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At least 217 records · Page 12Linked to original sources
PubMed1997

Tracheotomy and the intensive care unit patient.

Transportation of the intensive care unit (ICU) patient to the operating room for tracheotomy has been implicated as an unnecessary source of complications and has been cited as a relative indication for percutaneous tracheotomy. However, there is very little evidence in the literature to support this claim. We evaluated 100 consecutive patients who were transported from the ICU to the operating room for tracheotomy. There were no complications related to patient transportation. A total of five complications occurred, all unrelated to patient transportation. Two patients receiving pressure control ventilation developed a pneumothorax on postoperative days 7 and 8, respectively. There were three minor complications directly related to the tracheotomy: peristomal cellulitis, tracheitis, and hemorrhage of less than 25 cc on postoperative day 1. The minor complications were treated appropriately and resolved without any adverse sequelae. We provide a detailed review of 100 consecutive ICU patient tracheotomy cases and compare this with 109 tracheotomies in non-ICU patients. Transportation of the ICU patient does not appear to increase the risk of complications during tracheotomy and should not be cited as a cause of complications in the percutaneous tracheotomy literature. The results with standard surgical tracheotomy in the controlled setting of the operating room should serve as the standard by which other procedures are judged.

Adult↗
PubMed1996

Outbreak of meningitis in weaner pigs caused by unidentified asaccharolytic gram-negative bacterium.

Several organisms are known to cause outbreaks of meningitis in pigs, with Haemophilus species being the most frequently implicated. We report such an outbreak in which necropsied pigs manifested an unusual combination of meningitis, tracheitis, and bronchitis. The causative agent appeared to be an asaccharolytic gram-negative nonfermentative bacterium whose classification has yet to be determined. The organism was isolated from the brain and was extremely capnophilic, growing in air only after several serial subcultures.

Animals↗
PubMed1999

Utility of radiographs in the evaluation of pediatric upper airway obstruction.

The evaluation of children with airway obstruction always involves a history and physical examination. The definitive diagnosis is most often made with microlaryngoscopy and bronchoscopy (MLB), and in cases of extrinsic compression, information is gained from magnetic resonance imaging. Although plain radiographs of the airway are often used as a primary diagnostic modality in children with airway obstruction, the accuracy of plain radiographs in predicting specific airway abnormalities has not previously been evaluated. This study was designed to correlate the findings of plain airway radiographs with the diagnosis made at the time of MLB. Medical records from 1991 to 1996 were reviewed to identify patients that had MLB and airway radiographs within 2 days of one another. One hundred forty-four cases were identified and divided into diagnostic categories. Statistical analysis showed a high sensitivity (>86%) for the accuracy of the radiologic diagnoses of exudative tracheitis, airway foreign body, and innominate artery compression. Laryngomalacia and tracheomalacia had a much lower sensitivity (5% and 62%, respectively). We believe that plain radiographic evaluation of the airway provides important information to the diagnostician. However, plain radiographs can be inaccurate and must be considered along with a history, physical examination, and clinical suspicion. Microlaryngoscopy and bronchoscopy remains the ultimate diagnostic test for airway disorders.

Adolescent↗
PubMed1992

The old and new of acute laryngotracheal infections.

Laryngotracheal infections in childhood frequently result in airway obstruction, the major symptom of which is stridor. The primary aims of management are to establish a diagnosis rapidly and to maintain or secure the child's airway. Medical treatment and airway stabilization measures vary for the three most prevalent laryngotracheal infections--supraglottitis, laryngotracheitis, and bacterial tracheitis--as well as for older and newer infectious airway entities.

Acute Disease↗
PubMed1986

Infectious croup: a critical review.

Infectious croup is a viral or bacterial syndrome characterized by a barking cough, hoarseness, and stridor. Three separate conditions will be discussed: laryngotracheobronchitis, spasmotic croup, and bacterial tracheitis. Each clinical entity will be defined and its treatment reviewed. Current treatment regimens for infectious croup involve various combinations of mist therapy, racemic epinephrine, corticosteroids, and syrup of ipecac. Tradition, rather than science, appears to be the basis of many of these treatments. Despite the frequent occurrence of infectious croup, no treatment has proved consistently successful. Prevention and better treatment methods are the keys for reducing the high cost of infectious croup to the medical care system.

