Nasal Catheter Research Articles

Clearance of 99mTc DTPA from guinea pig nasal, tracheobronchial, and bronchoalveolar airways.

Technetium-99m labelled diethylenetriamine penta-acetate (99mTc-DTPA) was used to compare small solute absorption (clearance) from nasal, tracheobronchial, and bronchoalveolar airways in anaesthetised guinea pigs. 99mTc DTPA dissolved in saline was superfused through nasal and orolaryngeal catheters on to nasal and tracheobronchial airways; a small particle aerosol of nebulised 99mTc DTPA was delivered to the bronchoalveolar airways through a tracheostomy. Radioactivity over the appropriate region was then determined with a gamma camera. Mucociliary transport of 99mTc DTPA appeared not to contribute to the disappearance of 99mTc DTPA. Time-activity curves were obtained and half life values calculated by fitting a monoexponential equation to the experimental data. A progressive reduction in 99mTc DTPA was recorded from the nasal and tracheobronchial airways and from the bronchoalveolar airway, suggesting that absorption was occurring. The disappearance of 99mTc DTPA was fastest from the bronchoalveolar region, which also had the largest mucosal surface. The similar shape of the retention curves for the nasal and tracheobronchial regions suggests that the characteristics of nasal absorption of 99mTc DTPA could prove applicable to the tracheobronchial region. It is proposed that the present methods are suited for comparing the pharmacology of small solute absorption across nasal, tracheobronchial, and bronchoalveolar airway mucosa.

A Nasal Catheter for Monitoring Tidal Carbon Dioxide in Spontaneously Breathing Patients

A Nasal Catheter for Monitoring Tidal Carbon Dioxide in Spontaneously Breathing Patients

Oxygenation, heart rate and temperature in very low birthweight infants during skin-to-skin contact with their mothers.

Fourteen very low birthweight infants were studied positioned either prone horizontal or skin-to-skin at 60 degree tilt between the mother's breasts. Heart rate, skin temperature and oxygenation by transcutaneous PO2 and pulse oximetry were measured. Nine of the infants had normal lungs when studied. These infants showed no change in tcPO2 or oxygen saturation but heart rate increased significantly by a mean of 6.5 beats per min during skin-to-skin contact. Five infants with chronic lung disease, including two on nasal catheter oxygen, showed a significant 1.0 kPa rise in tcPO2 during skin-to-skin contact. Back skin temperature was well maintained during skin-to-skin contact with the room temperature at 26 to 29 degrees C. None of the infants had a significant apnoea or bradycardia during the study. Stable very low birthweight infants can enjoy such close contact with their mothers and the tilted position may improve pulmonary function in some cases.

Staphylococcus Aureus Nasal Carriage, Exit-Site Infection and Catheter Loss in Patients Treated with Continuous Ambulatory Peritoneal Dialysis (CAPD)

Over a three-year period, 217 episodes of bacterial peritonitis occurred in 183 patient years. Thirty-seven episodes were due to Staphylococcus aureus and 19 (51%) of these required removal of the catheter to eradicate infection. This compared with catheter loss in 4/63 (6.3%) coagulase negative staphylococci infections (p less than 0.001); 7/67 (9.5%) culture negative peritonitis (p less than 0.001); and 10/30 (33.3%) episodes due to gram-negative organisms (p less than 0.05). Over half (51.3%) the episodes due to S. aureus were associated with exit-site infections, and this rose to 100% (10/10) with recurrent peritonitis (p less than 0.01). A prospective analysis of nasal carriage and exit-site infections due to S. aureus was carried out in 87 patients. Exit-site infections were present in 21 (24%), almost entirely due to different strains as judged by sensitivity patterns and phage typing. Nasal carriage, defined as two positive swabs within the study period, was present in 20 (23%) patients. Fourteen (70%) of these had exit-site infections due to the same strain as that isolated from the nose, whereas no patient grew different strains from either site. Nasal carriage increased the risk of infection sixfold (p less than 0.001).

113: CHEMOREFLEX RESPONSES TO ALTERNATIONS OF FiO2 IN THE NEWBORN INFANT

We wondered whether infants would respond to alternations of inspired oxygen fraction (FiO2) with an alternating reflex respiratory response. Five infants born at term and aged 2-3 days were studied in quiet sleep. Respiration was measured by inductance plethysmography (Respitrace). Respiratory variables were measured on-line by a computer, which also controlled the delivery of inspired gas at 1 1/min via a nasal catheter, switching between two lines supplying air or a hypoxic gas (FiO2 0.16) at the start of alternate expirations. Thus 2-breath alternations of air and hypoxia were delivered for 50-100 breaths (test runs). For control runs air was delivered in both gas lines. Alternations in respiratory variables were quantified for the second of each pair of breaths using a modification of the method of Metias et al (1981). The results showed a significant increase in the alternation of tidal volume, frequency and ventilation during test runs in comparison to control. Thus newborn infants respond to 2-breath alternations in FiO2, presumably via a peripheral chemoreceptor reflex. We are currently developing the method for the assessment of peripheral chemosensitivity.

