Influence of 4 drain configurations on fluid dispersal and retrieval in an instillation model

OBJECTIVE

To describe and compare the pattern of fluid dispersal and retrieval in a novel instillation therapy system.

STUDY DESIGN

In vitro experimental study.

METHODS

A 10 cm² square model was constructed using plastic sheeting secured to plexiglass, with a wound infusion catheter and Jackson-Pratt (JP) active suction drain positioned in 4 configurations: parallel, perpendicular, diagonal, and opposite. Fluid was instilled using the wound infusion catheter, allowed to dwell for 10 min, and retrieved using the JP drain. Two surface area calculations were made using imaging software: coloration with diluted methylene blue (MB) on photos, and filling with diluted contrast on fluoroscopic images. Fluid retrieval was recorded. Statistical analysis was performed using a mixed-effects linear model (p < .05).

RESULTS

Configuration influenced fluid dispersion within the model (p = .0001); the diagonal configuration had the greatest surface area coverage (mean ± SD; 94.5 ± 2.4%) and the parallel configuration had the lowest surface area coverage (60.2 ± 2.9%). A dwell period increased fluid dispersal by an average of 4.0 ± 0.8% (p < .0001). Fluid retrieval exceeded 16.7 ± 1.5 mL (83.5 ± 7.5% volume instilled) for all configurations and was 0.5 ± 0.1 mL (2.5 ± 0.5% volume instilled) greater for MB than contrast agent (p < .0001).

CONCLUSION

Perpendicular or diagonal configurations and low-viscosity fluid maximized fluid dispersion and retrieval.

CLINICAL SIGNIFICANCE

Wound instillation therapy involves delivering lavage fluid or medications to a closed wound space. This is feasible using a wound-infusion catheter and active suction drain. Configuration should be considered to optimize fluid dispersal and retrieval when planning instillation therapy.

Comparison of 3 intraosseous catheter sites and methods of determining placement success in cadaver rabbits

The study goals were to determine if intraosseous (IO) catheters can be placed with greater success into the humerus, femur, or tibia of cadaver rabbits, and to evaluate the accuracy of perceived success (PS) and objective clinical success (OCS) criteria against true intramedullary catheterization confirmed by fluoroscopy. This was a prospective study utilizing 12 rabbit cadavers. Twenty-two participants attempted IO catheter placement at 3 sites. Perceived success, OCS, and fluoroscopic true success (FTS) were recorded. A Fisher's exact test was used to compare PS, OCS, and FTS, and FTS rates between sites (P < 0.05). A Wilcoxon test was used to compare speed of placement (P < 0.05). Overall, of 66 attempts, PS was reported in 86.4%, OCS was documented in 62.1%, FTS was confirmed in 43.9%. Perceived success and OCS overestimated FTS (P ≤ 0.01 and P = 0.027, respectively). Confirmation of FTS occurred in 10/22 (45.5%) humeral, 5/22 (22.7%) femoral, and 14/22 (63.6%) tibial (P = 0.03) attempts. Median time until placement for the humerus was 37.5 seconds (range: 15 to 125 seconds); the femur 135 seconds (range: 91 to 148 seconds); the tibia 49 seconds (range: 19 to 150 seconds). The humerus and tibia were faster to catheterize than the femur (P = 0.01 and 0.03, respectively). Participant PS and OCS criteria overestimated FTS. The humerus or tibia may be more successful and are faster to catheterize.

Nosocomial Intravascular Catheter Infections with Extended-spectrum Beta-lactamase-producing Escherichia coli in Calves after Strain Introduction from a Commercial Herd

An outbreak of intravascular catheter-related infections by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in calves in an animal teaching hospital is reported. Pulsed-field gel electrophoresis was used for strain typing to determine the origin and dissemination of these strains. All 19 strains harboured the blaCTX-M-14, and six strains also overexpressed their chromosomal AmpC gene. Evidence on the introduction of the strain from a beef herd, experiencing neonatal diarrhoea and increased mortality, to the clinic through admission of diarrhoeic calves was provided. Strains isolated from phlebitis cases from other herds up to 5 months later showed a high similarity with the initial strain, suggesting that the strain had become nosocomial. The catheter infections with ESBL/AmpC-producing E. coli resulted in a prolonged hospitalization, increased anti-microbial use and mortality. This report points towards the potential dangers of the emergence of ESBL/AmpC-producing bacteria in susceptible food animals and warns farmers and veterinarians for the facility by which they are introduced into another environment.

A noncalibration spectroscopic method to estimate ether extract and fatty acid digestibility of feed and its validation with flaxseed and field pea in pigs

