| |
 |
1: What features of the catheter determine patient tolerance of
oesophageal intubation? |
| |
Diameter, diameter
- then flexibility. Therefore, for routine
diagnostic use, choose a catheter diameter
that is as small as is compatible with the
use of standard manometric methods and which
still has adequate rigidity. The flexibility
of silicone rubber reduces the discomforts
of intubation.
|
|
2: What catheter diameter/extrusion type does Dentsleeve recommend
for routine oesophageal manometry? |
| |
Our 4mm diameter
8+1 extrusion (E114); because it gives the
best balance of diameter and stiffness. This
is why we use this extrusion in our main range
of oesophageal catheters. A reduction of catheter
diameter of 0.7mm from 4.7 to 4.0 sounds very
little, but it gives a major reduction of
catheter cross sectional area.
|
|
3: What are the situations when standard 4mm diameter catheters
might be unsuitable for oesophageal manometry? |
| |
None really, since
designs are available for passage over a previously
placed guidewire in patients with moderate
to major oesophageal dilatation. Guidewire
stiffeners can also be passed into the core
channel and retained there in catheters that
have this channel closed at its tip (see special
option available).
|
|
4: Why does Dentsleeve offer oesophageal catheters that have several
different diameters? |
| |
Because users have
differing priorities and needs, and smaller
diameter catheters are essential for paediatric
and neonatal manometry. For example, one major
surgical laboratory that we supply uses our
3.5mm diameter (E27) extrusion solely, because
they want patients to return for follow-up
research studies. Because the 3.5mm catheter
is so well tolerated, most patients agree
to subsequent studies.
|
|
5: Does the greater flexibility of silicone rubber catheters make
oesophageal intubation more difficult than
with PVC catheters? |
| |
No, provided the
correct type of catheter is used and the technique
of intubation adapted slightly. This is shown
by a now vast experience from clinical and
research laboratories around the world, including
achalasia patients(1,2).
|
|
6: How should intubation technique be adapted to suit silicone
rubber catheters? |
| |
Swallowing should
be used as the primary driver and guidance
for the catheter, at least until the catheter
tip reaches the oesophagus. This is actually
the best technique for all catheters, but
some users prefer to rely mainly on pushing
the catheter. Our silicone rubber catheters
can be pushed, but not as forcefully as PVC
catheters.
|
|
7: If silicone rubber catheters have a diameter less than 3.5mm,
they become very flexible. How can they be
passed successfully? |
| |
The smaller the passage
into which the catheter is being passed, the
less rigid the catheter needs to be. So, what
is too flexible for an adult is ideal for
a neonate. When a catheter is too flexible
for a particular application, it can be stiffened
to some degree with an implanted nickel-titanium
wire or sometimes a removable guide-wire (FAQ
3).
|
|
8: How should re-usable Dentsleeve catheters be cleaned and disinfected? |
| |
After washing and
syringing, catheters should be placed in an
autoclave pouch and autoclaved at 134 degrees
C and 206 kpa pressure for 5 minutes. The
unique feature of autoclavability, according
to this validated protocol and storage in
a pouch, ensures sustained freedom from infection
hazards from one use to the next.
|
