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Airway clearance

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https://www.readbyqxmd.com/read/28634173/a-comparison-of-2-respiratory-devices-for-sputum-clearance-in-adults-with-non-cystic-fibrosis-bronchiectasis
#1
Yasmin R Silva, Tracy A Greer, Lucy C Morgan, Frank Li, Claude S Farah
BACKGROUND: Airway clearance techniques are a vital part of routine care for patients with bronchiectasis. There is no clear superior modality. The Flutter combines oscillations (6-20Hz) and positive expiratory pressure; the Lung Flute combines positive expiratory pressure and low frequency acoustic waves (18-22Hz), to augment clearance. This project aimed to compare these devices. METHODS: This was a randomized crossover study of adult subjects with stable non-cystic fibrosis bronchiectasis (expectorating >25 mL/d)...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28619948/administration-of-immunobiotic-lactobacillus-plantarum-delays-but-does-not-prevent-lethal-pneumovirus-infection-in-rag1-mice
#2
Caroline M Percopo, Michelle Ma, Helene F Rosenberg
Administration of immunobiotic Lactobacillus plantarum (Lp) directly to the respiratory mucosa promotes cross-protection against lethal pneumovirus infection via B-cell-independent mechanisms. In this study, we examined Lp-mediated cross protection in Rag1(-/-) mice which cannot clear virus from lung tissue. Although Lp was initially protective, Rag1(-/-) mice ultimately succumbed to a delayed lethal outcome associated with local production of the proinflammatory cytokines CCL1, -2, and -7, granulocyte recruitment, and ongoing virus replication...
June 15, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28619528/ineffective-cough-and-mechanical-mucociliary-clearance-techniques
#3
A Fernández-Carmona, L Olivencia-Peña, M E Yuste-Ossorio, L Peñas-Maldonado
Cough is a fundamental defense mechanism for keeping the airway free of foreign elements. Life-threatening situations may arise when cough proves ineffective as a result of muscle weakness or altered mucociliary function. When a patient is unable to cough effectively, techniques are required to either reinforce or replace cough capacity. The use of mechanical systems that facilitate or substitute cough function is increasingly common in Intensive Care Units, where it is relatively frequent to find situations of ineffective cough due to different clinical causes...
June 12, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28614846/identification-of-swallowing-tasks-from-a-modified-barium-swallow-study-that-optimize-the-detection-of-physiological-impairment
#4
R Jordan Hazelwood, Kent E Armeson, Elizabeth G Hill, Heather Shaw Bonilha, Bonnie Martin-Harris
Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived Modified Barium Swallow Impairment Profile (MBSImP™©; Martin-Harris et al., 2008) Overall Impression (OI; worst) scores using generalized estimating equations...
June 15, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28607090/gel-forming-mucins-form-distinct-morphologic-structures-in-airways
#5
Lynda S Ostedgaard, Thomas O Moninger, James D McMenimen, Nicholas M Sawin, Connor P Parker, Ian M Thornell, Linda S Powers, Nicholas D Gansemer, Drake C Bouzek, Daniel P Cook, David K Meyerholz, Mahmoud H Abou Alaiwa, David A Stoltz, Michael J Welsh
Gel-forming mucins, the primary macromolecular components of airway mucus, facilitate airway clearance by mucociliary transport. In cystic fibrosis (CF) altered mucus properties impair mucociliary transport. Airways primarily secrete two closely related gel-forming mucins, MUC5B and MUC5AC. However, their morphologic structures and associations in airways that contain abundant submucosal glands and goblet cells are uncertain. Moreover, there is limited knowledge about mucins in airways not affected by inflammation, infection, or remodeling or in CF airways...
