Ultrasound guided blood sampling from fetal sheep

1989 ◽  
Vol 40 (2) ◽  
pp. 401 ◽  
Author(s):  
JP Newnham ◽  
RW Kelly ◽  
P Boyne ◽  
SE Reid
Keyword(s):  
Ultrasound Guidance ◽  
Needle Aspiration ◽  
Blood Sampling ◽  
Ultrasound Guided ◽  
Fetal Sheep ◽  
Arterial Blood Gas ◽  
Operator Experience ◽  
Arterial Blood ◽  
Fetal Death Rate ◽  
Repeated Sampling

The feasibility of obtaining fetal blood samples by needle aspiration under ultrasound guidance was assessed in 32 fetal sheep from 101-1 36 days' gestation. Seventy-six attempts at blood sampling were made, of which all but two were successful. The overall fetal death rate resulting from this procedure was 9.2%. However, with increasing operator experience and with advancing gestational age, 95.5% of fetuses survived the procedure. Repeated sampling from individual fetuses had minimal effects on arterial blood gas values. Ultrasound guided blood sampling now provides an alternative to chronic catheterization as a basis for some types of research with fetal sheep.

scholarly journals Dexmedetomidine sedation for endobronchial ultrasound-guided transbronchial needle aspiration, a randomised controlled trial

2020 ◽  
Vol 6 (4) ◽  
pp. 00064-2020
Author(s):  
Ting-Yu Lin ◽  
Yu-Chen Huang ◽  
Chih-Hsi Kuo ◽  
Fu-Tsai Chung ◽  
Yu-Ting Lin ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Recovery Period ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Propofol Sedation ◽  
Arterial Blood ◽  
Patient Cooperation ◽  
Group D

Background and aimAppropriate sedation is important to the success of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Dexmedetomidine is a sedative agent that operates via the α2 adrenergic agonist, which provides sleep-like sedation with little respiratory suppression. This study compared the efficacy and safety of dexmedetomidine sedation with propofol in cases of EBUS-TBNA.MethodsPatients requiring EBUS-TBNA were randomly assigned dexmedetomidine sedation (D, n=25) or propofol sedation (P, n=25). Vital signs, diagnostic yield and the bispectral index (BIS) were recorded throughout the bronchoscopic procedure and recovery period. The tolerance and cooperation of the patients were evaluated using questionnaires.Measurements and resultsThe lowest mean arterial blood pressure in group D (79.2±9.9 versus 72.5±12.9 mmHg, p=0.049) exceeded that in group P, the lowest heart rate was lower (60.9±10.2 versus 71.4±11.8 beats·min−1, p=0.006) and the mean BIS during sedation was significantly higher (84.1±8.3 versus 73.6±5.7, p<0.001). Patients in group D were more likely to report perceiving procedure-related symptoms and express an unwillingness to undergo the bronchoscopy again, if indicated (41.1 versus 83.3%, p=0.007). One subject in group D aborted EBUS-TBNA due to intolerance. Many of the variables in the two groups were similar, including the proportion of hypoxaemic events, recovery times, patient cooperation and diagnostic yield.ConclusionsThe effects of dexmedetomidine on haemodynamics were in line with its pharmacodynamic features. Patients who received dexmedetomidine were more likely than those who received propofol to perceive the procedures. Overall, dexmedetomidine did not prove inferior to propofol sedation in terms of patient cooperation or diagnostic yield.

scholarly journals Ultrasound-guided peripheral vascular catheterization in pediatric patients: a narrative review

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Yoshinobu Nakayama ◽  
Jun Takeshita ◽  
Yasufumi Nakajima ◽  
Nobuaki Shime
Keyword(s):  
Ultrasound Guidance ◽  
Pediatric Patients ◽  
Clinical Performance ◽  
Narrative Review ◽  
Peripheral Vascular ◽  
Comprehensive Understanding ◽  
Ultrasound Guided ◽  
Operator Experience ◽  
Vascular Catheterization ◽  
Selection Of

Abstract Peripheral vascular catheterization (PVC) in pediatric patients is technically challenging. Ultrasound guidance has gained the most interest in perioperative and intensive care fields because it visualizes the exact location of small target vessels and is less invasive than other techniques. There have been a growing number of studies related to ultrasound guidance for PVC with or without difficult access in pediatric patients, and most findings have demonstrated its superiority to other techniques. There are various ultrasound guidance approaches, and a comprehensive understanding of the basics, operator experience, and selection of appropriate techniques is required for the successful utilization of this technique. This narrative review summarizes the literature regarding ultrasound-guided PVC principles, approaches, and pitfalls to improve its clinical performance in pediatric settings.