Bronchitis↗
PubMed1983

Respiratory tract lesions from infectious laryngotracheitis virus of low virulence.

The pathogenicity of the A4557-5 strain of infectious laryngotracheitis virus for eight-week-old chickens was investigated by aerosol route of infection; chickens were necropsied five days after infection. The virus caused mild catarrhal tracheitis, peribronchial lymphoid infiltration, and focal lymphocytic infiltration in the lung and focal lymphocytic infiltration in the air sacs of some chickens. Chickens infected with this virus developed low levels of humoral antibody and were resistant to intratracheal challenge with the virulent V154 strain. By comparison, aerosol infection with a similar dose of virulent V154 strain caused severe necrotizing laryngotracheitis with marked suppurative bronchopneumonia and airsacculitis.

Animals↗
PubMed1975

A prospective study of complications after tracheostomy for assisted ventilation.

A prospective study of 40 patients having elective tracheostomy for ventilatory assistance used fiberoptic bronchoscopy and radiologic examination to assess tracheal healing after extubation. Ten percent of patients had bleeding complications of tracheostomy and 17.5 percent had tracheostomy management problems. Sixteen percent of survivors had asymptomatic stomal site tracheal narrowing and 8 percent required tracheal resection for symptomatic stomal site tracheal stenosis, 16 percent had asymptomatic tracheal defects at the cuff site. Stomal healing was seen to consist of gradual stomal shrinkage, resolution of tracheitis, and approximation of divided tracheal rings. No statistically significant correlation was demonstrated between various factors operative during ventilatory assistance and subsequent tracheal healing. All patients should have routine endoscopic or radiologic tracheal assessment after-tracheostomy.

Acute Disease↗
PubMed2000

A mouse model of aerosol-transmitted orthopoxviral disease: morphology of experimental aerosol-transmitted orthopoxviral disease in a cowpox virus-BALB/c mouse system.

OBJECTIVES: To determine the morphologic changes and disease progression of aerosolized cowpox virus infection in BALB/c mice and to ascertain the suitability of cowpox virus-infected BALB/c mice as a model of aerosol-transmitted, orthopoxviral respiratory disease. METHODS: BALB/c mice were inoculated with cowpox virus, Brighton strain, by aerosol or intranasal route. Mice were killed at specified times after inoculation, necropsied, and tissues were collected for routine histology, immunohistochemistry, and electron microscopy. RESULTS: Inoculation by both routes resulted in disease and death. Immunolabeled viral antigen and lesions predominated in the tissues associated with the inoculation route, that is, lungs, airways, trachea, and nasal passages and sinuses. Tracheitis was evident in the intranasally infected group only. Lesions were generally necrotizing and hemorrhagic, neutrophilic, and increased in extent and severity in a time-dependent fashion. Viral intracytoplasmic inclusion bodies, immunolabeled viral antigen, or virions were readily seen in epithelial tissues, smooth muscle cells of airways and vessels, fibroblasts, periosteal cells, perineural cells, and macrophages. Although the extension of infection appeared to be primarily direct, lesions suggesting hematogenous dissemination were occasionally noted in bone marrow and skin. Transmission electron microscopy demonstrated features of cell injury or death, virion assembly and maturation, and both A-type and B-type inclusions. CONCLUSIONS: Aerosol inoculation of BALB/c mice with cowpox virus provides a reliable and facilitative model of aerosol-transmitted, orthopoxviral respiratory disease.

Administration, Inhalation↗
PubMed2000

[Value of esophageal scintigraphy in exploration of a gastro-esophageal reflux in a respiratory patient].

Patients with respiratory pathologies in the forms of tracheitis, rhino-sinusitis, and asthma sometimes have symptoms of gastro-oesophageal reflux, that should be taken into consideration in order to treat the co-factors associated with the etiopathology. However, these patients, because of their respiratory handicaps, are frequently unwilling to submit themselves to traumatic investigations. Oesophageal scintigraphy, because of its perfect tolerance and reliability, seems to be an examination that is adapted to the situation to resolve this dilemma.

Adolescent↗
PubMed2000

Lower respiratory tract infections in adolescents.

