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Canadian Journal of Veterinary Research... Jul 2020Recumbency affects respiratory mechanics and oxygenation in anesthetized horses. Changes in pleural and abdominal pressures that can impair ventilation have not been...
Recumbency affects respiratory mechanics and oxygenation in anesthetized horses. Changes in pleural and abdominal pressures that can impair ventilation have not been described in all recumbencies. The objective of this study was to determine the effects of patient positioning on transdiaphragmatic pressure and selected hemodynamic variables. Horses were maintained under total intravenous general anesthesia with nasal oxygen supplementation. Transnasal balloon catheters in the stomach and thoracic esophagus were used to measure intrathoracic and gastric pressures in standing horses and in anesthetized horses positioned in right and left lateral recumbency, dorsal recumbency, reverse Trendelenburg position, and Trendelenburg position. Transdiaphragmatic pressure was calculated as the difference between gastric and intrathoracic pressures. Measurements of oxygen saturation (SpO), heart rate, systolic, diastolic and mean arterial pressures, and respiratory rate were obtained every 5 minutes. When compared to dorsal recumbency, gastric expiratory pressure is decreased in the standing position. Thoracic expiratory pressure is decreased in standing and reverse Trendelenburg. Transdiaphragmatic expiratory pressure and SpO are decreased in Trendelenburg. Heart rate is increased in reverse Trendelenburg. Systolic, diastolic, and mean arterial pressures are decreased in reverse Trendelenburg and increased in left lateral and right lateral recumbency. We found that there is wide variation in respiratory pressures between horses and positions and they are not predictive of associated changes in hemodynamic variables.
Topics: Anesthesia, General; Anesthetics, Intravenous; Animals; Body Weight; Diaphragm; Female; Heart Rate; Hemodynamics; Horses; Male; Oxygen; Pressure
PubMed: 32801455
DOI: No ID Found -
Journal of Tropical Pediatrics Feb 2023Feeding intolerance (FI) is a common condition in preterm infants because they have an immature gastrointestinal tract. There are studies on the effects of the position... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Feeding intolerance (FI) is a common condition in preterm infants because they have an immature gastrointestinal tract. There are studies on the effects of the position on gastric residual volume (GRV) in preterm infants. Kangaroo mother care (KMC) may be an instrument for reducing FI by providing an upright position to infants. Moreover, numerous studies conducted with this therapeutic position applied by putting an infant on the mother's chest have indicated its positive effects on the infant's weight gain, growth and development, and vital signs. Therefore, this study aimed to reveal the impact of KMC on FI in preterm infants.
METHODS
The population of the study, designed as a randomized trial, consisted of 168 preterm infants [KMC: 84, Standart Care (SC): 84] hospitalized in the neonatal intensive care unit of a university hospital between June and November 2020. Infants were randomly selected and divided into two groups. After the vital signs of the infants in both groups became stable, the infants were fed in the same position. KMC was applied to the infants in the intervention group for 1 h by preparing a suitable environment after feeding. Infants in the SC group were placed in the prone position after feeding. The GRVs of the infants in both groups were recorded on the Infant Follow-up Form before the next feeding.
RESULTS
No statistically significant difference was detected between the groups upon comparing them in terms of demographic and clinical characteristics. The body temperatures and O2 saturations of the participants in the KMC group were statistically significantly higher, and their respiratory and heart rates were lower than the SC group. The transition time to full enteral feeding was statistically significantly shorter, and FI was experienced significantly less in the KMC group infants than in the SC group (p < 0.05). There was no statistically significant difference between the groups in terms of the infants' weight gain and length of hospital stay (p > 0.05).
CONCLUSION
The present study demonstrated that KMC had a positive impact on FI in preterm infants. KMC is not only a safe care model providing the earliest contact between parents and infants but also a practice whose positive effect on the functioning of the digestive system in preterm infants we can use.
Topics: Child; Humans; Infant, Newborn; Infant, Low Birth Weight; Infant, Premature; Intensive Care Units, Neonatal; Kangaroo-Mother Care Method; Weight Gain
PubMed: 36897067
DOI: 10.1093/tropej/fmad015 -
Prone versus Barts “flank-free” modified supine percutaneous nephrolithotomy: a match-pair analysis.Turkish Journal of Medical Sciences Jun 2021In this study, we aimed to compare the results of prone and Barts “flank-free” modified supine percutaneous nephrolithotomy (PCNL) operations in our clinic.