49 SAFETY AND EFFECTIVENESS OF SKIN-TO-SKIN CONTACT FOR VERY LOW BIRTH WEIGHT INFANTS

Separation between mothers and very low birth weight (VLBW) infanta is often prolonged with subsequent psychological distress, behaviour problems and lactation failure. Babies as small as 700g with atable breathing can be enjoyably held naked, except for a nappy, between the mother's breasts for up to four hours a day.We have carried out a randomised trial among babies less than 1500g. Seventy one infants were randomised. In 35, the mother was helped to hold her baby in skin-to-akin contact and encouraged to do so whenever she visited the baby. In 36, the mother waa encouraged to handle her baby but without skin-to-skin contact. Mothers using skin-to-skin contact lactated for 4 weeks longer on average. At 6 months of age, the infants who had skin-to-skin contact cried sgnificantly less than the control group.Five Infants with chronic lung disease, including two with nasal catheter oxygen, showed a mean 7 mm Hg rise In tcpO2 comparing skin-to-skin contact at 60 degrees and horizontal in a crib. If the baby wears a hat and has a blanket over the back, skin temperature was well maintained.

Continuous positive airway pressure via a single nasal catheter in preterm infants.

We present the results of giving continuous positive airway pressure (CPAP) via a single nasal catheter to 20 preterm infants. A beneficial effect in terms of reduced work of breathing (P less than or equal to 0.01) and improved pattern of respiration (P less than or equal to 0.05) are demonstrated. CPAP via a single nasal catheter does not seem to mediate effects inside the thorax unlike CPAP delivered by a tight fitting face mask. Gross variations in CPAP level may result from altering the infant's position.

Oxygen therapy via nasal catheter for infants with bronchopulmonary dysplasia

Articles| May 01 1984 Oxygen therapy via nasal catheter for infants with bronchopulmonary dysplasia JA Coffman; JA Coffman Search for other works by this author on: This Site PubMed Google Scholar KP McManus KP McManus Search for other works by this author on: This Site PubMed Google Scholar Crit Care Nurse (1984) 4 (3): 22–23. https://doi.org/10.4037/ccn1984.4.3.22 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Cite Icon Cite Get Permissions Citation JA Coffman, KP McManus; Oxygen therapy via nasal catheter for infants with bronchopulmonary dysplasia. Crit Care Nurse 1 May 1984; 4 (3): 22–23. doi: https://doi.org/10.4037/ccn1984.4.3.22 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentCritical Care Nurse Search Advanced Search You do not currently have access to this content.

Low flow oxygen therapy in infants.

Fifty one infants who were oxygen dependent after treatment for neonatal respiratory disease were entered into a study programme where 100% oxygen was delivered at low flow through a nasal catheter. Thirty five (69%) of the infants were discharged home and the remainder were either discharged to a convalescent hospital or back to their peripheral referring hospital. Excluding repeat admissions for monitoring or for the treatment of acute infections, 2760 hospital days (79 days/patient) were saved, representing a financial saving of $11990 (pounds 6500) per treated infant. A home low flow oxygen therapy programme has benefits to the infant/parent relationship, provides a more constant flow of oxygen than conventional methods, and the early hospital discharge represents a considerable financial saving.

Acceptability of Continuous Nasal Nitrous Oxide during Labour. A Field Trial in Six Maternity Hospitals

In six maternity hospital 516 mothers during labour received 50% nitrous oxide and 50% oxygen (Entonox) continuously at 5 litres/minute through a single-end nasal catheter and intermittently by a mouthpiece for a mean duration of 3 hours 30 minutes (513 mothers). A comparison was made with a control group of 575 mothers who had intermittent inhalation of Entonox only for a mean duration of 3 hours 6 minutes (574 mothers). The midwives had no difficulty learning to manage the administration of nasal Entonox. Eighty-six per cent of mothers agreed to use the nasal method and 70% continued for the duration of their labour. The midwives reported that pain relief was improved, and 51 (92%) would wish to continue offering the technique.