Lower respiratory tract infections are an important cause of morbidity and occasional mortality in adolescents. This article reviews lower respiratory tract infections by anatomic location. Laryngotracheitis, tracheitis, bronchitis, pneumonia, and parapneumonic effusions are discussed. Specific viral, bacterial, mycoplasmal, and chlamydial etiologies are discussed. The epidemiology and clinical manifestations of lower respiratory tract infections in adolescents are presented according to anatomic site. Treatment for the spectrum of lower respiratory tract infections is also reviewed. Treatment options include supportive care, humidification, corticosteroids, antivirals, antibiotics, and appropriate drainage. Appropriate drainage of parapneumonic effusions includes thoracentesis, closed-tube thoracostomy, and surgery (thoracoscopy or thoracotomy). Imaging modalities include conventional radiography, computed tomography, and ultrasonography. Emphasis is placed on the common lower respiratory tract infections that affect the normal adolescent population.

Adolescent↗
PubMedDate not supplied

Isolation of avian influenza virus (H10N7) from an emu (Dromaius novaehollandiae) with conjunctivitis and respiratory disease.

Avian influenza virus was isolated from the conjunctiva of a male emu chick. Clinical observations included ocular discharge, dyspnea, and mild respiratory signs. Lesions included conjunctivitis, tracheitis, bronchopneumonia, and airsacculitis. Escherichia coli was isolated from the conjunctiva and the sinus, and Staphylococcus sp. was isolated from the conjunctiva. Influenza A viral nucleoprotein was detected immunohistochemically in epithelial cells of the bronchi, lung parenchyma and tracheal mucosa, and mononuclear inflammatory cells within the exudate of the bronchial lumen; conjunctiva, air sacs, kidney, intestine, and liver were negative for the viral nucleoprotein. The isolated influenza virus was typed as H10N7 and was determined to be nonpathogenic for chickens.

Air Sacs↗
PubMedDate not supplied

Avian influenza epidemic in Italy due to serovar H7N1.

Beginning at the end of March 1999, a syndrome characterized by severe depression, anorexia, fever, and respiratory and enteric symptoms appeared in flocks of turkeys and, to a lesser extent, of chickens in the densely populated poultry-rearing regions of northeast Italy. The disease was characterized by sinusitis, tracheitis, peritonitis, and pancreatitis. The mortality varied between 5% and 90%. The disease was diagnosed as low pathogenic avian influenza, H7N1 serotype. After a summer period of declining cases, the disease reappeared in autumn exclusively in turkeys. Since the middle of December 1999, many farms of chickens, turkeys, and guinea fowl were abruptly affected by a highly pathogenic H7N1 virus, with very severe depression and mortality up to 100% in a few days. By the end of March 2000, nearly 500 farms, representing over 15 million birds, were affected or depopulated. To date, control measures have focused on improved biosecurity measures. Vaccine was not allowed, but its use was debated.

Animals↗
PubMedDate not supplied

[Complications arising from the use of controlled respiration in patients with neurological diseases].

The authors applied controlled respiration in 112 cases of central nervous system diseases, polyneuropathies and myasthenia. During clinical observation or on autopsy in 30 cases complications were found in the form of subcutaneous and mediastinal emphysema or pneumothorax, narrowing or chondromalacis of the trachea, granuloma formation, decubitus ulcers in the trachea with or without bleeding, and haemorrhagic-ulcerative tracheitis. In 7 cases (6.25%) these complications caused death. Factors leading to complications and their prevention are discussed.

Adolescent↗
PubMed1992

Necrotizing tracheobronchitis identified on an indium-111-white blood cell scan.

The clinical entity of necrotizing tracheobronchitis (NTB) is well described in the pediatric literature. The incidence of NTB in neonatal autopsies varies from 4% to 44%. More than 3 hr of assisted ventilation may be necessary for the development of NTB in neonates. A similar clinical problem was described as "hemorrhagic tracheitis" in two adults during high frequency jet ventilation and as a complication of conventional mechanical ventilation in an adult. We present here a rather unusual case of NTB in an adult on mechanical ventilation, in whom tracheobronchitis was diagnosed incidentally with an 111In white blood cell scan obtained for other purposes.

Bronchitis↗
PubMed2004

[Gastroesophagopharyngeal reflux in infants and children with recurrent symptoms of the upper respiratory tract].