BACKGROUND/AIM
In this study, we aimed to compare the results of prone and Barts “flank-free” modified supine percutaneous nephrolithotomy (PCNL) operations in our clinic.
MATERIALS AND METHODS
The data from patients that underwent Barts “flank-free” modified supine PCNL (BS-PCNL) (n = 52) between June 2018 and July 2020 and prone PCNL (P-PCNL) (n = 286) between April 2014 and June 2018 were retrospectively evaluated. Of those 286 patients, 104 patients whose sex, age, body mass index, American Society of Anesthesiology score, stone localization, stone size, and hydronephrosis matched the BS-PCNL group in a 1:2 ratio were included in the study. The groups were compared in terms of intraoperative outcome, complication rates, and stone-free rates.
RESULTS
The mean age of all patients (58 females, 98 males) included in the study was 41.8 ± 15.2 years, and the mean body mass index (BMI) was 24.7 ± 2.9 kg/m2. The mean operation time was significantly shorter in the BS-PCNL group than in the P-PCNL group (80.2 ± 15.1 min vs. 92.4 ± 22.7 min and p = 0.01). There was no significant difference between the two groups in terms of fluoroscopy time, intraoperative complications, postoperative complications, and stone-free rates.
CONCLUSION
Our study shows that BS-PCNL is an effective and safe method that significantly reduces the operation time and should be considered as one of the primary treatment options for patients scheduled for PCNL.
Topics: Adult; Female; Humans; Kidney Calculi; Male; Middle Aged; Nephrolithotomy, Percutaneous; Patient Positioning; Retrospective Studies; Supine Position; Treatment Outcome
PubMed: 33550764
DOI: 10.3906/sag-2011-21 -
Life Sciences, Society and Policy Dec 2017The aim of this manuscript is to highlight that from the phenomenology and psychoanalysis point of view, the meaning of the notion of the body is different from the...
The aim of this manuscript is to highlight that from the phenomenology and psychoanalysis point of view, the meaning of the notion of the body is different from the medical biologicist discourse. In psychoanalysis, the body is an erogenized body. It is constituted as an object for another self. Similarly, in phenomenology, the body is an own body in first instance. It is the body of a self, rather than a living body and a material body. Both positions enable us to understand how this conceptualization of the body is essential in any human field. Especially in the clinic, the position of the subject before the other will lead to a specific form of intervention. From this understanding of the human body, both phenomenology and psychoanalysis confirm that the biologicist understanding of the body, presumed by all psychological and medical practices, is insufficient.
Topics: Concept Formation; Human Body; Humans; Psychoanalysis; Self Concept
PubMed: 28447286
DOI: 10.1186/s40504-017-0051-0 -
RoFo : Fortschritte Auf Dem Gebiete Der... Feb 2014The urge to increase magnetic field strength is driven by a number of potentially beneficial physical changes, possibly resulting in improved MR diagnostics. With the... (Review)
Review
The urge to increase magnetic field strength is driven by a number of potentially beneficial physical changes, possibly resulting in improved MR diagnostics. With the successful introduction of in-vivo ultra-high-field MR imaging, by means of 7 Tesla MRI, the focus of scientific research has been set on compiling different applications of brain and body imaging. This review presents an overview on the current status of 7 T MR imaging, investigating the opportunities as well as challenges associated with ultra-high-field MRI. Citation Format: • Umutlu L, Ladd ME, Forsting M et al. 7 Tesla MR Imaging: Opportunities and Challenges. Fortschr Röntgenstr 2014; 186: 121 - 129.
Topics: Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Patient Positioning
PubMed: 23996625
DOI: 10.1055/s-0033-1350406 -
Pediatric Research Mar 2018BackgroundIt has been hypothesized that life-threatening events are caused by supraesophageal reflux (SER) of gastric contents that activates laryngeal...
BackgroundIt has been hypothesized that life-threatening events are caused by supraesophageal reflux (SER) of gastric contents that activates laryngeal chemoreflex-stimulated apnea. Placing infants supine decreases the risk of sudden infant death syndrome (SIDS). The aim of this study was to determine whether body position affects esophageal reflexes that control SER.MethodsWe instrumented the pharyngeal and esophageal muscles of decerebrate cats (N=14) to record EMG or manometry, and investigated the effects of body position on the esophago-upper esophageal sphincter (UES) contractile reflex (EUCR), esophago-UES relaxation reflex (EURR), esophagus-stimulated pharyngeal swallow response (EPSR), secondary peristalsis (SP), and pharyngeal swallow (PS). EPSR, EUCR, and SP were activated by balloon distension, EURR by air pulse, and PS by nasopharyngeal water injection. The esophagus was stimulated in the cervical, proximal thoracic, and distal thoracic regions. The threshold stimulus for activation of EUCR, EURR, and PS, and the chance of activation of EPSR and SP were quantified.ResultsWe found that only EPSR was significantly more sensitive in the supine vs. prone position regardless of the stimulus or the position of the stimulus in the esophagus.ConclusionWe hypothesize that the EPSR may contribute to the protection of infants from SIDS by placement in the supine position.