A rapid nasal packing catheter for emergency evaluation and management of epistaxis

Oral and maxillofacial surgeons may meet the problems of epistaxis either primarily, as a result of trauma, or secondarily, during the perioperative period of elective surgical procedures. Control of primary hemorrhage and establishment of a patent airway is a major concern, so that stabilization and evaluation of the patient can be made possible. Management of secondary hemorrhage and airway complications may also be necessary after traumatic nasal intubations or after orthognathic procedures in which manipulation of the nasal apparatus may have contributed to the epistaxis. The Surgitek@ Reuter Epi-Tek@S rapid nasal packing catheter lends itself nicely to both speedy control and management of these problems of hemorrhage and airway, as well as to the diagnostic localization of the involved bleeding site. The Reuter Epi-Tek is constructed of a bioimplantable silicone rubber, possessing the properties of adequate strength and durability for nasal insertion and packing and also of softness and pliability to allow atraumatic contact with the nasal mucosa.3 The tube resembles a nasal airway with a doublelumened, independently inflatable, large volume, low-pressure cuffed system (Fig. 1). Prior to insertion, the nose is cleared of any foreign debris or blood clots. The catheter is then lubricated, inserted, and fully advanced in the same manner as a nasal airway, care being taken to make sure the posterior balloon extends into the nasal pharynx. Inflation of the posterior cuff with 4 to 8 ml of air is then accomplished via the white valve (Fig. 2). Slight outward traction on the Reuter Epi-Tek seats the posterior balloon, completing the posterior

The Physician in Court

To the Editor. —The average, sophisticated, informed, and well-educated hospitalized patient is usually familiar with his illness, including not only its signs and symptoms but also the reason for each diagnostic test, the rationale for therapeutic measures being used, and the prognosis of the disease. Physicians today are morally obligated and legally required to obtain informed consent from their patients for diagnostic procedures and planned therapeutic interventions. Nevertheless, many an acutely ill patient admitted to the hospital is anxious and nervous, tense, and frightened of the milieu where acute medical care is being rendered. Bottles hanging from intravenous stands with unknown solutions entering the patient's veins, the hiss of oxygen flowing by mask or nasal catheter into the patient's lungs, the beep-beep of the monitor attached to the patient's chest, the repeated measurement of pulse rate, blood pressure, temperature, and respirations, and the low murmuring of the physicians, nurses, and

Enrichisseurs d’oxygène et différents modes d’utilisation

Different ways of using oxygen enrichers have been studied. First, the performances of two different devices were tested: the results were very similar to the constructors' previsions. Second, oxygen concentrations in venturi masks connected to enrichers were measured with a mass spectrometer. The authors suggest to adjust the flow delivered by enrichers at 3 liters/min for any type of venturi mask. Pharyngeal oxygen concentration curves show the reliability of masks connected to enrichers compared to other modes of administration (nasal cannulae, nasal catheter).

Flow thresholds of nonodorous air through the human naris as a function of temperature and humidity.

The process of olfactory sensation is probably a Gestalt consisting of motor, physical, and chemical components formed during the transport of the odor-bearing airstream past the olfactory epithelium. In studying a sensory process, it is often necessary to examine the components independently. Apart from its contribution to the olfactory Gestalt, in dynamic olfactometry airflow may distract from, compete with, or mask chemical sensation. Four nonsmoking male subjects were employed to obtain flow thresholds of nonodorous air at eight temperature/ humidity combinations. The stimulus-generating apparatus was housed in a temperature-regulated oven. All materials in contact with the airstream were thoroughly cleaned and were constructed of nonreactive materials to avoid olfactory cues. An evaluation of the quality of the output demonstrated purity. A Béésy technique was used to deliver stimuli via a nasal catheter to the subject. Thresholds were found to be nearly identical for the lowest humidity levels regardless of the temperature. In general, the closer the temperature/humidity was to physiological normal, the higher the threshold. Since the thresholds were so strongly functions of temperature and humidity, it is likely that transduction was by trigeminal thermoreceptive afferents. The utilization of subthreshold flows in olfactory research may reduce the trigeminal component in olfaction, thus permitting better assessment of the contribution of the olfactory nerve to olfactory sensation.

A computer-controlled vapor-dilution olfactometer

A computer-controlled olfactometer with several innovations leading to closer control over the stimulus parameters and minimization of nonolfactory cues is presented. A microcomputer is used to control the stimulus duration and interstimulus interval. Electronic mass flow con-trollers are employed to maintain close control over the flow in the pure air line and the stimulus-bearing line. Both humidity and temperature are closely regulated. Using a nasal catheter, this stimulus delivery system coupled with velopharyngeal closure and oral breathing permits accurate specification of the quantity of stimulus material actually entering a subject’s nares. The design is such that the computer programming, patch panel interface, and threaded tubing allow versatility in the type of olfactometric study that can be conducted. This system is amenable for threshold, electrophysiological, and sensory adaptation studies of olfaction.