Digestibility of ether extract (EE) or fatty acids (FA) is traditionally measured by chemical analyses for EE or GLC methods for FA combined with marker concentration in diet and digesta or feces. Digestibility of EE or FA may be predicted by marker concentrations and spectral analyses of diet and digesta or feces. On the basis of Beer's law, a noncalibration spectroscopic method, which used functional group digestibility (FGD) determined with marker concentration and peak intensity of spectra of diets and undigested residues (digesta or feces), was developed to predict the apparent ileal digestibility (AID) of total FA and apparent total tract digestibility (ATTD) of EE. To validate, 4 diets containing 30% flaxseed and field pea coextruded with 4 extruder treatments and a wheat and soybean basal diet with predetermined AID of total FA and ATTD of EE were used. Samples of ingredients, diets, and freeze-dried digesta and feces were scanned on a Fourier transform infrared (FT-IR) instrument with a single-reflection attenuated total reflection (ATR) accessory. The intensity of either the methylene (CH2) antisymmetric stretching peak at 2,923 cm(-1) (R(2) = 0.90, P < 0.01) or the symmetric stretching peak at 2,852 cm(-1) (R(2) = 0.86, P < 0.01) of ingredients, diet, and digesta spectra was related strongly to the concentration of total FA. The AID of total FA of diets measured using GLC was predicted by the spectroscopic method using FGD at 2,923 and 2,852 cm(-1) (R(2) = 0.75, P < 0.01) with a bias of 0.54 (SD = 3.78%) and -1.35 (SD = 3.74%), respectively. The accumulated peak intensity in the region between 1,766 and 1,695 cm(-1) of spectra was related to EE concentration in ingredients and diets (R(2) = 0.61, P = 0.01) and feces (R(2) = 0.88, P < 0.01). The relation was improved by using second-derivative spectra of the sum of peak intensities at 1,743 and 1,710 cm(-1) for ingredients and diets (R(2) = 0.90, P = 0.01) and at 1,735 and 1,710 cm(-1) for feces (R(2) = 0.92, P < 0.01). The ATTD of EE of test diets determined with proximate analysis was estimated by the FGD of nonderivative spectra with or without baseline (R(2) = 0.90, P < 0.01) with a bias of 3.15 (SD = 3.14%) and 3.50 (SD = 3.24%), respectively. In conclusion, instead of using GLC methods or predictions based on calibrations, the AID of total FA and ATTD of EE can also be estimated directly from ATR FT-IR spectra, provided the ratio of marker in the diet and undigested residue is known.

Relationships among dietary fiber components and the digestibility of energy, dietary fiber, and amino acids and energy content of nine corn coproducts fed to growing pigs

An experiment was conducted to determine a best fitting dietary fiber (DF) component to estimate the effect of DF concentration on the digestibility of energy, DF, and AA and energy value of 9 corn coproducts: corn bran (37.0% total nonstarch polysaccharides [NSP]); corn bran with solubles (17.1% NSP); cooked corn distillers dried grains with solubles (DDGS; 20.4% NSP); reduced oil DDGS (25.0% NSP); uncooked DDGS (22.0% NSP); high protein distillers dried grains (21.9% NSP); dehulled, degermed corn (1.1% NSP); corn germ meal (44.4% NSP); and corn gluten meal (4.9% NSP). A total of 20 growing pigs (initial BW: 25.9 ± 2.5 kg) were fitted with a T-cannula in the distal ileum and allotted to 10 dietary treatment groups in a 4-period incomplete block design with 8 observations per treatment. Treatments included a corn-soybean meal-based basal diet and 9 diets obtained by mixing 70% of the basal diet with 30% of the test ingredient. In tested ingredients, 11 DF components were determined: 1) ADF, 2) NDF, 3) total dietary fiber, 4) hemicellulose, 5) total NSP, 6) NSP arabinose, 7) NSP xylose, 8) NSP mannose, 9) NSP glucose, 10) NSP galactose, and 11) arabinoxylan. The apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of GE, DM, and NDF and the AID of AA of ingredients were measured. A single best fitting DF component was assessed and ranked for each trait, showing that arabinoxylan concentration best explained variance in AID of GE (R(2) = 0.65; cubic, P < 0.01) and DM (R(2) = 0.67; cubic, P < 0.01). The NSP xylose residue best explained variance in ATTD of GE (R(2) = 0.80; cubic, P < 0.01), DM (R(2) = 0.78; cubic, P < 0.01), and NDF (R(2) = 0.63; cubic, P < 0.01); AID of Met (R(2) = 0.40; cubic, P = 0.02), Met + Cys (R(2) = 0.44; cubic, P = 0.04), and Trp (R(2) = 0.11; cubic, P = 0.04); and DE (R(2) = 0.66; linear, P = 0.02) and ME (R(2) = 0.71; cubic, P = 0.01) values. The AID of Lys was not predictable (P > 0.05) from the DF concentration. In conclusion, the arabinoxylan and NSP xylose residue were the DF components that best explained variation due to DF concentration and, with the exception of AID of Lys, can be used to predict the digestibility of energy and DF and the DE and ME values in corn coproducts.

Simultaneous pulmonary and systemic blood pressure and ECG Interval measurement in conscious, freely moving rats

Here we evaluated the ability of a new, dual blood-pressure telemetry transmitter to simultaneously measure pulmonary and systemic blood pressure and the electrocardiogram in rats. The transmitter was implanted in normotensive and monocrotaline-induced pulmonary hypertensive Wistar rats, with sensing catheters placed in the pulmonary artery (channel 1) and descending aorta (channel 2). Biopotential electrodes were positioned to record an apex-based lead II electrocardiogram. Pulmonary and systemic arterial blood pressure and electrocardiographic waveforms were recorded between 2 and 12 wk after implantation of the transmitter. During this period, pulmonary arterial pressure progressively increased in monocrotaline-treated compared with saline-treated rats. The pharmacologic response of rats to reference compounds was measured by using the transmitter to validate the technique and to evaluate the ability of the device to transmit changes in blood pressure and the electrocardiogram. Validation against 2 Millar high-fidelity blood-pressure catheters confirmed the accuracy of the blood pressure data recorded with the transmitter. In addition, local tolerance of the associated catheters was confirmed by histologic examination.