Instillation of normal saline during endotracheal suctioning: effects on mixed venous oxygen saturation.

BACKGROUND: Instillation of normal saline before endotracheal suctioning is thought to facilitate removal of secretions and ultimately to improve the patient's oxygenation status. To date, no studies have used an in vivo measure of oxygenation such as mixed venous oxygen saturation to characterize the effects of instillation of normal saline. OBJECTIVES: To describe the effects of instillation of normal saline into an endotracheal tube before suctioning on mixed venous oxygen saturation in critically ill adult patients. METHODS: In a descriptive, observational study, 35 patients were assigned to either of 2 groups after coronary artery bypass grafting. One group had 5 mL of normal saline instilled at the start of endotracheal tube suctioning; the other group had the same endotracheal tube suctioning procedure without the use of saline. Data on mixed venous oxygen saturation were recorded at 1-minute intervals for a 5-minute baseline period and then throughout the suctioning procedure until mixed venous oxygen saturation returned to baseline levels. RESULTS: The time required for mixed venous oxygen saturation to return to baseline values after suctioning was an average of 3.78 minutes longer when saline was used. CONCLUSIONS: Instillation of normal saline before endotracheal suctioning has an adverse effect on oxygenation as indicated by mixed venous oxygen saturation. This finding contradicts the assumption that instillation of normal saline improves oxygenation status.

Inuit foods and diet: a preliminary assessment of benefits and risks.

Traditional Inuit foods are contaminated with chemical residues from industrial and other activities around the world. The intake of polychlorinated biphenyls (PCBs) and polychlorinated camphenes (PCCs) exceeds the 'tolerable daily intake' (TDI) for many consumers. The implications of long term contaminant intake, even for single contaminants, are not known and will be difficult or impossible to determine in the foreseeable future. Traditional foods form a substantial part of the Inuit diet and are a major source of energy and essential nutrients. Available alternative imported foods are nutritionally inferior and substitution may lead to nutritional deficiencies and associated risks to health and to the social and cultural life of Arctic communities.

The composition of red cell membrane phospholipids in Canadian Inuit consuming a diet high in marine mammals.

A study of the fatty acid composition of red cell phosphatidylcholine and phosphatidylethanolamine and serum cholesterol was undertaken in 185 Canadian Inuit (age 2 months-82 years). Samples from 24 Canadian men and women (21-50 years) living in Vancouver were also analyzed as a reference for the Inuit in this age range. Dietary survey of the Inuit community (325 Inuit) demonstrated a diet based on traditional foods in which the principal source of n-3 fatty acid was marine mammal flesh (mean intake: 164 g/person/day) rather than fish (mean intake: 13 g/person/day). Compared to the Vancouver samples, the Inuit phosphatidylethanolamine had higher 20:5n-3 and 22:6n-3 and lower 20:4n-6, but similar 18:2n-6 levels. The level of 20:5n-3 was higher and 20:4n-6 was lower in the Inuit than in the Vancouver red cell phosphatidylcholine. Despite these differences in percentage content of C20 and C22 n-6 and n-3 fatty acids, the mean chain length and unsaturation index of the Inuit and Vancouver red cell phosphatidylcholine and phosphatidylethanolamine were very similar. Serum cholesterol concentration showed no sex difference within the Inuit, and no difference from Vancouver men and women of similar age. The analyses suggest that the fatty acid composition of the Inuit red cell phospholipids are primarily a reflection of their diet-fat composition.

Northern obstetrics: a 5-year review of delivery among Inuit women.

There are over 18,000 Inuit in the Northwest Territories. As a group they have the highest birth rate, the lowest cesarean section rate and one of the highest perinatal death rates in Canada. We reviewed the obstetric experience of 512 Inuit women who either gave birth at Stanton Yellowknife Hospital or were referred from Yellowknife and gave birth at a southern facility between January 1981 and December 1985. Our experience is consistent with that documented in earlier reviews, which concluded that Inuit women tend to have efficient uterine action, to endure labour well and to rarely have dystocia. During the periods covered by these reviews delivery was frequently in the settlements; now hospital delivery is the norm. Substantial improvements in perinatal outcome are evident, but there remains a considerable gap between the northern and southern experience. Those attempting further progress must recognize that the need for obstetric care away from the home community is not fully appreciated by Inuit women, their families or their communities.