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Background Acute lung injury and respiratory failure in patients in the intensive care unit (ICU) present challenges owing to varied factors. Manual suctioning, which is the current standard, burdens healthcare professionals and poses risks. The Lmeca.A1000 automatic suction device offers an innovative solution to this problem. This study aimed to evaluate the safety of this device. Methods This prospective, multicenter, randomized trial compared automatic and manual suction in ICU patients. Mucosal injury and pneumonia were assessed using bronchoscopy and monitoring. Mechanical stability and adverse events were also evaluated. Results In total, 117 critically ill adults were screened: 56 in the experimental group and 53 in the control group completing the study. No significant difference in mucosal injury was found at 3 or 7 days after treatment ( p  = 0.871, and 0.750). The incidence of VAP over 2 weeks was 5.36% in the experimental group and 1.89% in the control group, not significantly different ( p  = 0.582). Adverse events occurred in 14.3 and 13.2%, respectively, with no significant difference ( p  = 0.870). The incidence of clinical trial device malfunction within 3 days of application was 0.03% and within 2 weeks of follow-up was 0.02%. Conclusions This study evidenced the non-inferiority of the automatic suction device to the manual method in terms of safety. The adoption of an automated system could alleviate the workload of healthcare professionals while maintaining effective airway management.

Objectives This study aimed to evaluate the clinical efficacy and cost-effectiveness of using a disposable bendable negative pressure suction sheath in combination with a disposable ureteroscope for treating upper urinary tract calculi and to compare it with the conventional ureteral access sheath with a lassoed mesh basket. Methods A retrospective analysis was conducted on clinical data from patients with upper urinary tract calculi who underwent flexible ureteroscopy at a tertiary hospital in Beijing between March 2023 and March 2024. The study included two groups: 69 patients were treated with disposable bendable negative pressure suction sheaths (negative pressure group) and 83 with conventional ureteral access sheath combined with lassoed mesh baskets (conventional group). Variables analyzed included operative time, stone-free rate, length of postoperative hospital stay, postoperative complication rate, and hospitalization cost. Result The operative time for the negative pressure group was 119.8 ± 10.4 min, which was longer than that in the conventional group (93.2 ± 9.8 min). The postoperative hemoglobin drop was 5.3 ± 2.2 g/L in the negative pressure group and 4.7 ± 1.2 g/L in the conventional group. The hospitalization cost for the negative pressure group was ¥28,273 ± 5389, which was significantly lower than that for the conventional group (¥30,786.1 ± 4055). The stone-free rate at 1 week postoperatively was 84.1% (58/69) in the negative pressure group, which was significantly higher than that in the conventional group (68.7%). However, there was no statistically significant difference in stone-free rate at 1 month postoperatively between the two groups. Conclusions The use of a disposable ureteroscope with a bendable negative pressure suction sheath can improve short-term postoperative stone-free rate. However, this approach may increase surgical complexity, extend operative time, and heighten the risk of intraoperative bleeding. This procedure is recommended to be performed by physicians with extensive experience in flexible ureteroscopy to ensure safety and efficacy.

Background The principles of chest drainage have not changed significantly since 1875 when Bülau introduced the idea of underwater drainage tube which became a trademark of thoracic surgery. We performed a prospective, randomized trial comparing omitting pleural drain (drainless group) versus drainage with small low suction drain (drainage group) strategies of thoracic surgery when the visceral pleura remains intact. Aiming to investigate whether these approaches represent safe treatment options. Methods A multi-center, prospective, parallel group, randomized, controlled trial enrolling patients after thoracic procedures in which visceral pleura remained intact at the end of surgery between August 2020 and September 2023. After completion of the procedure a suction-seal test was conducted on all patients. If suction-seal test was positive to confirm absence of air leak, patients were randomized to either receive low auto-suction drain as a solo pleural drain (drainage group) or not to receive drain (drainless group). Results During the study period, 111 patients were recruited. Eleven patients had negative Suction-seal test and were excluded by inserting a traditional underwater seal. The remaining 100 patients were randomly assigned to either drainage group with low suction drain (Fig.  1 ) ( n  = 50) or drainless group ( n  = 50). Conclusion The results of this study suggest that either omitting drain or inserting a low auto suction drain safely substitutes the one-way valve when the visceral pleura remains intact. Omitting drain or inserting portable small caliber drain encourages early mobilization and is associated with shorter hospital stay.

Novice nurses often find endotracheal suctioning signs unfamiliar. The Endotracheal Suction Assessment Tool© (ESAT©) aids pediatric nurses in suctioning but lacks an adult equivalent. A valid and reliable ESAT© for assessing intensive care unit patients’ suction needs across different populations is necessary. To test the validity and reliability of the ESAT© in adult ICU patients. This methodological study assessed suction needs in patients at a tertiary adult ICU of a university hospital. Two independent observers used the ESAT© to determine suction needs. Data from 106 suction procedures were collected using a patient characteristics form, the ESAT©, and a suction monitoring form. The ESAT© includes eight respiratory and ventilation parameters and seven clinical consideration parameters. Hemodynamic and respiratory parameters were measured before, and one and five minutes after suction. Linguistic validity, content validity, and pilot testing were conducted. Interobserver agreement was evaluated, and psychometric evaluation was done using content validity index (CVI) and intraclass correlation coefficient (ICC). Data were analyzed with paired samples t-test and ANOVA. Item CVI ranged from 0.80 to 1.00, and scale CVI was 0.96. Inter-item correlation and ICC for inter-rater reliability were both 0.933 (95 % CI = 0.903–0.954, p < 0.001 for ICC). Cohen’s Kappa coefficients ranged from 0.690 to 1.000 (p < 0.001), indicating high consistency between raters for all tool items. All scale items showed near-perfect agreement except SpO2, which showed substantial agreement. The S-CVI was good, indicating near-perfect agreement among raters. ESAT© is highly reliable and valid for determining suction needs in adult intensive care patients. The ESAT© aids autonomous decision-making for suctioning needs. Originally for novice pediatric nurses, the ESAT© was adapted for adult intensive care nurses. The ESAT© is valid and reliable for adult intensive care patients.

