gas properties, Mach number, and flow and work coefficients. One of the main features of the developed technique is the fact that it considers the variation in the gas properties and stage efficiency which makes it appropriate with hydrocarbons. This method has been tested to predict the performance of two multistage centrifugal compressors and the estimated characteristics are compared with the measured data. The carried comparison revealed a good matching with the actual values, including the stable operation region limits. Furthermore, an optimization study was conducted to investigate the influences of suction conditions on the stage efficiency and surge margin. Moreover, a new sort of presentation has been generated to obtain the equivalent performance characteristics for a constant discharge pressure operation at variable suction pressure and temperature working conditions. A further validation is included in part two of this study in order to evaluate the prediction capability of the derived model at various gas compositions.

  8. Science policy up close

    CERN Document Server

    Marburger, John H

    2015-01-01

    In a career that included tenures as president of Stony Brook University, director of Brookhaven National Laboratory, and science advisor to President George W. Bush, John Marburger (1941 2011) found himself on the front line of battles that pulled science ever deeper into the political arena. From nuclear power to global warming and stem cell research, science controversies, he discovered, are never just about science. Science Policy Up Close" presents Marburger s reflections on the challenges science administrators face in the twenty-first century. In each phase of public service Marburger came into contact with a new dimension of science policy. The Shoreham Commission exposed him to the problem of handling a volatile public controversy over nuclear power. The Superconducting Super Collider episode gave him insights into the collision between government requirements and scientists expectations and feelings of entitlement. The Directorship of Brookhaven taught him how to talk to the public about the risks ...

  9. Jealousy and Relationship Closeness

    Directory of Open Access Journals (Sweden)

    Mark Attridge

    2013-02-01

    Full Text Available This study confirmed a hypothesis from the Emotion-in-Relationships conceptual model, which predicts that greater interdependence between relationship partners—or closeness—creates the potential for jealousy. The study also sought to better define the positive side of romantic jealousy in addition to its more negative attributes. College students in premarital relationships (N = 229 completed a questionnaire, including 27 different measures and the Multidimensional Jealousy Scale. Select data were obtained from 122 cases at 3-month follow-up. Each jealousy scale was tested for associations with demographic (age, sex, and race, person (life satisfaction, loneliness, romantic attachment styles, love styles, and romantic beliefs, and relationship (affective, closeness, and social exchange theory constructs. Results clearly distinguished emotional/reactive jealousy as mostly “good” and cognitive/suspicious jealousy as “bad.” Behavioral jealousy was associated with few measures. Implications are discussed for the interdependence model of relationships and the transactional model of jealousy.

  10. Closed metal supports

    Energy Technology Data Exchange (ETDEWEB)

    Dolotov, N P; Afanas' yev, Yu V; Brednev, V A; Nuzhadikhin, A G; Tsiplakov, B V; Uskov, I T

    1980-08-30

    A closed metal support system that has a specific profile includes roof timber, ledger and roof timber. For convenience of transport, assembly, disassembly and repeated use during operation of an extraction powered system, the uprights in the central part are made sectional and are connected to one another by a hinge for folding into transport position. Longitudinal openings are made at the ends of the uprights in order to provide strength by creating flexibility in the hinged connections. The hinged connections of the sectional uprights have elastic gaskets. For convenience in folding the reinforcement, the ends of the uprights of the roof timber and ledger have the shape of a channel at junctions of their hinged connection.

  11. Nonrelativistic closed string theory

    International Nuclear Information System (INIS)

    Gomis, Jaume; Ooguri, Hirosi

    2001-01-01

    We construct a Galilean invariant nongravitational closed string theory whose excitations satisfy a nonrelativistic dispersion relation. This theory can be obtained by taking a consistent low energy limit of any of the conventional string theories, including the heterotic string. We give a finite first order worldsheet Hamiltonian for this theory and show that this string theory has a sensible perturbative expansion, interesting high energy behavior of scattering amplitudes and a Hagedorn transition of the thermal ensemble. The strong coupling duals of the Galilean superstring theories are considered and are shown to be described by an eleven-dimensional Galilean invariant theory of light membrane fluctuations. A new class of Galilean invariant nongravitational theories of light-brane excitations are obtained. We exhibit dual formulations of the strong coupling limits of these Galilean invariant theories and show that they exhibit many of the conventional dualities of M theory in a nonrelativistic setting