Serum thyroid hormones and tissue 5'-monodeiodinase activity in acutely thyroidectomized newborn lambs

1986 ◽  
Vol 251 (2) ◽  
pp. E151-E155 ◽  
Author(s):  
D. H. Polk ◽  
S. Y. Wu ◽  
D. A. Fisher
Keyword(s):  
Sham Operation ◽  
Fetal Sheep ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Brown Adipose ◽  
Serum T3 ◽  
Serum T4 ◽  
Serum Thyroid Hormones ◽  
Metabolic Significance

After either total thyroidectomy or sham operation in full-term fetal sheep, fetuses were delivered and serial blood samples were obtained for measurements of thyroxine (T4), triiodothyronine (T3), and catecholamines. Despite comparable serum T4 values (T4 means +/- SE, sham 7.1 +/- 0.6 micrograms/dl, thyroidectomized 6.8 +/- 0.7 micrograms/dl at 60 min after birth), serum T3 values were lower in the thyroidectomized animals (T3 means +/- SE, thyroidectomized 39 +/- 4.8 ng/dl, sham 153 +/- 20.1 ng/dl at 60 min after birth). Four hours after birth, the animals were killed with an intravenous overdose of barbiturate. Brain, thyroid, liver, kidney, and brown adipose tissues were dissected and analyzed for thyroxine 5'-monodeiodinase (5'-MDI) activity in vitro. 5'-MDI activity was comparable in all tissues from sham-operated and thyroidectomized lambs. Plasma epinephrine and norepinephrine concentrations, mean arterial pressure, mean pulse, rectal temperature, and arterial blood gas values were similar in the two groups of animals. These data support the hypothesis that the thyroid gland is the major source of T3 for the T3 surge in the immediate newborn period. They also indicate that the neonatal T3 surge has limited immediate metabolic significance in euthyroid newborns.

scholarly journals Evaluation and Comparison of Performance Parameters and Impact of Telepathology and Operator Experience on Endobronchial and Endoscopic Ultrasound-Guided Fine-Needle Aspiration

2020 ◽  
Author(s):  
Meghan M Hupp ◽  
Subhan Khan ◽  
H Erhan Dincer ◽  
J Shawn Mallery ◽  
Michael T Shyne ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Management Training ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Training Methods ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Operator Experience

Abstract Objectives Endobronchial ultrasound- and endoscopic ultrasound-guided fine-needle aspiration (EBUS-/EUS-FNA) are minimally invasive techniques of diagnosing and staging malignancies. The procedures are difficult to master, requiring specific feedback for optimizing yield. Methods Over 2 years, EBUS-/EUS-FNA cases were gathered using the institutional pathology database. Patient and specimen characteristics were collected from the pathology database and electronic medical record. Results In 2 years, 789 unique FNA specimens were collected (356 EBUS and 433 EUS specimens). The cohort and each subgroup had excellent performance, which was enhanced by telepathology. The discrepancy rate was satisfactorily low. Hematolymphoid neoplasms are overrepresented in discrepant EBUS cases. The malignancy rates of cytology diagnostic categories were comparable to the literature. Conclusions Using diagnostic yield and concordance results allow for comprehensive evaluation of the entire process of EBUS-/EUS-FNAs. This study’s findings can influence patient management, training methods, and interpretation of results, while also acting as a model for others to investigate their own sources of inadequacy, discrepancy, and training gaps.

