Chapters Transcript Video Reflux Probe Model Guide This tutorial describes the architecture and part numbering system of the Reflux Probe and the process in choosing the right probe for the study. Hope Model guide. At the conclusion of this tutorial, you should be able to understand probe architectures, understand the rationale for infused and not infused probes, be able to select the appropriate probe for specific clinical applications and understand how to select a probe model number. In addition, you can download the probe catalog simply by going to the left of this screen and going to download documents. Probe architectures all sandhill scientific impedance pH probes Use the same probe architecture, which includes six impedance channels and up to three pH channels. And this architectures is based on the esophageal length and the application for the probe. How to choose the right Probe for the right study Gene I have a question. What's the difference between infused and non infused? Well, that's basically understanding how you're going to finally place the probe accurately in the esophagus. There are basically two methods to do this. The first is using Manama tree, and if you use Manama tree, you can use a non infused probe. However, if you're going to use an air sphincter locator to calculate where to place the probe, you're going to need to use the infused probe. Excellent thanks for helping me understand that. Now, here's a question. I know that you can have a probe with either a single or dual channel Ph sensor. What does that mean? Why would I choose one versus the other? Well, both of those probes have the pH sensor or sensors in the esophagus, so these air, typically referred to as esophageal Onley, probes esophageal Onley. Probes are used when the patient is not on anti reflux medication or you're not concerned with the acidification of the stomach. So for the single channel that will give you just one pH sensor, which helps to identify the distal esophageal pH or the dual channel adds an additional pH sensor in the proximal esophagus to not only understand the Bullis transit up to the proximal esophagus with reflux, but also to understand the acid content of that Boulis. Excellent. So if I heard you correctly, if I'm on any type of anti reflux medication and I go for a reflux study, then I should have a probe with a gastric pH sensor. That's correct. If the patient is being studied on medication, typically you want to choose ah probe that has a gastric sensor in addition to the esophageal sensor, because then, when the patient is on the PP eye, you can understand if and when the stomach re acidified. Great. And one last question. I know that sandal has three types of probes based on Asafa Geul length. Can you tell me the difference is sure we want to stay away from identifying pediatric, infant or adult probes because we know that the esophageal length is really what we want to address when we're looking at the impedance sensors and where they're located. So instead of using pediatric and infant type models we use based on Asafa Jill length, So we have greater than or equal to 18 centimeters in length, 15 to 18 and less than 15 centimeters. And how do you measure esophageal length? Well, there are different methods for the longer esophagus. Basically, you're really wanting to know, um, from sphincter distinct. Er what that length is, and you can do that by Manama tree or for a shorter esophagus. You can use what's called a Strobel formula, or you can also identify proper placement based on X ray. Excellent. Thank you. And now jeans gonna walk through several examples of probes so you can get a further understanding of what we just discussed. This first example is a probe that's appropriate for the esophageal length greater than or equal to 18 centimeters. Notice where the impedance sensors are located. We have a station at 357 and nine centimeters above the L. E s to identify and understand distal esophageal reflux. And then there are two sensors in the proximal esophagus at 15 and 17 centimeters, so that we can understand if and when the reflux reaches the proximal esophagus. Notice that the pH sensor is located at the second station above the L. E S. And that is because we want to understand the direction of Ebola's before Ebola's touches the pH sensor in this example. Also notice that this one has a sphincter location port and notice that the the distance between the esophageal Ph sensor and the port is six centimeters, depending on the type of probe. The distance between the sphincter locator and the esophageal sensor may be different. So when calculating probe depth, you're going to want to understand the distance between the port and the Ph sensor. This is also a probe for the 18 centimeter esophageal length. So noticed that the impedance channels are still at the same locations within the esophagus and that the distal esophageal pH sensor is also located in the same location at five centimeters above the L. E s. But now we've added an additional ph sensor, which is in the proximal esophagus. This enables you to not only measure by impedance the bolas transit to the proximal esophagus, but also to understand the pH value of that bolas. Again, this model is for the 18th centimeter esophageal length. But now, instead of adding the second pH sensor at the proximal esophagus, we've now added the pH sensor distantly from the esophageal pH sensor. This enables you to have a pH sensor in the stomach so that if you're measuring a patient who are still on PP, I therapy. During the study, you can notice when the patient is taking the P p I, and also understand if the stomach is re Acidifying and when that's occurring during the study. This model is for the sa vigil length of 15 to 18 centimeters long. Notice that now the impedance stations are a little bit closer spaced and Onley go up to 12 centimeters above the L ES. This enables you to measure the impedance all within that Asafa Jill length. The pH sensor is still located at the second station above the L E s to enable you to identify direction of bullets before the bolas touches the pH sensor. But now the pH sensor is at three centimeters above the L es, again adjusting for a shorter Asafa Jill length. This first model of the less than 15 centimeter esophageal length has an internal reference, meaning that the the loop or the calibration loop for the pH is all internal. Within the probe. Notice that the Ph sensor is at the most distal impedance station and this is just due to the short, esophageal length and that the pH sensor is typically placed at two centimeters above the L es again making for that same adjustment. However, with the internal reference probe, there is a nine centimeter tail on the probe which can trans verse the l E s. So make sure that you understand that the internal reference probe in this model does trans verse the L. E s. This model is also for the less than 15 centimeter esophageal length. However, this model is an external reference probe to enable you to not have the reference tail and therefore not trans versus the L E s. So the architecture is still the same as the previous model. But now this one does not have a tail on it so that you can avoid transfer Sing the l E s. Sometimes I get calls from customers because they don't understand how toe order the right probe so they don't understand the model number. Jean, let me go over that. That's a great question. What you see here is this an example z a n b s 01 and let me go through this and give you a better understanding of how to order our probes. Dizzy, which begins all of our impedance pH probes stands for impedance. Next you'll see in a API or and I A is for an esophageal length of greater than or equal to 18 centimeters. P is an esophageal length 15 to 18 centimeters, and finally, I is an esophageal length of less than 15 centimeters. Next you'll find either an n or an eye, and this stands for either non infused or infuse, which we spoke about previously. The next letter is B, and that's a connector type, and it's not relevant to when you're ordering probes. The next letter is an S, A D or a G, and this denotes the pH Sensors. S is for a single esophageal pH sensor. Dual is for to Asafa Geo pH Sensors and G has a gastric pH sensor. Finally, you'll see two numbers at the end of the string, in this case 01 This simply refers to a protocol number, and when you're in the Zephyr set up page, you'll choose the protocol number that matches the one on the probe. And finally, sandhill can make any type of custom probe that may be needed for your specific clinical applications. Just contact sandhill for further details. Thank you to. That really helps Created by