Gastroesophageal reflux (GER) plays an important role in pathogenesis of recurrent/chronic disorders of the respiratory tract. Atypical symptoms of GER can be suggested to be cause of the otorhinolaryngological problems. For these last manifestations no cause-effect relationship has yet been proven. There are many therapeutic studies, in which treatment of GERD is examined for its impact on coexisting respiratory disorders. The aim of our study was to confirm the presence of acid reflux by using 24-hour intraesophageal pH monitoring. From the group of 29 patients with recurrent episodes of the pharyngitis, laryngitis and tracheitis, we evaluated 18 children aged 3 months to 8 years (mean, 4.23 +/- 2.85) with coexisting reflux symptoms. The protocol included a parenteral interview, physical examination, roentgenograms of the chest and larynx, laryngoscopy, as well as 24-hour simultaneous proximal and distal esophageal pH monitoring. The most significant differences between examined patients and control subjects was noted in terms of the lowest pH value, number of reflux episodes and index reflux while pH dropped below 4. Every significant drop under pH 6 recorded in proximal esophagus was simultaneous with reflux episode in distal esophagus. We found increased both sensitivity and specificity of the simultaneous pH monitoring in the distal and proximal part of the esophagus comparing to monitoring by the single probe. We confirmed the presence of gastroesophagopharyngeal reflux in patients with recurrent disorders of pharynx, larynx and/or trachea.

Case-Control Studies↗
PubMed2005

[Lymphocyte subsets in patients with recurrent upper airway infections].

UNLABELLED: The aim of our study was to evaluate the digressions of lymphocyte subsets in patients with recurrent upper airway infectious diseases. METHODS: We studied 35 patients (mean of age 11.1+/-2.1 years) with recurrent upper airway infections. The first group consisted of patients, who had acute upper airway infections: rhinitis, pharyngitis, laryngitis and tracheitis more than 6 times per last year, sinusitis or otitis more than 4 times per last year. The control group comprised of 9 healthy subjects. Subsets of lymphocytes (CD3+, CD4+, CD8+, CD4+/CD8+, CD16+/56+ and CD19+) were detected by FACS Calibur cytometer. RESULTS: We found a significantly lower count of CD4+ lymphocytes in the patients' group compared to the control group (37.5+/-1.2 vs 45.7+/-3.1% of total lymphocytes, p<0.01). We did not find any significant differences of other lymphocyte subsets between patients and control groups. CONCLUSION: We propose that patients with recurrent upper airway infections have alterations of the cellular immunity -- decreased amount of CD4+ lymphocytes.

Acute Disease↗
PubMed1990

[Experiences with long-term transtracheal oxygen therapy].

A transtracheal catheter (TTC) (Scoop) was implanted in 24 patients (19 men, 5 women) with a mean age of 64 +/- 9 (47 to 78) years. The pO2 was 6.78 +/- 1.65 kPa. Two patients suffered from pulmonary restriction, 22 from severe COPD with a FEV1 of 880 +/- 165 ml. Purulent tracheitis developed in six patients. The pre-Scoop catheter had to be removed in three. In four patients, bronchoscopic aspiration of mucus plugs adhering to the tip of the TTC was necessary. In one patient, the TTC was removed after an uneventful course due to patient's discomfort; another patient no longer qualified for LOT. 19 patients were using the TTC without major problems. Of those, five have died due to severe lung disease. By using TTC, oxygen consumption is halved for the same degree of oxygenation. 12 are using a demand valve device (Oxymatic), which allows a further conservation of oxygen. Patients prefer LOT by a TCC for cosmetic reasons and lack of nasal discomfort.

Aged↗
PubMedDate not supplied

Rhinotracheitis in turkey poults.

A severe upper respiratory disease of young turkeys is described that resulted in high morbidity and mortality. Death was due to asphyxiation produced by occlusion of the trachea or nostrils. The postmortem lesions were tracheitis, pulmonary edema, swollen livers and spleens, and a drastic reduction in bursa size. Bursal necrosis and loss of tracheal epithelium were found in tissue sections from clinically affected birds. Antibody to infectious bursal disease was found by agar-gel precipitin and virus-neutralization tests of serum samples from affected flocks. A geometric mean titer of 31.5 for Newcastle disease was found in unvaccinated flocks of five-week-old turkeys.

Animals↗