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Translaryngeal Tracheostomy Needle Introducer: a simple device to improve safety and reduce complications during Fantoni's translaryngeal tracheostomy procedure: trial on human cadavers.

ABSTRACT: BACKGROUND:Percutaneous dilatational tracheostomy (PDT) is the most frequently performed procedure in patients requiring prolonged mechanical ventilation. A crucial step in such procedures is needle insertion into the trachea. To simplify this procedure and increase its safety, we developed a new device, the translaryngeal Tracheostomy Needle Introducer (tTNI), for use with Fantoni's method. This cadaver study was designed to assess the performance of the tTNI on human anatomy. METHODS:We tested the tTNI in a cadaver laboratory; the operators included two experts trained in PDT and three without specific training in the procedure. We performed 58 needle insertion attempts on 13 cadavers. We compared the tTNI technique with the standard needle insertion approach using external landmarks. We recorded the number of attempts needed to optimise needle insertion, time required in seconds, final position of the needle and complications related to needle insertion. RESULTS:tTNI use resulted in fewer puncture attempts (1.91?±?1.34 vs. 1.19?±?0.5, p?

SUBMITTER: Terrani A

PROVIDER: S-EPMC6890899 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Translaryngeal Tracheostomy Needle Introducer: a simple device to improve safety and reduce complications during Fantoni's translaryngeal tracheostomy procedure: trial on human cadavers.

Terrani Alessandro A Bassi Enrico E Valcarenghi Caterina C Charbonney Emmanuel E Ouellet Paul P Gosselin Patrice P Bellani Giacomo G Foti Giuseppe G

Intensive care medicine experimental 20190128 1

<h4>Background</h4>Percutaneous dilatational tracheostomy (PDT) is the most frequently performed procedure in patients requiring prolonged mechanical ventilation. A crucial step in such procedures is needle insertion into the trachea. To simplify this procedure and increase its safety, we developed a new device, the translaryngeal Tracheostomy Needle Introducer (tTNI), for use with Fantoni's method. This cadaver study was designed to assess the performance of the tTNI on human anatomy.<h4>Method ...[more]

PMID: 30689119

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Project description:BackgroundDiabetes complications are the leading cause of mortality in diabetic patients. The common complications are decline in antioxidant capacity and the onset of micro-inflammation syndrome. At present, glucose-responsive nanoparticles are widely used, as they can release insulin-loaded ultrafine particles intelligently and effectively reduce blood sugar. However, the toxicology of this method has not been fully elucidated. The plant extracts of pterostilbene (PTE) have a wide range of biological applications, such as antioxidation and inflammatory response improvement. Therefore, we have proposed new ideas for the cross application of plant extracts and biomaterials, especially as part of a hypoglycaemic nano-drug delivery system.ResultsBased on the PTE, we successfully synthesised poly(3-acrylamidophenyl boric acid-b-pterostilbene) (p[AAPBA-b-PTE]) nanoparticles (NPs). The NPs were round in shape and ranged between 150 and 250 nm in size. The NPs possessed good pH and glucose sensitivity. The entrapment efficiency (EE) of insulin-loaded NPs was approximately 56%, and the drug loading (LC) capacity was approximately 13%. The highest release of insulin was 70%, and the highest release of PTE was 85%. Meanwhile, the insulin could undergo self-regulation according to changes in the glucose concentration, thus achieving an effective, sustained release. Both in vivo and in vitro experiments showed that the NPs were safe and nontoxic. Under normal physiological conditions, NPs were completely degraded within 40 days. Fourteen days after mice were injected with p(AAPBA-b-PTE) NPs, there were no obvious abnormalities in the heart, liver, spleen, lung, or kidney. Moreover, NPs effectively reduced blood glucose, improved antioxidant capacity and reversed micro-inflammation in mice.Conclusionsp(AAPBA-b-PTE) NPs were successfully prepared using PTE as raw material and effectively reduced blood glucose, improved antioxidant capacity and reduced the inflammatory response. This novel preparation can enable new combinations of plant extracts and biomaterials to adiministered through NPs or other dosage forms in order to regulate and treat diseases.

Dataset Information

Translaryngeal Tracheostomy Needle Introducer: a simple device to improve safety and reduce complications during Fantoni's translaryngeal tracheostomy procedure: trial on human cadavers.

Publications

Translaryngeal Tracheostomy Needle Introducer: a simple device to improve safety and reduce complications during Fantoni's translaryngeal tracheostomy procedure: trial on human cadavers.

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