June 12, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28596972/targets-of-neutrophil-influx-and-weaponry-therapeutic-opportunities-for-chronic-obstructive-airway-disease
#6
REVIEW
Carina Kärrman Mårdh, James Root, Mohib Uddin, Kristina Stenvall, Anna Malmgren, Kostas Karabelas, Matthew Thomas
Neutrophils are important effector cells of antimicrobial immunity in an acute inflammatory response, with a primary role in the clearance of extracellular pathogens. However, in respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), there is excessive infiltration and activation of neutrophils, subsequent production of reactive oxygen species, and release of serine proteases, matrix metalloproteinases, and myeloperoxidase-resulting in collateral damage as the cells infiltrate into the tissue...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28596950/review-quality-of-life-in-children-with-non-cystic-fibrosis-bronchiectasis
#7
REVIEW
Anna Marie Nathan, Jessie Anne de Bruyne, Kah Peng Eg, Surendran Thavagnanam
Non-cystic fibrosis bronchiectasis (NCFB) has gained renewed interest, due to its increasing health-care burden. Annual mortality statistics in England and Wales showed that under 1,000 people die from bronchiectasis each year, and this number is increasing by 3% yearly. Unfortunately, there is a severe lack of well-powered, randomized controlled trials to guide clinicians how to manage NCFB effectively. Quality-of-life (QOL) measures in NCFB are an important aspect of clinical care that has not been studied well...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28570692/natural-killer-t-cell-sensitization-during-neonatal-respiratory-syncytial-virus-infection-induces-eosinophilic-lung-disease-in-re-infected-adult-mice
#8
Seung Young Lee, Youran Noh, Jung Hyun Goo, Semi Rho, Min Jung Kim, Chang-Yuil Kang, Manki Song, Jae-Ouk Kim
Respiratory syncytial virus (RSV) is a major viral pathogen that causes severe lower respiratory tract infections in infants and the elderly worldwide. Infants with severe RSV bronchiolitis tend to experience more wheezing and asthma in later childhood. Because invariant natural killer T (iNKT) cells are associated with the asthma pathology, we investigated whether neonatal iNKT cells are involved in the aggravation of pulmonary diseases following RSV infection in mice. Intranasal exposure to the iNKT cell ligand α-galactosylceramide (α-GC) with RSV primary infection in neonatal mice elicited neither cytokine production (except for a slight increase of IL-5) nor pulmonary eosinophilia, despite the presence of both CD1d+ cells and NKT cells...
2017: PloS One
https://www.readbyqxmd.com/read/28566368/caspofungin-increases-fungal-chitin-and-eosinophil-and-%C3%AE-%C3%AE-t-cell-dependent-pathology-in-invasive-aspergillosis
#9
Nansalmaa Amarsaikhan, Ethan M Sands, Anand Shah, Ali Abdolrasouli, Anna Reed, James E Slaven, Darius Armstrong-James, Steven P Templeton
The polysaccharide-rich fungal cell wall provides pathogen-specific targets for antifungal therapy and distinct molecular patterns that stimulate protective or detrimental host immunity. The echinocandin antifungal caspofungin inhibits synthesis of cell wall β-1,3-glucan and is used for prophylactic therapy in immune-suppressed individuals. However, breakthrough infections with fungal pathogen Aspergillus fumigatus are associated with caspofungin prophylaxis. In this study, we report in vitro and in vivo increases in fungal surface chitin in A...
May 31, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#10
REVIEW
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28552099/bacteriology-and-treatment-of-infections-in-the-upper-and-lower-airways-in-patients-with-primary-ciliary-dyskinesia-adressing-the-paranasal-sinuses
#11
Mikkel Christian Alanin
The respiratory tract is lined with motile cilia that transport respiratory mucus. Primary ciliary dyskinesia (PCD) is a chronic genetic disease caused by mutations in genes responsible for ciliary structure and function. Non-functional airway cilia impair the mucociliary clearance (MCC), causing mucostasis, lung infections and destruction, chronic rhinosinusitis (CRS) and hearing impairment. It is of paramount importance to postpone chronic lung infection mainly with Gram-negative bacteria (GNB) in patients with an impaired MCC...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28546380/respiratory-implications-of-pediatric-neuromuscular-disease
#12
Howard B Panitch
Children with progressive neuromuscular weakness undergo a stereotypical progression of respiratory involvement, beginning with impaired airway clearance and progressing to nocturnal and then diurnal ventilatory failure. This review examines issues related to airway clearance and mucus mobilization, sleep problems, and use of assisted ventilation in children with neuromuscular diseases. Interventions for each of these problems have been created or adapted for the pediatric population. The use of airway clearance therapies and assisted ventilation have improved survival of children with neuromuscular weakness...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28540765/an-update-on-pediatric-bronchiectasis
#13
Danielle F Wurzel, Anne B Chang
The prevalence and awareness of bronchiectasis not related to cystic fibrosis (CF) is increasing and it is now recognized as a major cause of respiratory morbidity, mortality and healthcare utilization worldwide. The need to elucidate the early origins of bronchiectasis is increasingly appreciated and has been identified as an important research priority. Current treatments for pediatric bronchiectasis are limited to antimicrobials, airway clearance techniques and vaccination. Several new drugs targeting airway inflammation are currently in development...
June 5, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28540046/evaluation-of-a-novel-technique-in-airway-clearance-therapy-specific-cough-technique-sct-in-cystic-fibrosis-a-pilot-study-of-a-series-of-n-of-1-randomised-controlled-trials
#14
Sandra Gursli, Leiv Sandvik, Egil Bakkeheim, Bjørn Skrede, Britt Stuge
OBJECTIVES: The aim of this pilot study was to evaluate the efficacy, safety and participants' perception of a novel technique in airway clearance therapy - specific cough technique in cystic fibrosis. METHODS: We conducted randomised controlled individual trials (N-of-1 randomised controlled trials) in six adults. Each trial included 8 weeks of treatment with two interventions each week, one with specific cough technique and one with forced expiration technique...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28534851/respiratory-care-considerations-for-children-with-medical-complexity
#15
REVIEW
Jackie Chiang, Reshma Amin
Children with medical complexity (CMC) are a growing population of diagnostically heterogeneous children characterized by chronic conditions affecting multiple organ systems, the use of medical technology at home as well as intensive healthcare service utilization. Many of these children will experience either a respiratory-related complication and/or they will become established on respiratory technology at home during their care trajectory. Therefore, healthcare providers need to be familiar with the respiratory related complications commonly experienced by CMC as well as the indications, technical and safety considerations and potential complications that may arise when caring for CMC using respiratory technology at home...