This study takes the suction cup as the research object and determines the key Angle in the tilt process of the suction cup by analyzing the tilt Angle of the vacuum suction cup. On this basis, the tilt Angle of the suction cup is divided into two stages, and the relationship formula between the tilt Angle of the suction cup and the area of the suction cup in the two stages is carefully analyzed, and then the relationship formula between the tilt Angle of the suction cup and the adsorption force is established. The error analysis, finite element simulation, and experimental research are carried out to improve the reliability of theoretical analysis.

Background Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to improve breathing and circulatory function. It is a simple and life-saving procedure; nevertheless, it carries morbidity, even after its removal. Efforts have been made continuously to shorten the duration of ICD, but mostly in non-trauma patients. In this study, we evaluated the impact of negative pleural suction over the duration of ICD. Methods This study was a prospective randomized controlled interventional trial conducted at Level 1 Trauma Centre. Thoracic trauma patients with ICD, who met the inclusion criteria (sample size 70) were randomized into two groups, the first group with negative pleural suction up to -20 cm H2O, and the second group as conventional, i.e. ICD connected to underwater seal container only. The primary objective was to compare the duration of ICDs and the secondary objectives were the length of hospital stay and various complications of thoracic trauma. Results Duration of ICD was measured in median days with minimum & maximum days. For the negative suction group, it was 4 days (2-16 days); for the conventional group, it was also 4 days (2-17 days). There was also no significant difference among both groups in length of hospital stay. Conclusion The beneficial effect of negative pleural suction to ICD could not be demonstrated over the duration of ICD and hospital stay. In both groups, there was no significant difference in complication rates like recurrent pneumothorax, retained hemothorax, persistent air leak, and empyema. Level of evidence Therapeutic Study, Level II Trial registration This trial was registered with the Clinical Trial Registry of India (CTRI) with registration no. REF/2020/11/038403.

To control secondary flow effects and enhance the aerodynamic performance of the compressor, the flow control effects of the flow suction at the endwall with different circumferential positions and at the blade tip were numerically investigated in the cantilever stator of an axial single-stage transonic compressor. The main purpose was to gain a better understanding of the application of boundary layer suction and the associated control mechanisms in the cantilever stator. The studies show that the optimal position of the endwall suction slot should be located up the stator blade, in terms of the leakage flow structures and the blade tip unloading effect. In addition, the flow control effects of the suction at the blade tip on leakage flow upstream is better than that of the endwall flow suction with the same structure. Further, the studies of compressor aerodynamic performance curves illustrate that the efficiency and pressure ratio is increased by 0.34% and 1.09% at the peak efficiency point, and are increased by 0.39% and 0.14% at the near stall point, respectively.

This study aimed to evaluate the effect of closed versus open endotracheal tube suction in reducing ventilator-associated pneumonia in mechanically ventilated neonates. In this open-label, parallel-group, randomized controlled trial with allocation concealment, ventilated neonates (≥ 28 weeks and ≥ 800 g) were either allocated to the closed-suction group ( n  = 41) or open-suction group ( n  = 39). The ventilator circuit of the babies enrolled in the closed-suction group was attached to the closed-suction catheter on the requirement of their first suction, and it was changed after every 48 h or earlier if visibly soiled whereas babies enrolled in the open-suction group were suctioned with a new suction catheter each time they require suction. The primary outcome was the incidence of VAP per 1000 days. Baseline maternal and neonatal characteristics were comparable between the two groups. The proportion of neonates with VAP in the closed-suction group was 3 (7.3%) and 1 (2.6%) in the open-suction group with an RR of 2.8 (95% CI : 0.30–26.28) and a p -value of 0.35. The incidence of VAP in the closed-suction group was 3.9 per 1000 ventilator days and 1.3 per 1000 ventilator days in the open-suction group. The incidence of clinical VAP/1000 ventilator days was 33.63 ± 22.96 in the closed-suction group and 28.67 ± 12.32 in the open-suction group with a mean difference of 5 (95% CI : − 3.26 to 13.26) and p -value of 0.24. Conclusion : In a unit with a low incidence of VAP, the effect of the endotracheal suction method alone did not impact the occurrence of VAP in the study population. Clinical trial registration : CTRI/2020/03/023679; Date: 17.02.2020. What is Known: • Better physiological stability of the closed-suctioning method on short-term measures including noticeably fewer episodes of hypoxia, a smaller drop in TcPO2 levels, and less variability in heart rate and bradycardia episodes. What is New: • In a unit with a low incidence of VAP in the neonates, randomized control trial studying the effect of the endotracheal suction method alone did not impact the occurrence of VAP amongst the study population.