ambu
227131074
Blind intubation through an i gel(r) in the prone position: A prospective cohort study
Accidental extubation in the prone position is a medical emergency in which quick and low resource demanding airway management is required. Regaining oxygenation is the primary goal, but sometimes intubation may be required to regain oxygenation. Blind intubation through an i gel(r) (Intersurgical Ltd, Wokingham, Berkshire, UK) may be a quick and low resource demanding method. However, the success rate of the use of an i gel as an intubation conduit in the prone position is unknown. This was a prospective study in patients scheduled for lumbar surgery. General anaesthesia was induced in the prone position and an i gel was inserted. After successful ventilation, up to three attempts at intubation using a VivaSight SL single lumen tube (Ambu A/S, Ballerup, Denmark) were performed. The first attempt was blinded for the operator and the patient's head was in a neutral position. The second attempt was blinded for the operator with the patient's head rotated laterally. The third attempt was on screen and allowed various manoeuvres to facilitate intubation. A success rate of 70% was deemed clinically acceptable. The study was terminated early after 14 subjects because the success rate of 70% was not achievable. However, ventilation using the i gel in the prone position was successful in 13 patients (93% Intubation was successful in only one patient at the first attempt, one patient at the second attempt and three patients at the third attempt. Overall, the success rate was 36% Blind intubation using an i gel as an intubation conduit in the prone position is not recommended. Netherlands Trial Register number NL6387 (NTR7659)
Anaesthesia and intensive care
Maarten van Dijck Bernard M Houweling Mark V Koning
226346361
A NURBS based solid modeling to enhance rapid prototyping in the restoration of decorative elements
In this research, we describe a computer aided approach to improve the reconstruction method of decorum in architectural surfaces and sculpture. The effects of withdrawal caused by catalysis of mold in silicone was evaluated and simulated by a NURBS based solid modelling. A tolerance analysis model was developed to predict manufacturing precision levels. In particular, differential increment along three dimensions was performed considering different volume distributions. The methodology was validated by experimental data obtained during the coffered ceiling restoration of Teatro Massimo Vittorio Emanuele in Palermo. The proposed methodology allowed the reconstruction of decorations or fragments of decoration with high accuracy.
Michele Cali Salvatore Massimo Oliveri Placido Cali Rita Ambu
211545357
A new dataset of soil Carbon and Nitrogen stocks and profiles from an instrumented Greenlandic fen designed to evaluate land surface models
Abstract. Arctic and boreal peatlands play a major role in the global carbon (C) cycle. They are particularly efficient at sequestering carbon due to their high water content which makes primary productivity exceed decomposition rates. Though, their future in a climate change context is quite uncertain in terms of carbon emissions and carbon sequestration. Nuuk fen site is a well instrumented greenlandic site of particular interest for testing and validating land surface models with monitoring of soil physical variables and greenhouse gas fluxes (CH4 and CO2) But knowledge of soil carbon stocks and profiles is missing. This is a crucial shortcoming for a complete evaluation of models, as soil carbon is one of the primary drivers of CH4 and CO2 soil emissions. To tackle this issue, we measured for the first time soil carbon and nitrogen density, profiles and stocks in the Nuuk peatland, at the exact location of fluxes monitoring. Measurements were made along two transects. Measurements horizontal resolution is 5 meter, vertical resolution ranges from 5 to 10 cm. Mean soil carbon density is 50.2 kgC.m 3. These new data are in the range of those encountered in other arctic peatlands. This new dataset can contribute to further develop joint modelisation of greenhouse gas emissions and soil carbon in land surface models. The dataset is open access and available at https:/doi.org/10.1594/PANGAEA.909899 (Morel et al. 2019b)
Xavier Morel Birger Ulf Hansen Christine Delire Per L Ambus Mikhail Mastepanov Bertrand Decharme
222166942
A 12 month follow up of primary and secondary root canal treatment in teeth obturated with a hydraulic sealer