May 19, 2017: Children
https://www.readbyqxmd.com/read/28523001/the-role-of-transient-receptor-potential-vanilloid-4-in-pulmonary-inflammatory-diseases
#16
REVIEW
Rachel G Scheraga, Brian D Southern, Lisa M Grove, Mitchell A Olman
Ion channels/pumps are essential regulators of organ homeostasis and disease. In the present review, we discuss the role of the mechanosensitive cation channel, transient receptor potential vanilloid 4 (TRPV4), in cytokine secretion and pulmonary inflammatory diseases such as asthma, cystic fibrosis (CF), and acute lung injury/acute respiratory distress syndrome (ARDS). TRPV4 has been shown to play a role in lung diseases associated with lung parenchymal stretch or stiffness. TRPV4 indirectly mediates hypotonicity-induced smooth muscle contraction and airway remodeling in asthma...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28513198/cleaning-and-infection-control-of-airway-clearance-devices-used-by-cf-patients
#17
Eynav Manor, Michal Gur, Yuval Geffen, Lea Bentur
Respiratory treatment for cystic fibrosis (CF) patients includes use of respiratory devices. Contamination of airway clearance devices has not been adequately explored. We aimed to determine whether airway clearance devices are contaminated after use and whether cleaning guidelines for nebulizers are as effective for airway clearance devices. Patients brought their airway clearance devices to the clinic. Swabs from the devices were taken before and after cleaning and were cultured for bacterial counts. Total colony-forming units (CFU) was determined, and predominant colonies were identified using Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry technology...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28511651/high-resolution-mucociliary-transport-measurement-in-live-excised-large-animal-trachea-using-synchrotron-x-ray-imaging
#18
Martin Donnelley, Kaye S Morgan, Maged Awadalla, Nigel R Farrow, Chris Hall, David W Parsons
BACKGROUND: The Australian Synchrotron Imaging and Medical Beamline (IMBL) was designed as the world's widest synchrotron X-ray beam, enabling both clinical imaging and therapeutic applications for humans as well as the imaging of large animal models. Our group is developing methods for imaging the airways of newly developed CF animal models that display human-like lung disease, such as the CF pig, and we expect that the IMBL can be utilised to image airways in animals of this size. METHODS: This study utilised samples of excised tracheal tissue to assess the feasibility, logistics and protocols required for airway imaging in large animal models such as pigs and sheep at the IMBL...
May 16, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28497033/intrapulmonary-percussive-ventilation-as-an-airway-clearance-technique-during-venoarterial-extracorporeal-life-support-in-an-infant-with-pertussis
#19
Conrad Krawiec, Ken Ballinger, E Scott Halstead
Initiation of extracorporeal life support (ECLS) is often followed by complete opacification of pulmonary parenchyma and volume loss. The optimal mechanical ventilator management and lung recruitment strategy of a pediatric patient requiring extracorporeal membrane oxygenation is not known. We present a case of a 4-week old infant who developed a severe pertussis infection requiring ECLS. The severity of his illness and pertussis infection-associated intraluminal bronchiole obstruction made medical management challenging...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28493047/effects-of-cpap-in-patients-with-obstructive-apnoea-is-the-presence-of-allergic-rhinitis-relevant
#20
A Cisternas, F Aguilar, J M Montserrat, M Àvila, M Torres, A Iranzo, J Berenguer, I Vilaseca
PURPOSE: The aim of the study is to compare the effects of continuous positive airway pressure (CPAP) on the nasal cavities of patients with obstructive sleep apnoea (OSA) and with or without allergic rhinitis (AR/nonAR). METHODS: This paper is a prospective, longitudinal study. Thirty-four consecutive CPAP treatment-adherent patients with OSA (17 AR and 17 nonAR) were evaluated before and 2 months after treatment, by means of clinical (otorhinolaryngological symptoms, daytime sleepiness, overall and rhinoconjunctivitis-specific quality of life), anatomical (otorhinolaryngological examination), functional (auditory function, tubal function, nasal airflow, and mucociliary clearance), and biological variables (nasal cytology)...
May 10, 2017: Sleep & Breathing, Schlaf & Atmung
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