Topics: Animals; Cats; Disease Models, Animal; Electromyography; Esophageal Sphincter, Upper; Esophagus; Humans; Infant; Manometry; Muscle Contraction; Patient Positioning; Peristalsis; Reflex; Sudden Infant Death; Supine Position
PubMed: 29166377
DOI: 10.1038/pr.2017.302 -
The Cochrane Database of Systematic... Jan 2017It has been proposed that body positioning in preterm infants, as compared with other, more invasive measures, may be an effective method of reducing clinically... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It has been proposed that body positioning in preterm infants, as compared with other, more invasive measures, may be an effective method of reducing clinically significant apnoea.
OBJECTIVES
To determine effects of body positioning on cardiorespiratory parameters in spontaneously breathing preterm infants with clinically significant apnoea.Subgroup analyses examined effects of body positioning of spontaneously breathing preterm infants with apnoea from the following subgroups.• Gestational age < 28 weeks or birth weight less than 1000 grams.• Apnoea managed with methylxanthines.• Frequent apnoea (> 10 events/d).• Type of apnoea measured (central vs mixed vs obstructive)
SEARCH METHODS
We used the standard search strategy of the Cochrane Neonatal Review Group (CNRG) to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 10), MEDLINE via PubMed (1966 to 14 November 2016), Embase (1980 to 14 November 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 2016 November 14). We also searched clinical trials databases and conference proceedings for randomised controlled trials and quasi-randomised trials.
SELECTION CRITERIA
Randomised and quasi-randomised controlled clinical trials with parallel, factorial or cross-over design comparing the impact of different body positions on apnoea in spontaneously breathing preterm infants were eligible for our review.
DATA COLLECTION AND ANALYSIS
We assessed trial quality, data extraction and synthesis of data using standard methods of the CNRG. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence.
MAIN RESULTS
The search conducted in November 2016 identified no new studies. Five studies (N = 114) were eligible for inclusion. None of the individual studies nor meta-analyses showed a reduction in apnoea, bradycardia, oxygen desaturation or oxygen saturation with body positioning (supine vs prone; prone vs right lateral; prone vs left lateral; right lateral vs left lateral; prone horizontal vs prone head elevated; right lateral horizontal vs right lateral head elevated, left lateral horizontal vs left lateral head elevated).
AUTHORS' CONCLUSIONS
We found insufficient evidence to determine effects of body positioning on apnoea, bradycardia and oxygen saturation in preterm infants. No new studies have been conducted since the original review was published. Large, multi-centre studies are warranted to provide conclusive evidence, but it may be plausible to conclude that positioning of spontaneously breathing preterm infants has no effect on their cardiorespiratory parameters.
Topics: Apnea; Bradycardia; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Oxygen Consumption; Patient Positioning; Posture; Randomized Controlled Trials as Topic; Respiration
PubMed: 28067942
DOI: 10.1002/14651858.CD004951.pub3 -
World Journal of Gastroenterology Jan 2015The incidence of gastric cancer remains high in South Korea. Upper gastrointestinal (GI) endoscopy, i.e., esophagogastroduodenoscopy (EGD), has a higher diagnostic... (Review)
Review
The incidence of gastric cancer remains high in South Korea. Upper gastrointestinal (GI) endoscopy, i.e., esophagogastroduodenoscopy (EGD), has a higher diagnostic specificity and sensitivity than the upper GI series. Additionally, EGD has the ability to biopsy, through taking a tissue of the pathologic lesion. Successful training of EGD procedural skills require a few important things to be learned and remembered, including the posture of an examinee (e.g., left lateral decubitus and supine) and examiner (e.g., one-man standing method vs one-man sitting method), basic skills (e.g., tip deflection, push forward and pull back, and air suction and infusion), advanced skills (e.g., paradoxical movement, J-turn, and U-turn), and intubation techniques along the upper GI tract (e.g., oral cavity, pharynx, larynx including vocal cord, upper and middle and lower esophagus, gastroesophageal junction, gastric fundus, body, and antrum, duodenal bulb, and descending part of duodenum). In the current review, despite several limitations, we explained the intubation method of EGD for beginners. We hope this will be helpful to beginners who wish to learn the procedure.