  12. Closing the gap

    International Nuclear Information System (INIS)

    Moxon, Suzanne

    1999-01-01

    The problem of fish going through turbines at hydroelectric power plants and the growing concern over the survival rate of salmon at the US Army Corps operated Bonneville lock and dam on the Columbia river in the Pacific Northwest is discussed. The protection of the fish, the assessment of the hazards facing fish passing through turbines, the development of a new turbine, and improved turbine efficiency that reduces cavitation, turbulence and shear flow are examined. The closing of the gap between the turbine blades, hub and discharge ring to increase efficiency and reduce the risk to fish, and the development of the minimum gap runner (MGR) are described, and the lower maximum permitted power output of MGR is noted. (UK)

  13. Closing the fuel cycle

    International Nuclear Information System (INIS)

    Aycoberry, C.; Rougeau, J.P.

    1987-01-01

    The progressive implementation of some key nuclear fuel cycle capecities in a country corresponds to a strategy for the acquisition of an independant energy source, France, Japan, and some European countries are engaged in such strategic programs. In France, COGEMA, the nuclear fuel company, has now completed the industrial demonstration of the closed fuel cycle. Its experience covers every step of the front-end and of the back-end: transportation of spent fuels, storage, reprocessing, wastes conditioning. The La Hague reprocessing plant smooth operation, as well as the large investment program under active progress can testify of full mastering of this industry. Together with other French and European companies, COGEMA is engaged in the recycling industry, both for uranium through conversion of uranyl nitrate for its further reeichment, and for plutonium through MOX fuel fabrication. Reprocessing and recycling offer the optimum solution for a complete, economic, safe and future-oriented fuel cycle, hence contributing to the necessary development of nuclear energy. (author)

  14. The closed fuel cycle

    International Nuclear Information System (INIS)

    Froment, Antoine; Gillet, Philippe

    2007-01-01

    Available in abstract form only. Full text of publication follows: The fast growth of the world's economy coupled with the need for optimizing use of natural resources, for energy security and for climate change mitigation make energy supply one of the 21. century most daring challenges. The high reliability and efficiency of nuclear energy, its competitiveness in an energy market undergoing a new oil shock are as many factors in favor of the 'renaissance' of this greenhouse gas free energy. Over 160,000 tHM of LWR1 and AGR2 Used Nuclear Fuel (UNF) have already been unloaded from the reactor cores corresponding to 7,000 tons discharged per year worldwide. By 2030, this amount could exceed 400,000 tHM and annual unloading 14,000 tHM/year. AREVA believes that closing the nuclear fuel cycle through the treatment and recycling of Used Nuclear Fuel sustains the worldwide nuclear power expansion. It is an economically sound and environmentally responsible choice, based on the preservation of natural resources through the recycling of used fuel. It furthermore provides a safe and secure management of wastes while significantly minimizing the burden left to future generations. (authors)

  15. Cupping therapy: An analysis of the effects of suction on skin and the possible influence on human health.

    Science.gov (United States)