Umbilical cord occlusion stimulates breathing independent of blood gases and pH

1991 ◽  
Vol 70 (4) ◽  
pp. 1796-1809 ◽  
Author(s):  
S. L. Adamson ◽  
I. M. Kuipers ◽  
D. M. Olson
Keyword(s):  
Prostaglandin E2 ◽  
Umbilical Cord ◽  
Blood Gases ◽  
High Frequency Oscillation ◽  
Breathing Rate ◽  
Fetal Sheep ◽  
Arterial Pco2 ◽  
Arterial Blood Gas ◽  
Arterial Blood

The role of umbilical cord occlusion in the initiation of breathing at birth was investigated by use of 16 unanesthetized fetal sheep near full term. Artificial ventilation with high-frequency oscillation was used to control fetal arterial blood gas tensions. At baseline, PCO2 was maintained at control fetal values and PO2 was elevated to between 25 and 50 Torr. In the first study on six intact and four vagotomized fetuses, arterial PCO2 and PO2 were maintained constant during two 30-min periods of umbilical cord occlusion. Nevertheless, the mean fetal breathing rate increased significantly when the umbilical cord was occluded. In the second study on six intact fetuses, hypercapnia (68 Torr) was imposed by adding CO2 to the ventilation gas. When the umbilical cord was occluded, there was a significantly greater stimulation of breathing (rate, incidence, and amplitude) in response to hypercapnia than in response to hypercapnia alone. During cord occlusion, plasma prostaglandin E2 concentration decreased significantly. Results indicate that cord occlusion stimulates breathing possibly by causing the removal of a placentally produced respiratory inhibitor such as prostaglandin E2 from the circulation.

scholarly journals The benefits of on-site cytology with ultrasound-guided fine needle aspiration in a one-stop neck lump clinic

2010 ◽  
Vol 92 (8) ◽  
pp. 660-664 ◽  
Author(s):  
A Ganguly ◽  
TE Giles ◽  
PA Smith ◽  
FE White ◽  
PP Nixon
Keyword(s):  
Fine Needle Aspiration ◽  
Ultrasound Guidance ◽  
Clinical Excellence ◽  
Needle Aspiration ◽  
University Hospital ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
One Stop ◽  
Neck Lump ◽  
Set Up

INTRODUCTION In the National Institute for Health and Clinical Excellence (NICE) guidance on cancer services published in 2004, it was recommended that specialist clinics should be set up for the assessment of patients with neck lumps, structured in a similar way to one-stop breast lump clinics with a cytopathologist present and preferably ultrasound guidance. The aim of this study was to audit the performance of ultrasound-guided fine needle aspiration (FNA) with on-site cytology in a one-stop neck lump clinic at The Royal Liverpool University Hospital. PATIENTS AND METHODS Data were collected between November 2008 and May 2009 (7 months). Details of the adequacy rate for the FNA were recorded and whether multiple passes were required. The likely adequacy rate if ultrasound guidance was not available was also calculated. RESULTS A total of 274 patients were included in the audit. Of these, 227 (83%) patients required a single pass for adequate diagnostic material. Of the remaining, 45 (16%) required two passes and 2 (1%) required three passes. The overall sample inadequacy rate was 11 of 274 (4%). From these results, it could be predicted that, if immediate cytological evaluation was unavailable, the inadequacy rate would have been 41 of 274 (15%). CONCLUSIONS This audit has illustrated the benefits of a one-stop clinic with on-site cytology in providing a rapid diagnostic head and neck cancer service.

The role of laboratory processing in determining diagnostic conclusiveness of breast fine needle aspirations: conventional smearing versus a monolayer preparation

2009 ◽  
Vol 62 (10) ◽  
pp. 931-934 ◽  
Author(s):  
C A P Wauters ◽  
B Kooistra ◽  
L J A Strobbe
Keyword(s):  
Ultrasound Guidance ◽  
Needle Aspiration ◽  
Processing Technique ◽  
Benign Lesions ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Malignant Lesions ◽  
The Difference

