SUBARACHNOID HAEMORRHAGE DUE TO THE RUPTURE OF A HIGH FLOW ANEURYSM DEVELOPED ON AN INTRADURAL ARTERY FEEDING A JUGULOTYMPANIC PARAGANGLIOMA

Until recently the prime purposes of filters have been to produce clear filtrates or to collect particles from solution and then remove the filter medium and examine the particles by transmission electron microscopy. These filters have not had the best characteristics for scanning electron microscopy due to the size of the pores or the surface topography. Advances in polymer chemistry and membrane technology resulted in membranes whose characteristics make them versatile substrates for many scanning electron microscope applications. These polysulphone type membranes are anisotropic, consisting of a very thin (0.1 to 1.5 μm) dense skin of extremely fine, controlled pore texture upon a much thicker (50 to 250μm), spongy layer of the same polymer. Apparent pore diameters can be controlled in the range of 10 to 40 A. The high flow ultrafilters which we are describing have a surface porosity in the range of 15 to 25 angstrom units (0.0015-0.0025μm).

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High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00158 ◽

2020 ◽

Vol 5 (4) ◽

pp. 1006-1010

Author(s):

Jennifer Raminick ◽

Hema Desai

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Oxygen Therapy ◽

Respiratory Illness ◽

High Flow ◽

Oral Feeding ◽

Respiratory Support ◽

Acute Respiratory Illness ◽

High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

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