    Lowe, Duane T

    2017-11-01

    Cupping therapy is a traditional therapy that has been employed worldwide for thousands of years. Despite a lack of quality clinical studies evaluating the efficacy of cupping therapy, its long history and widespread use throughout the world suggests the commonly claimed health benefits should not be completely discounted as without merit. The goal of this paper is to present the research detailing what is known concerning the effects of suction on skin and underlying tissue, and the reaction of the body to that stimulus. Understanding the literature on the physiological effects of this mechanical force may help elaborate an explanation for the advertised local and systemic effects of cupping therapy. Negative pressure causes stretching of the skin and underlying tissue and dilation of the capillaries. This stimulates an increase in tissue blood flow, eventually leading to capillary rupture and ecchymosis. Macrophages phagocytize the erythrocytes in the extravascular space which stimulates the production of Heme Oxygenase-1 (HO-1) to metabolize the heme. Heme catalysis results in the production of carbon monoxide (CO), biliverdin(BV)/bilirubin(BR) and iron. HO-1, BV, BR, and CO has been shown to have antioxidant, anti-inflammatory, antiproliferative, and neuromodulatory effects in animal and human systems. These substances also stimulate a shift of macrophages to the anti-inflammatory M2 phenotype. There is evidence that the effects are both local and systemic. Besides the mechanical effect of cupping increasing the local blood flow and stretching underlying tissue, activation of the HO-1 system could account for many of cupping therapy's claimed local and systemic health benefits. Published by Elsevier Ltd.

  16. High current vacuum closing switch

    International Nuclear Information System (INIS)

    Dolgachev, G.I.; Maslennikov, D.D.; Romanov, A.S.; Ushakov, A.G.

    2005-01-01

    The paper proposes a powerful pulsed closing vacuum switch for high current commutation consisting of series of the vacuum diodes with near 1 mm gaps having closing time determined by the gaps shortening with the near-electrode plasmas [ru

  17. Close to the Sky

    Science.gov (United States)

    2007-11-01

    Today, a new ALMA outreach and educational book was publicly presented to city officials of San Pedro de Atacama in Chile, as part of the celebrations of the anniversary of the Andean village. ESO PR Photo 50a/07 ESO PR Photo 50a/07 A Useful Tool for Schools Entitled "Close to the sky: Biological heritage in the ALMA area", and edited in English and Spanish by ESO in Chile, the book collects unique on-site observations of the flora and fauna of the ALMA region performed by experts commissioned to investigate it and to provide key initiatives to protect it. "I thank the ALMA project for providing us a book that will surely be a good support for the education of children and youngsters of San Pedro de Atacama. Thanks to this publication, we expect our rich flora and fauna to be better known. I invite teachers and students to take advantage of this educational resource, which will be available in our schools", commented Ms. Sandra Berna, the Mayor of San Pedro de Atacama, who was given the book by representatives of the ALMA global collaboration project. Copies of the book 'Close to the sky' will be donated to all schools in the area, as a contribution to the education of students and young people in northern Chile. "From the very beginning of the project, ALMA construction has had a firm commitment to environment and local culture, protecting unique flora and fauna species and preserving old estancias belonging to the Likan Antai culture," said Jacques Lassalle, who represented ALMA at the hand-over. "Animals like the llama, the fox or the condor do not only live in the region where ALMA is now being built, but they are also key elements of the ancient Andean constellations. In this sense they are part of the same sky that will be explored by ALMA in the near future." ESO PR Photo 50c/07 ESO PR Photo 50c/07 Presentation of the ALMA book The ALMA Project is a giant, international observatory currently under construction on the high-altitude Chajnantor site in Chile

  18. Closed cycle device

    International Nuclear Information System (INIS)

    Ruby, L.E.; Witt, D.L.; Staley, C.F.

    1975-01-01

    A gas dynamic laser wherein the lasing fluid is recirculated in a closed loop is described. The flow can be assumed to start with the lasing gas passing through a cascade of supersonic nozzles. This low pressure, high velocity gas is then passed through a lasing cavity where the lasing action takes place. The energy of the high velocity gas stream is converted back to static pressure in a supersonic diffuser. The diffuser is constructed with (1) variable geometry, and (2) provisions for bleeding off the boundary layer for improved efficiency. Downstream of the supersonic diffuser there is a heat exchanger which partially cools the gas in the loop. This partially cooled gas is then supplied to a compressor where the pressure and temperature are raised back to the level at the start of the flow. The lasing gas is directed from the exit of the compressor to a manifold upstream of the cascade of supersonic nozzles. The compressor only supplies a pressure rise equal to the pressure loss by inefficiencies in the nozzle, the supersonic diffuser and the pressure drop in the heatexchanger and plumbing. To provide for cooling of the compressor, the gas bled from the diffuser is cooled by a second heat exchanger and pumped back to compressor inlet pressure and introduced into the compressor for cooling. In steady state operation, both heat exchangers referred to above, are designed to regulatethe nozzle inlet gas temperature by removing the amount of heat energy added by compressing minus the amount of energy extracted in the lasing beam and energy lost to the environment. The compressor and pumping means for cooling the compressor can be driven by any means desired. (U.S.)