Perforation of the nasal septum in patients with renal failure.

Spontaneous perforation of the nasal septum was observed in 8 out of 104 patients (74 on maintenance hemodialysis; 30 after cadaveric renal transplantation). All patients showed a round or oval defect of the non-osseous septum, which was accompanied by marked atrophic rhinitis. Epistaxis was common in uremic patients in general and was also present in 5 patients with septal perforation, but otherwise the defect was hardly associated with any symptoms. Various factors may play a role in the pathogenesis of this lesion; local trauma from nasal catheters postoperatively; impaired mucosa cell proliferation; disturbed innervation of the vessels in the nasal septum due to polyneuropathy of the autonomous nervous system; ischemia secondary to arteriolar narrowing.

Intragastric drinking in the rat: Evidence for a role of oropharyngeal stimulation

Two experiments analyzed the contribution of oropharyngeal stimulation to the acquisition and maintenance of intragastric self-injection of water in the rat. Animals were trained to press a lever for delivery of intragastric water routed to the stomach by either a subcutaneous gastric cannula or a nasopharyngeal catheter. Animals readily acquired the response via the nasal catheter but not via the gastric cannula. When switched from intragastric drinking via the nasal catheter to the gastric cannula, three of four animals showed extinction. Acquisition of self-injection behavior was precluded in nasal catheter animals if the water was warmed to 36.5°C, but when switched from 22°C to 36.5°C water, only one of five animals reached extinction. The one rat self-injecting by gastric fistula and all nasal catheter animals invariably licked and chewed metal objects during self-injections and thereby appeared to mediate the reinforcing properties of intragastric water with self-produced oral stimulation. Oropharyngeal stimulation, either experimenter-controlled or self-produced during metal licking, is important for reinforcing operant behavior with intragastric delivery of water in the rat.

Apnea, Hypoxemia, and Aborted Sudden Infant Death Syndrome

To find out whether there is any relationship between the ventilatory response to hypoxia and the sudden infant death syndrome (SIDS), we studied the effects of mild induced hypoxia (PIO2, 120 mm Hg = 17% oxygen) in 16 infants aged 2 weeks to 6 months. Eight had recurrent apneic spells (apnea group) (five had aborted SIDS and three had recurrent apnea in the intensive care nursery) and eight were "well" preterm infants about to fly in a pressurized airplane (PIO2, 120 mm Hg) (control group). Mean birth weights were 2,245 and 1,400 gm and mean gestational ages were 35 and 30 weeks. Postconceptual ages (41.8 and 41.3 weeks) were almost identical. Heart rate was obtained from an ECG, and respiratory rate and pattern were obtained from a pneumogram. In addition, end-tidal PCO2 and PN2 or PO2 were obtained with a nasal catheter and gas analyzers. In the apnea group with inhalation of 17% oxygen, we observed an increase in periodic breathing and an increase in both rate and total duration of respiratory pauses. In the control group there were no significant changes. Heart rate and PCO2 did not change in either group. Our findings suggest that infants prone to apnea may have unique respiratory responses to mild induced hypoxia.

Complication Using A Nasal Oxygen Catheter

We would like to report a complication that resulted from using a nasal oxygen catheter in a manner similar to that described by Pinney and Cotton. A 2-month-old boy with a large ventricular septal defect was admitted with fever, severe congestive failure, and hypoxemia. A feeding catheter was inserted 2 to 3 cm into one nare and nebulized oxygen was supplied at a flow rate of 0.5 liters/min. The catheter used was a No. 8 French Cutter Resiflex with a blind tip and two side holes. There was a p-off on the nebulizer.

MEASUREMENT OF CARBON DIOXIDE OUTPUT, ALVEOLAR CARBON DIOXIDE CONCENTRATION AND ALVEOLAR VENTILATION IN THE NEONATE

A system is described for measuring carbon dioxide output and alveolar carbon dioxide concentration in the neonate and for deriving the volume of alveolar ventilation. Air is drawn through a soft rubber face mask applied loosely to the face so that all expired gas is entrained. A fraction of the flow is sampled by an infra-red analyser, the signal from which is integrated to provide a measure of carbon dioxide output. Alveolar carbon dioxide concentration is measured by continuous sampling of expired gas through a nasal catheter. The response time of the catheter-analyser system is 140 ms. In 20 healthy 1-day-old neonates the mean carbon dioxide excretion was 5.86 ml/min. kg-1 (STPD) and the mean alveolar PCO2 was 4.85 kPa. From these measurements mean alveolar ventilation 147 ml/min. kg-1 (BTPS) was calculated. These results are similar to those obtained by other methods.