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tracheal occlusion

J Degenhardt, C Enzensberger, A Tenzer, A Kawecki, T Kohl, E Widriani, R Axt-Fliedner
: Purpose: To evaluate pre- and postprocedural myocardial function in fetuses with moderate to severe congenital diaphragmatic hernia (CDH) who underwent FETO to improve survival and to reduce morbidity and to compare these data with fetuses and CDH not undergoing FETO and normal controls. Materials and Methods: 8 fetuses with isolated left-sided CDH were included and underwent FETO at our center between 2012 and 2013. Prior to and after the operation, myocardial function was assessed by measuring the mitral annular plane systolic excursion (MAPSE), the tricuspid annular plane systolic excursion (TAPSE), Tei index, isovolumetric contraction time (ICT), ejection time (ET), isovolumetric relaxation time (IRT) for the left ventricle in PW Doppler ultrasound as well as ICT, ET, IRT and Tei index in pulsed wave tissue Doppler imaging (PW-TDI) for the left and right ventricle...
September 14, 2016: Ultraschall in der Medizin
Ethan E Mann, Chelsea M Magin, M Ryan Mettetal, Rhea M May, MiKayla M Henry, Heather DeLoid, Justin Prater, Lauren Sullivan, John G Thomas, Mark D Twite, Albert E Parker, Anthony B Brennan, Shravanthi T Reddy
Tracheal intubation disrupts physiological homeostasis of secretion production and clearance, resulting in secretion accumulation within endotracheal tubes (ETTs). Novel in vitro and in vivo models were developed to specifically recapitulate the clinical manifestations of ETT occlusion. The novel Sharklet™ micropatterned ETT was evaluated, using these models, for the ability to reduce the accumulation of both bacterial biofilm and airway mucus compared to a standard care ETT. Novel ETTs with micropattern on the inner and outer surfaces were placed adjacent to standard care ETTs in in vitro biofilm and airway patency (AP) models...
August 17, 2016: Annals of Biomedical Engineering
Rachel Kaye, Todd Goldstein, Danielle Aronowitz, Daniel A Grande, David Zeltsman, Lee P Smith
OBJECTIVE: To design and evaluate an ex vivo model of tracheomalacia with and without a three-dimensional (3D)-printed external tracheal splint. STUDY DESIGN: Prospective, ex vivo animal trial. METHODS: Three groups of ex vivo porcine tracheas were used: 1) control (unmanipulated trachea), 2) tracheomalacia (tracheal rings partially incised and crushed), and 3) splinted tracheomalacia (external custom tracheal splint fitted onto group 2 trachea)...
August 17, 2016: Laryngoscope
Gloria Pelizzo, Maria Chiara Mimmi, Jose Luis Peiro, Mario Marotta, Francesco Amoroso, Mario Fusillo, Veronica Carlini, Valeria Calcaterra
OBJECTIVE: To compare endotracheal fluid (EF) and amniotic fluid (AF) phospholipidic profile changes following tracheal occlusion (TO) in the congenital diaphragmatic hernia (CDH) fetal lamb model, in order to support the efficacy of TO on lung maturity. METHODS: A diaphragmatic defect was induced at 70 days' gestation, TO was carried out at day 102 and cesarean section at 136 days' gestation. EF and AF samples, collected at delivery, were evaluated using mass spectrometry (the analysis focused on palmitoyloleoyl-phosphatidylcholine [POPC, PC(18:1/16:0)], dipalmitoyl-phosphatidylcholine [DPPC, PC(16:0/16:0)] and sphingomyelins [SMs])...
August 11, 2016: Journal of Perinatal Medicine
Sarah M Greising, Carlos B Mantilla, Gary C Sieck
The diaphragm muscle must be able to generate sufficient forces to accomplish a range of ventilatory and non-ventilatory behaviors throughout life. Measurements of transdiaphragmatic pressure (Pdi) can be conducted during eupnea, hypoxia (10 % O2)-hypercapnia (5 % CO2), chemical airway stimulation (i.e., sneezing), spontaneously occurring deep breaths (i.e., sighs), sustained airway or tracheal occlusion, and maximal efforts elicited via bilateral phrenic nerve stimulation, representing the full range of motor behaviors available by the diaphragm muscle...