  19. Muscle activity during endotracheal intubation using 4 laryngoscopes (Macintosh laryngoscope, Intubrite, TruView Evo2 and King Vision – A comparative study

    Directory of Open Access Journals (Sweden)

    Tomasz Gaszyński

    2016-04-01

    Full Text Available Background: Successful endotracheal intubation requires mental activity and no less important physical activity from the anesthesiologist, so ergonomics of used devices is important. The aim of our study has been to compare 4 laryngoscopes regarding an operator’s activity of selected muscles of the upper limb, an operator’s satisfaction with used devices and an operator’s fatigue during intubation attempts. Material and Methods: The study included 13 anesthesiologists of similar seniority. To measure muscle activity MyoPlus 2 with 2-channel surface ElectroMyoGraphy (sEMG test device was used. Participant’s satisfaction with studied devices was evaluated using Visual Analog Scale. An operator’s fatigue during intubation efforts was evaluated by means of the modified Borg’s scale. Results: The highest activity of all the studied muscles was observed for the Intubrite laryngoscope, followed by the Mackintosh, TruView Evo2 and the lowest one – for the King Vision video laryngoscope. A significant statistical difference was observed for the King Vision and the rest of laryngoscopes (p 0.05. The shortest time of intubation was achieved using the standard Macintosh blade laryngoscope. The highest satisfaction was noted for the King Vision video laryngoscope, and the lowest for – the TruView Evo2. The Intubrite was the most demanding in terms of workload, in the opinion of the participants’, and the least demanding was the King Vision video laryngoscope. Conclusions: Muscle activity, namely the force used for intubation, is the smallest when the King Vision video laryngoscope is used with the highest satisfaction and lowest workload, and the highest muscle activity was proven for the Intubrite laryngoscope with the highest workload. Med Pr 2016;67(2:155–162

  20. Evaluation of performance of Streamlined Liner of the Pharynx Airway™, Laryngeal Mask Airway-ProSeal and endotracheal tube in prone position: A prospective, randomised study

    Directory of Open Access Journals (Sweden)

    Harihar Vishwanath Hegde

    2018-01-01

    Full Text Available Background and Aims: Airway used in prone position should be efficacious and safe. The Streamlined Liner of the Pharynx Airway (SLIPA™ and Laryngeal Mask Airway-ProSeal (PLMA provide better airway seal and protection against aspiration. We planned to evaluate the performance of SLIPA™, PLMA and endotracheal tube (ETT in prone position. Methods: 114 adult patients undergoing elective surgery in prone position under general anaesthesia were randomised into Group-T (ETT, Group-S (SLIPA™ and Group-P (PLMA. Airways were inserted in supine position and patients turned prone subsequently. Airway characteristics, ventilatory parameters and complications were noted. One-way analysis of variance, Mann–Whitney U-test and Chi-square or Fisher's exact test were used. Results: Tidal volumes, peak airway pressure and compliance were comparable at all times. Leak pressure was significantly higher (P < 0.001 in Group-T (mean leak pressure = 40 cmH2O when compared to Group-S and Group-P at all the times of recording, and there was no significant difference between Group-S and Group-P. The number of patients requiring airway/neck manipulation in prone position was significantly higher (P < 0.001 in Group-S (19 [55.9%] when the three groups were compared (none in Group-T and in comparison with Group-P (5 [14.7%], P < 0.001. On airway removal, the incidence of complications and airway reaction was significantly higher in Group-T. Group-S had a significantly higher incidence of dysphagia at 2 h postoperatively. Conclusion: ETT was most efficacious. SLIPA™ and PLMA were efficacious, safe and less stimulating to the airway during removal. More patients required SLIPA™ airway/neck manipulation.