Topics: Clinical Competence; Curriculum; Education, Medical, Graduate; Endoscopes, Gastrointestinal; Endoscopy, Gastrointestinal; Equipment Design; Humans; Learning Curve; Patient Positioning; Predictive Value of Tests; Teaching
PubMed: 25624710
DOI: 10.3748/wjg.v21.i3.759 -
Journal of Internal Medicine May 2002World Health Organization (WHO) guidelines recommend that the blood pressure (BP) should be routinely measured in sitting or supine followed by standing position,...
AIMS
World Health Organization (WHO) guidelines recommend that the blood pressure (BP) should be routinely measured in sitting or supine followed by standing position, providing that the arm of the patient is placed at the level of the right atrium in each position. The aim of our study was to test the influence of body and arm position on BP measurement in diabetic patients.
METHODS
In 142 patients with diabetes mellitus the BP was measured using a semiautomatic oscillometric device (Bosomat-R): (i) after 5 min of rest sitting on a chair with one arm supported at the right atrial level and with the other arm placed on the arm support of the chair, (ii) after 5 min of rest lying on a bed with both arms placed on a bed, and (iii) after 30 s and after 2 min of standing with one arm (the same as in sitting position) supported at the right atrial level and with the other arm vertical, parallel to the body.
RESULTS
Both systolic (SBP) and diastolic (DBP) blood pressures were significantly lower in sitting position with the arm at the right atrial level than in supine position (by 7.4 and 6.6 mmHg, respectively, P < 0.01). In sitting and standing positions, SBP and DBP were higher when the arm was placed either on the arm support of the chair or vertical, parallel to the body, than when the arm was supported at the level of the right atrium (by 6-10 mmHg, P < 0.001). Duration of standing did not influence the estimation of orthostatic hypotension.
CONCLUSIONS
The data of this study indicate that the WHO recommendation with regard to the equivalence of sitting and supine BP readings is incorrect at least in diabetic patients, as the sitting BP is lower than the supine BP when the arm was positioned at the right atrial level. In addition, incorrect positioning of the arm in standing position results in an underestimation of prevalence of orthostatic hypotension. We conclude that during BP measurement the arm should be placed at the right atrial level regardless of the body position.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Arm; Blood Pressure Determination; Diabetes Mellitus; Female; Heart Rate; Humans; Male; Middle Aged; Posture
PubMed: 11982738
DOI: 10.1046/j.1365-2796.2002.00958.x -
Urology Annals 2023The objective is to compare supine and prone positions in terms of arterial blood gas during lithotripsy endourology procedures in different stages.
OBJECTIVE
The objective is to compare supine and prone positions in terms of arterial blood gas during lithotripsy endourology procedures in different stages.
MATERIAL AND METHODS
Cases of during lithotripsy endourology procedures in our department from March to September 2020 were included prospectively. The variables registered were body mass index, age, the American Society of Anesthesiologists (ASA) score, diabetes mellitus, positive end-expiratory pressure (PEEP), FiO, stone size, stone location, procedural type, position, procedure duration, PaO, SaO, PaCO, pH, and dynamic compliance. PaO, SaO, PaCO pH, and dynamic compliance were recorded at the beginning of the procedure, 5 min later, 15 min later, and at the end of the procedure.
RESULTS
Thirty patients in prone position and 30 in lithotomy position were included in this study. Patients in prone position underwent percutaneous nephrolithotomy, and patients in supine/lithotomy underwent retrograde intrarenal surgery or ureteroscopy. Statistically significant differences were found in PEEP, duration, PaO at the beginning, SaO at the beginning and at the end of the procedure, PaCO at the beginning and at minute 5 and pH at the beginning of the surgery. The saturation PaO2 increased significantly on prone position and was statistically significantly better at the end of the surgery.
CONCLUSIONS
Both prone and supine positions were safe regarding anesthesiologic risk and had no clinically relevant differences in terms of individual comparisons in arterial blood gas parameters in static moments of the procedure. Prone position was related to an increase in PaO and a drop in PaCO gradually from the beginning to the end of the surgery.
PubMed: 37664107
DOI: 10.4103/ua.ua_113_22