Objectives This randomized, controlled, pilot study assessed the outcome of non surgical primary/secondary root canal treatments either with a novel bioactive sealer and the single cone technique or with gutta percha, zinc oxide eugenol sealer (ZOE) and warm vertical compaction. Materials and methods Sixty nine patients were randomly divided into two groups that were treated using the single cone technique with BioRootTM RCS (Septodont) (BIO group) or warm vertical compaction with gutta percha and ZOE sealer (PCS group) Two subsamples (BIOAP and PCSAP) comprised the cases with apical periodontitis. Treatment was undertaken by four residents using a standardized instrumentation and disinfection protocol. The periapical index (PAI) was recorded, and clinical and radiographic follow up performed at 1, 3, 6, and 12 months. Treatment success was assessed according to "periapical healing" and "tooth survival" The test for the equality of proportions, t tests for the equality of means, and non parametric K sample tests for the equality of medians were applied when appropriate. Results The survival rate was similar in the BIO and PCS (p 0.4074) and the BIOAP and PCSAP groups (p 0.9114) The success rate was higher in the BIO groups, but not statistically significant (p 0.0735) In both BIOAP and PCSAP groups, a progressive decrease in the PAI was observed. Conclusion At 12 months, both techniques showed reliable results. Further studies and longer follow ups are needed. Clinical relevance This study documents the feasibility of using a bioactive sealer in conjunction with the single cone technique to obturate the root canal and obtaining a predictable outcome. Trial registration ClinicalTrials.gov Identifie: NCT04249206
Clinical oral investigations
Giulia Bardini Laura Casula Emanuele Ambu Davide Musu Montse Mercade E Cotti
222344693
Clinical Outcomes of a Modified Laryngeal Mask Airway (LMA(r) Gastro(tm) Airway) During Esophagogastroduodenoscopy in Children and Adolescents: A Randomized Study
Introduction During esophagogastroduodenoscopy (EGD) general anesthesia (GA) may be provided using a laryngeal mask airway (LMA) with the endoscope inserted behind the cuff of the LMA into the esophagus. Passage of the endoscope may increase the intracuff of the LMA. We evaluated a newly designed LMA (LMA(r) Gastro(tm) Airway) which has an internal channel exiting from its distal end to facilitate EGD. The current study compared the change of LMA cuff pressure between this new LMA and a standard clinical LMA (Ambu(r) AuraOnce(tm) during EGD. Methods Patients less than 21 years of age and weighing more than 30 kg were randomized to receive airway management with one of the two LMAs during EGD. After anesthetic induction and successful LMA placement, the intracuff pressure of the LMAs was continuously monitored during the procedure. The primary outcome was the change of intracuff pressure of the LMAs. Results The study cohort included 200 patients (mean age 13.6 years and weight 56.6 kg) who were randomized to the LMA(r) Gastro(tm) Airway (n=100) or the Ambu(r) AuraOnce(tm) LMA (n=100) Average intracuff pressures during the study period (before and after endoscope insertion) were not different between the two LMAs. Ease of the procedure was slightly improved with the LMA(r) Gastro(tm) Airway (p<0.001) Discussion The LMA(r) Gastro(tm) Airway blunted, but did not prevent an increase in intracuff pressure during EGD when compared to the Ambu(r) AuraOnce(tm) LMA. Throat soreness was generally low, and complications were infrequent in both groups. The ease of the procedure was slightly improved with the LMA(r) Gastro(tm) Airway compared to the Ambu(r) AuraOnce(tm) LMA.
Medical devices
Mohammed Hakim Jason Bryant Renata M Miketic Kent C Williams Steven H Erdman Shabana Shafy Stephanie S Kim Joseph Drew Tobias
221782328
Additive manufacturing in fighting against novel coronavirus COVID 19
Nowadays, COVID 19 also known as novel coronavirus has become a global pandemic by causing severe respiratory tract infections in humans without any definite treatment or vaccine. Therefore, disease control measures include slowing down or averting the transfer of this viral infection from person to person. Continuous efforts are carried out to avoid the transmission of this disease to frontline healthcare personnel using single use personal protective equipment (PPE) However, a critical shortage in this equipment around the world is becoming an alarming concern. Therefore, it is vital to present a possible alternative to overcome the acute shortage of protective gear such as face masks against this infectious disease which can have universal accessibility and is easily available. Additive manufacturing (AM) also known as 3D printing, is a possible solution to overcome the shortage of protective gear and can play a vital role in supporting their conventional production supplies during this global pandemic situation. In this context, this paper provides a brief background study of COVID 19, its conventional preventive measure, and a detailed overview regarding the latest AM efforts including designers' providers and makers in the 3D printing community. Moreover, numerous inquiries and questions such as technical factors, testing recommendations and characterization methods and biological concerns such as biocompatibility and sterilization for the AM manufactured medical devices are addressed in this paper. In the end, two examples of AM medical devices, i.e. face mask and Ambu bag ventilator, are presented and studied through numerical simulations.