2016: Methods in Molecular Biology
Nicola Persico, Isabella Fabietti, Fabrizio Ciralli, Valerio Gentilino, Francesco D'Ambrosi, Simona Boito, Manuela Wally Ossola, Mariarosa Colnaghi, Valentina Condò, Francesco Macchini, Ernesto Leva, Fabio Mosca, Luigi Fedele
OBJECTIVE: To report on our experience in the prenatal treatment of severe congenital diaphragmatic hernia (CDH) by fetoscopic endoluminal tracheal occlusion (FETO). METHODS: Between 2012 and 2014, FETO was performed at our center in 21 cases of CDH considered to be severe based on sonographic measurement of observed/expected lung-to-head ratio (O/E LHR) and side of the defect. We reported pre- and postoperative ultrasound findings, procedure-related complications, pregnancy outcome and survival at 1-3 years of age...
August 4, 2016: Fetal Diagnosis and Therapy
Riccardo Pinciroli, Cristina Mietto, Annop Piriyapatsom, Christopher T Chenelle, John G Thomas, Massimiliano Pirrone, Lynn Bry, Gregory R Wojtkiewicz, Matthias P Nahrendorf, Robert M Kacmarek, Lorenzo Berra
INTRODUCTION: Intubation compromises mucus clearance, allowing secretions to accumulate inside the endotracheal tube (ETT). The purpose of this trial was to evaluate a novel device for ETT cleaning. We hypothesized that its routine use would reduce tube occlusion due to mucus accumulation, while decreasing airway bacterial colonization. METHODS: Subjects were randomized to either the use of the device every 8 h, or the institutional standard of care (blind tracheal suction) only...
July 26, 2016: Respiratory Care
Brian M Varisco, Lourenco Sbragia, Jing Chen, Federico Scorletti, Rashika Joshi, Hector R Wong, Rebecca Lopes-Figueira, Marc Oria, Jose Peiro
Congenital diaphragmatic hernia (CDH) causes severe pulmonary hypoplasia from herniation of abdominal contents into the thorax. Tracheal occlusion (TO) for human CDH improves survival, but morbidity and mortality remain high, and we do not fully understand the cellular pathways and processes most severely impacted by CDH and TO. We created a left diaphragmatic hernia (DH) in rabbit fetuses with subsequent TO and collected left lung sections for NextGen mRNA sequencing. DH, TO, and DHTO fetuses had comparable body and organ growth to control except for lower lung weights in DH (p<0...
July 19, 2016: Molecular Medicine
Christoph Kampmann, Christiane M Wiethoff, Ralf G Huth, Gundula Staatz, Eugen Mengel, Michael Beck, Stefan Gehring, Torsten Mewes, Tariq Abu-Tair
Several different lysosomal storage diseases, mainly mucopolysaccharidosis (MPS) type I, II, and VI, are complicated by severe obstruction of the upper airways, tracheobronchial malacia, and/or stenosis of the lower airways. Although enzyme replacement therapies (ERTs) are available, the impact of these on tracheobronchial alterations has not been reported. By extending the life expectancy of MPS patients with ERTs, airway problems may become more prevalent at advanced ages. These airway abnormalities can result in severe, potentially fatal, difficulties during anesthetic procedures...
July 22, 2016: JIMD Reports
Satoshi Watanabe, Kazuo Kasahara, Yuko Waseda, Hazuki Takato, Shingo Nishikawa, Taro Yoneda, Johsuke Hara, Takashi Sone, Miki Abo, Hideharu Kimura, Shinji Nakao
BACKGROUND: Imatinib, a tyrosine kinase inhibitor, has been proposed as a potential anti-fibrotic agent for fibroproliferative diseases, including bronchiolitis obliterans (BO). However, the underlying anti-fibrotic mechanisms of the agent remain unclear. We evaluated whether bone (BM)-derived progenitor cells, fibrocytes, might be a target of imatinib in the attenuation of BO. METHODS: We used a murine BO model induced by heterotopic tracheal transplantation and assessed the origin of fibroblasts by using green fluorescent protein-BM chimeric mice...
June 3, 2016: Journal of Heart and Lung Transplantation
Frances Lilian Lanhellas Gonçalves, Rebeca Lopes Figueira, