Instillation of normal saline before suctioning in patients with pulmonary infections: a prospective randomized controlled trial

1998 ◽  
Vol 7 (4) ◽  
pp. 261-266 ◽  
Author(s):  
MH Ackerman ◽  
DJ Mick
Keyword(s):  
Blood Pressure ◽  
Adverse Effect ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Normal Saline ◽  
Pulmonary Infection ◽  
Controlled Trial ◽  
Pulmonary Infections ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial

OBJECTIVE: To determine the effect of instillation of normal saline before suctioning on oxygen saturation, heart rate, and blood pressure in patients with pulmonary infections. METHODS: A prospective randomized controlled trial was conducted in the surgical, medical, and burn/trauma ICUs of an academic medical center. Eighteen men and 11 women (mean age = 60 years) receiving mechanical ventilation who met the criteria for pulmonary infection were randomly assigned to 2 groups. One group had instillation of a 5-mL bolus of normal saline before suctioning; the other did not. Suctioning was done as needed during an 8-to 12-hour period. Oxygen saturation, heart rate, and blood pressure were measured noninvasively immediately before and after suctioning, at 1-minute intervals for 5 minutes after suctioning, and at 10 minutes after suctioning. RESULTS: Instillation of normal saline had an adverse effect on oxygen saturation, which worsened over time. Differences in saturation between the 2 groups were significant at 4, 5, and 10 minutes after suctioning. Differences in heart rate and blood pressure were not significant. CONCLUSION: Instillation of normal saline before suctioning has an adverse effect on oxygen saturation and should not be used routinely in patients receiving mechanical ventilation who have pulmonary infection.

scholarly journals Breast Feeding as Analgesia in Neonates: A Randomized Controlled Trial

2017 ◽  
Vol 36 (3) ◽  
pp. 238-242 ◽  
Author(s):  
Rajesh Kumar Singh ◽  
Ashish Kumar Simalti ◽  
Daljit Singh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Controlled Trial ◽  
Oxygen Saturation ◽  
Breast Feeding ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Group I ◽  
Heel Prick ◽  
Breast Fed

Introduction: Major myth regarding neonatal pain suggests that neonates because of their neurological immaturity do not experience pain. Although exact mechanism is not known, it is proposed that breast feeding through combination of various senses and the closeness of the infant’s mother, saturates the senses thus reducing perception of noxious stimuli. The objective of this study was to investigate the analgesic effect of breastfeeding during blood sampling through heel lance in healthy term neonates.Material and Methods: This was a Randomized controlled trial done in a Tertiary level Neonatal Intensive Care Unit. Sixty healthy term newborns, undergoing heel prick were included in study. Neonates were randomly assigned to two groups: Group I (breastfed) with; Group II (not breast fed). Babies were given heel prick and crying time, Heart rate, SpO2 and BP monitored. Changes in various physiological parameters following a heel prick were studied in two groups.Results: Neonates in both groups expressed pain by crying, increase in heart rate, fall in transcutaneous oxygen saturation and rise in blood pressure. Compared to control group, the babies who were breast fed were found to have lesser crying time (40.04 sec and 69.09 sec respectively, p<0.05) and lesser rise in heart rate (rise of 21.78 and 34.46 bpm respectively, p<0.03). In the breast fed group there was a trend to a lesser decrease in oxygen saturation and lesser rise in blood pressure though this was not statistically significant.Conclusion: Breast feeding offers a quick and effective means of reducing pain in neonates during routine neonatal procedures.J Nepal Paediatr Soc 2016;36(3):238-242

scholarly journals Variable versus fixed-rate infusion of phenylephrine during cesarean delivery: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ahmed Hasanin ◽  
Sara Habib ◽  
Yaser Abdelwahab ◽  
Mohamed Elsayad ◽  
Maha Mostafa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cesarean Delivery ◽  
Controlled Trial ◽  
Controlled Study ◽  
Lower Systolic Blood Pressure ◽  
Randomized Controlled ◽  
Phenylephrine Infusion ◽  
Infusion Regimen

Abstract Background Phenylephrine is the most commonly used vasopressor for prophylaxis against maternal hypotension during cesarean delivery; however, the best regimen for its administration is not well established. Although variable infusion protocols had been suggested for phenylephrine infusion, evidence-based evaluation of variable infusion regimens are lacking. The aim of this work is to compare variable infusion, fixed on-and-off infusion, and intermittent boluses of phenylephrine for prophylaxis against maternal hypotension during cesarean delivery. Methods A randomized controlled study was conducted, including full-term pregnant women scheduled for elective cesarean delivery. Participants were divided into three groups which received phenylephrine by either intermittent boluses (1.5 mcg/Kg phenylephrine), fixed on-and-off infusion (with a dose of 0.75 mcg/Kg/min), or variable infusion (with a starting dose of 0.75 mcg/Kg/min). The three groups were compared with regard to frequency of: maternal hypotension (primary outcome), second episode hypotension, reactive hypertension, and bradycardia. Other outcomes included heart rate, systolic blood pressure, physician interventions, and neonatal outcomes. Results Two-hundred and seventeen mothers were available for final analysis. The 2 infusion groups showed less incidence of maternal hypotension {26/70 (37%), 22/71 (31%), and (51/76 (67%)} and higher incidence of reactive hypertension compared to the intermittent boluses group without significant differences between the two former groups. The number of physician interventions was highest in the variable infusion group compared to the other two groups. The intermittent boluses group showed lower systolic blood pressure and higher heart rate compared to the two infusion groups; whilst the two later groups were comparable. Conclusion Both phenylephrine infusion regimens equally prevented maternal hypotension during cesarean delivery compared to intermittent boluses regimen. Due to higher number of physician interventions in the variable infusion regimen, the current recommendations which favor this regimen over fixed infusion regimen might need re-evaluation.

scholarly journals Perbandingan Peningkatan Laju Nadi dan MAP antara Laringoskopi Menggunakan Bilah Laringoskop Macintosh dan McCoy

2019 ◽  
Vol 7 (1) ◽  
pp. 1-9
Author(s):  
Andy Hutariyus ◽  
Iwan Fuadi ◽  
Dewi Yulianti Bisri
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Test Results ◽  
Increased Intracranial Pressure ◽  
Lower Heart Rate ◽  
Randomized Controlled ◽  
St Segment ◽  
Laryngoscope Blades

Tindakan laringoskopi dan intubasi dapat menyebabkan peningkatan kadar katekolamin di dalam darah sehingga meningkatkan respons hemodinamik seperti takikardia, peningkatan tekanan darah, peningkatan tekanan intrakranial, aritmia, dan perubahan segmen ST. Respons ini bergantung pada seberapa banyak manipulasi di daerah lidah, faring, laring, dan epiglotis pada saat laringoskopi direk. Tujuan penelitian ini membandingkan peningkatan laju nadi dan mean arterial pressure (MAP) antara laringoskopi intubasi menggunakan bilah Macintosh dan McCoy. Metode penelitian ini adalah uji klinis acak terkontrol buta tunggal pada 40 pasien yang menjalani operasi dengan anestesi umum di RSUP Dr. Hasan Sadikin Bandung dari bulan Juli hingga Agustus 2018. Subjek penelitian dibagi menjadi dua kelompok, kelompok MI laringoskopi intubasi dengan Macintosh dan kelompok MC laringoskopi intubasi dengan McCoy. Data hasil penelitian diuji secara statistik menggunakan uji t tidak berpasangan dan Uji Mann-Whitney. Hasil penelitian ini menunjukkan perbedaan laju nadi dan MAP setelah intubasi pada kelompok McCoy lebih rendah dibanding dengan Macintosh pada menit ke-1, menit ke-2,5, dan menit ke-5 dengan perbedaan signifikan (p˂0,05). Simpulan penelitian ini menunjukkan bahwa laringoskopi dengan bilah laringoscop McCoy dapat mengurangi peningkatan laju nadi dan MAP dibanding dengan Macintosh.  Comparison between Laryngoscopy Using Macintosh and McCoy Laryngoscope Blades in Increasing Heart Rate and Mean Arterial PressureLaryngoscopy and intubation often increase hemodynamic responses such as tachycardia, increased blood pressure, increased intracranial pressure, arrhythmia, and changes on the ST segment due to increased blood catecholamines. This response depends on how much the tongue, pharynx, larynx, and epiglottis are manipulated during a direct laryngoscopy. This study was a single blinded randomized controlled trial on 40 patients who underwent surgery under general anesthesia in Dr. Hasan Sadikin General Hospital from July to August 2018. Subjects of study were randomly divided into two groups, Macintosh (MI) and McCoy (MC) groups. Data were analyzed using t-test and Mann-Whitney test. Results of this study found that lower heart rate and MAP increases were identified in McCoy group when compared to the Macintosh group in minute 1, minute 2,5, and minute 5 after intubation. Both variables had statistically significant differences (p<0.05). This study concludes that laryngoscopy using McCoy laryngoscope blade was is able to prevent increase in heart rate and MAP compared to Macintosh.

scholarly journals Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial

2019 ◽  
Vol 8 (5) ◽  
pp. 1921
Author(s):  
Anjuman Alam ◽  
S. M. A. Zakaria
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Urine Output ◽  
Gestational Hypertension ◽  
Controlled Trial ◽  
Pressure Control ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Hypertensive Emergencies ◽  
To Receive

Background: To compare intravenous labetalol with oral nifedipine in terms of rapidity at which they control blood pressure in acute hypertensive emergencies of pregnancy.Methods: A randomized controlled study. Pregnant women with severe gestational hypertension with BP ≥160/110 mmHg after ≥20 weeks of gestation were randomized with computer generated numbers, either to receive IV labetalol with an escalating dose of 20, 40, 80, 80 and 80 mg or nifedipine capsule orally in a dose of 10 mg every 15 minutes (upto 5 doses) until a BP of ≤150/100 mmHg is achieved. Crossover treatment was to be effected if initial treatment regimen was unsuccessful. Primary outcome was time taken and number of doses required to achieve the target BP of ≤150/100 mmHg. Secondary outcomes were volume of urine output, maternal heart rate changes, fetal heart rate abnormality, perinatal and maternal outcome and side effects.Results: Oral nifedipine achieved the target BP (≤150/100 mmHg) more rapidly in (26.25±12.60) minutes in comparison to (32.62±12.19) minutes with IV labetalol (p= 0.024). Nifedipine group also took less number of doses to achieve the target BP of (≤150/100 mmHg) mmHg than IV labetalol (1.75±0.840 vs. 2.18±0.83), p= 0.024. Volume of urine output was also significantly more in nifedipine group (94.90±1.84 ml) at 1 hour and thereafter till 24 hour of treatment in comparison to IV labetalol (41.28±2.14 ml), p= 0.000. Side effects are few and not serious. No patient required crossover treatment.Conclusions: Both the drugs are equally effective in controlling acute hypertensive emergencies of pregnancy, however oral nifedipine is more rapid in controlling severe hypertension and also it is associated with significantly increased urine output.

scholarly journals Comparing the efficacy of 7%, 5% hypertonic saline and 0.9% normal saline in acute bronchiolitis: a randomized controlled trial

2018 ◽  
Vol 7 (5) ◽  
pp. 819
Author(s):  
Adel Ahadi ◽  
Manouchehr Barak ◽  
Fatemeh Amani
Keyword(s):  
Randomized Controlled Trial ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Study Groups ◽  
Acute Bronchiolitis ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
The Mean

Background: The study aimed to investigate the effect of nebulized 5% and 7% Hypertonic Saline (HS) versus Normal Saline (NS) in acute viral bronchiolitis.Methods: This is a prospective, randomized controlled trial study that has been done on 90 infants presenting with acute bronchiolitis. All infants divided randomly in three equal size and matched groups (n=30). Subjects received 4ml nebulized 5% and 7% HS along with 0.15mg/kg Adrenaline or 4 ml 0.9%NS every 6 hours from enrolment until hospital discharge. For all patients, clinical symptoms such as sputum, wheezing, retraction rate, heart rate, fever, crackle, irritability, week nutrition and breathing were recorded in baseline and length of wheezing, cough, and crackle, length of stay (LOS), fever and sputum based on days in the end of study. Collected data analyzed by statistical methods in SPSS.19.Results: At baseline, study groups were similar in demographic and clinical characteristics. The mean age of all patients was 5.5±3.6 months, and 59 (65.6%) were male. The length of cough and crackle, and the length of LOS in 5% and 7% HS groups was significantly lower than NS group.Conclusions: Among infants admitted to the hospital with viral bronchiolitis, treatment with nebulized 5% HS and 7% HS had significant effect on decreasing clinical symptoms length and LOS when compared with NS.

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