Effect of closed endotracheal suction in high-frequency ventilated premature infants measured with electrical impedance tomography

Objective: To determine the global and regional changes in lung volume during and after closed endotracheal tube (ETT) suction in high-frequency ventilated preterm infants with respiratory distress syndrome (RDS). Design: Prospective observational clinical study. Setting: Neonatal intensive care unit. Patients: Eleven non-muscle relaxed preterm infants with RDS ventilated with open lung high-frequency ventilation (HFV). Interventions: Closed ETT suction. Measurements and results: Changes in global and regional lung volume were measured with electrical impedance tomography. ETT suction resulted in an acute loss of lung volume followed by spontaneous recovery with a median residual loss of 3.3% of the maximum volume loss. The median stabilization time was 8 s. At the regional level, the lung volume changes during and after ETT suction were heterogeneous in nature. Conclusions: Closed ETT suction causes an acute, transient and heterogeneous loss of lung volume in premature infants with RDS treated with open lung HFV

Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography

Aims Although suctioning is a standard airway maintenance procedure, there are significant associated risks, such as loss of lung volume due to high negative suction pressures. This study aims to assess the extent and duration of change in end-expiratory level (EEL) resulting from endotracheal tube (ETT) suction and to examine the relationship between EEL and regional lung ventilation in ventilated preterm infants with respiratory distress syndrome. Methods A prospective observational clinical study of the effect of ETT suction on 20 non-muscle-relaxed preterm infants with respiratory distress syndrome (RDS) on conventional mechanical ventilation was conducted in a neonatal intensive care unit. Ventilation distribution was measured with regional impedance amplitudes and EEL using electrical impedance tomography. Results ETT suction resulted in a significant increase in EEL post-suction (P < 0.01). Regionally, anterior EEL decreased and posterior EEL increased post-suction, suggesting heterogeneity. Tidal volume was significantly lower in volume-guarantee ventilation compared with pressure-controlled ventilation (P = 0.04). Conclusions ETT suction in non-muscle-relaxed and ventilated preterm infants with RDS results in significant lung volume increase that is maintained for at least 90 min. Regional differences in distribution of ventilation with ETT suction suggest that the behaviour of the lung is heterogeneous in nature

Weaponized humor : the cultural politics of Turkish-German ethno-comedy

My thesis aims to show how the humor of Turkish-German ethno-comedians fulfills a double purpose of entertaining its audience while advancing a cultural political agenda that Kathrin Bower called “transnational humanism.” It includes notions of human rights consensus, critical self-reflection, respect, tolerance, and openness to cultural diversity. Promoting these values through comedy, the artists hope to contribute to abating prejudice and discrimination in Germany’s multi-ethnic society. Fusing the traditional theatrical principle of “prodesse et delectare” with contemporary cultural politics, these comedians produce something of political relevance: making their audience aware of its conceptions of “self” and “other” and fostering a sense of community across diverse cultural identifications. My thesis builds mainly on the works of Kathrin Bower, Maha El Hissy, Erol Boran, Deniz Göktürk, and Christie Davies. Whereas Davies denies humor’s potential for cultural impact, Göktürk elucidates its destabilizing power in immigrant films. Boran elaborates this function for Turkish-German Kabarett. El Hissy connects Kabarett, film, and theater of polycultural artists and ties them to Bakhtin’s concept of the carnivalesque and the medieval jester. Bower published several essays on the works of ethno-comedians as humorous catalysts for advancing a multiethnic Germany. I hope to continue and substantiate this line of research. Following the assumption that humor can have a significant social impact, I focus on the question of how exactly ethno-comedy promotes its cultural political agenda. Three survey chapters examine the cultural history of German-Turkish relations including the sources and nature of ethnic stereotypes as the main material of today’s ethno-comedians, the origins and development of the comedians’ social role in the jester tradition, and humor theory. Drawing on Freud, Bhabha, and Bakhtin’s works my subsequent case studies elucidate the specific conditions which govern the artists’ performative space and turn their distinct humor into an integrative tool in culturally diverse demographics. My contribution to the field of Turkish-German studies lies in suggesting a more specific definition of ethno-comedy as a performative paradigm, identifying typical strategies of fighting ignorance with laughter, and illustrating this aesthetic model with two representative, complementary case studies on performances by Bülent Ceylan and Serdar Somuncu.Arts, Faculty ofCentral, Eastern, and Northern European Studies, Department ofGraduat