Aim:To compare breast fine needle aspiration (FNA) specimens prepared by conventional smearing (CS) versus monolayer preparation (MP), with respect to the conclusiveness of the cytopathological diagnosis.Methods:From 1992 to 1996, aspirators prepared aspirates themselves by direct smearing onto 2–4 slides. From 1999 to 2003, aspirate preparation was performed in the laboratory, creating a MP, using a Hettich cytocentrifuge. FNA diagnoses were categorised into inadequate (C1), benign (C2), atypical (C3), suspicious for malignancy (C4) and malignant (C5). The reference standard constituted histological follow-up. A conclusive FNA diagnosis was defined as C2 in lesions benign on follow-up and C5 in lesions malignant on histology.Results:From 1992 to 1996, 692 aspirates were processed by CS, whereas from 1999 to 2003, 1301 aspirates were processed by MP. More FNA were ultrasound-guided in the MP group (85.6% versus 21.5%, p<0.001). When compared with CS, MP-prepared FNA had conclusive diagnoses significantly more often (72.8% versus 58.5%, p<0.001). This effect remained significant when corrected for the difference in ultrasound guidance (adjusted odds ratio 1.7, 95% confidence interval 1.3 to 2.2, p<0.001), and was larger for malignant lesions than for benign lesions (51.7% versus 79.9%, p<0.001).Conclusion:Patients presenting with breast lesions can more often be offered a same-day, conclusive cytopathological diagnosis when FNA are prepared by a manual MP processing technique.

scholarly journals Dry Needling and Antithrombotic Drugs

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
María Muñoz ◽  
Jan Dommerholt ◽  
Sara Pérez-Palomares ◽  
Pablo Herrero ◽  
Sandra Calvo
Keyword(s):  
Clinical Practice ◽  
Ultrasound Guidance ◽  
Fine Needle Aspiration Biopsy ◽  
Current Knowledge ◽  
Needle Aspiration ◽  
Published Data ◽  
Dry Needling ◽  
Antithrombotic Drugs ◽  
Ultrasound Guided ◽  
Antithrombotic Medication

Many clinicians increasingly use dry needling in clinical practice. However, whether patients’ intake of antithrombotic drugs should be considered as a contraindication for dry needling has not been investigated to date. As far as we know, there are no publications in analyzing the intake of antiplatelet or anticoagulant agents in the context of dry needling techniques. A thorough analysis of existing medications and how they may impact various needling approaches may contribute to improved evidence-informed clinical practice. The primary purpose of this paper is to review the current knowledge of antithrombotic therapy in the context of dry needling. In addition, reviewing guidelines of other needling approaches, such as electromyography, acupuncture, botulinum toxin infiltration, and neck ultrasound-guided fine-needle aspiration biopsy, may provide specific insights relevant for dry needling. Based on published data, taking antithrombotic medication should not be considered an absolute contraindication for dry needling techniques. As long as specific dry needling and individual risks are properly considered, it does not change the risk and safety profile of dry needling. Under specific circumstances, the use of ultrasound guidance is recommended when available.

scholarly journals Nerve Injury During Ultrasound-Guided Thyroid Biopsy—A First Reported Complication of Permanent Vocal Fold Paralysis

2020 ◽  
pp. 014556132090285 ◽  
Author(s):  
Lyndsay L. Madden ◽  
Moeko Nagatsuka ◽  
Azeem Z. Vasi ◽  
Jayesh Madrecha ◽  
Libby J. Smith
Keyword(s):  
Nerve Injury ◽  
Needle Biopsy ◽  
Vocal Fold ◽  
Thyroid Nodules ◽  
Ultrasound Guidance ◽  
Needle Aspiration ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Laryngeal Nerve Injury

Needle biopsy is a well-established component in the evaluation of thyroid nodules. The biopsy is usually performed with an ultrasound guidance and consists of either fine-needle aspiration or core needle biopsy. Although these terms are often used interchangeably, their difference is important. To our knowledge, we discuss the first reported case of biopsy-proven laryngeal nerve injury and permanent vocal fold paralysis following ultrasound-guided core biopsy of the thyroid. We advocate this complication be discussed as part of the consent process.

Sign in / Sign up

Export Citation Format

Share Document