The International journal, advanced manufacturing technology
Mostapha Tarfaoui Mourad Nachtane Ibrahim Goda Yumna Qureshi Hamza Benyahia
224883733
Q VENT A novel device for emergency ventilation of the lungs in patients with respiratory failure due to diseases such as COVID 19
Abstract Since the end of 2019, a novel coronavirus (SARS CoV 2) causing pneumonia, often progressing to rapid deterioration with acute respiratory distress syndrome (ARDS) requiring advanced life support, has been spreading worldwide The humanitarian crisis we are currently witnessing across the globe is threatening access to artificial ventilation of the lungs (AVL) for patients with respiratory failure Q vent is a multi way air valve system with filters and heater/humidifier module produced by 3D printer from a new composite material based on Phloxine B, Saponite, and Polylactic acid that prevents the formation of bacterial biofilms This automated device, which can be fitted with commercially available Ambu? Breathing Bags or similar, provides a high degree of controllability along with one box complexity A built in cough sensor warns of patient?s awakening In the case of power failure, Q vent switches to battery reserve The developed device was tested on an intubated model (Gaumard? Scientific UNI? corresponding to a patient (80 kg) with lung compliance 50 ml cm H2O to simulate ARDS for 24 hours The inspiration to expiration (I: E) ratio, tidal volume set to 8 ml/kg PBW (L type pneumonia) and 6 ml/kg PBW (H type Pneumonia) and frequency of inspiration were adjusted to test Q Vent operation at a range of different conditions All functions performed reliably throughout the testing procedure Q Vent successfully passed the Rapidly Manufactured Ventilator System (RMVS001) validation issued by MHRA and is awaiting clinical trials to determine its value in overcoming crises caused by the lack of conventional AVL
Patrik Palacka Samuel Furka Daniel Furka Tibor Huzevka Dalibor Gallik Marian Janek
221521693
Increasing ventilator surge capacity in COVID 19 pandemic: design, manufacture and in vitro in vivo testing in anaesthetized healthy pigs of a rapid prototyped mechanical ventilator
Objective The advent of new technologies has made it possible to explore alternative ventilator manufacturing to meet the worldwide shortfall for mechanical ventilators especially in pandemics. We describe a method using rapid prototyping technologies to create an electro mechanical ventilator in a cost effective, timely manner and provide results of testing using an in vitro in vivo testing model. Results Rapid prototyping technologies (3D printing and 2D cutting) were used to create a modular ventilator. The artificial manual breathing unit (AMBU) bag connected to wall oxygen source using a flow meter was used as air reservoir. Controlled variables include respiratory rate, tidal volume and inspiratory: expiratory (I:E) ratio. In vitro testing and In vivo testing in the pig model demonstrated comparable mechanical efficiency of the test ventilator to that of standard ventilator but showed the material limits of 3D printed gears. Improved gear design resulted in better ventilator durability whilst reducing manufacturing time 2 h) The entire cost of manufacture of ventilator was estimated at 300 Australian dollars. A cost effective novel rapid prototyped ventilator for use in patients with respiratory failure was developed in 2 h and was effective in anesthetized, healthy pig model.
BMC research notes
Jayesh A Dhanani George Pang Jason Pincus Benjamin J Ahern Wendy Goodwin Nicholas Cowling Grant Whitten Mohd Hafiz Abdul-Aziz Steven Martin Peter I Corke Kevin B Laupland
221505265
Comparison of Fiberoptic Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu(r) Aura i(tm) A Randomized Clinical Study
Background and aim The primary aim of the study was to compare the intubation characteristics and effectiveness of intubating laryngeal mask airway (ILMA) and Ambu(r) Aura i(tm) as a conduit for facilitating fiberoptic guided intubation. Methods Eighty patients were enrolled in the randomized controlled hospital based study. After inducing general anesthesia, an appropriately sized ILMA (group 1)/Ambu Aura I (group 2) was placed. Fiberoptic assessment of the glottic view was done followed by fiberoptic guided tracheal intubation. The time taken for the insertion of ILMA/Ambu Aura i, glottic view grading, time taken for fiberoptic guided intubation, ease of intubation, time taken for the removal of ILMA/Ambu Aura i were recorded. Data analysis was done using the two tailed independent t test, paired t test, and Fisher's exact probability test. Result Anthropometric and airway parameters were similar in both groups. The success rate of the insertion of both devices was 100% In group 1, the mean time taken for the insertion was 20.53+ 1.91, and it was 13.98+ 2.4 in group 2 (P<0.001S) Fiberoptic assessment of the glottic view in group 1 (ILMA group) was grade 1 in 80% of the patients, whereas it was 92% in group 2 (Ambu Aura i) (P=0.54) The mean time taken for fiberoptic guided intubation was 14.95+ 1.85 in group 1 and 14.15+ 1.37 in group 2 (P>0.001) No significant difference was observed according to the number of attempts in intubating through ILMA/Ambu Aura i. Seventy five percent (75% in group 1 and 87.5% in group 2 were successfully inserted on the first attempt (p 0.33) The time taken for the removal of the device was 11.87 +1.265 seconds in group 1 and 11.25+ 1.58 seconds in group 2 (P=0.054) Conclusion The Ambu Aura i scores superiorly over ILMA in requiring less time for successful insertion on the basis of statistical analysis and hence appears to be a better independent ventilatory device.
Cureus
Navya Mishra Avnish Bharadwaj
221920471
Unpredictable malfunction of the laryngeal mask Ambu(r)Aura i(tm) as a conduit for fiberoptic bronchoscope intubation
3. Walker BJ, Long JB, Sathyamoorthy M, et al. Complications in pediatric regional anesthesia: an analysis of more than 100,000 blocks from the pediatric regional anesthesia network. Anesthesiology. 2018;129(4):721 732. 4. Ecoffey C, Lacroix F, Giaufre E, et al. Epidemiology and morbidity of regional anesthesia in children: a follow up one year prospective survey of the French Language Society of Paediatric Anaesthesiologists (ADARPEF) Paediatr Anaesth. 2010;20(12):1061 1069. 5. Boretsky KR. A review of regional anesthesia in infants. Paediatr Drugs. 2019;21(6):439 449.
Paediatric anaesthesia
Vinicius Caldeira Quintao Gabriel Soares de Sousa Marcella Malavazzi Claudia Marquez Simoes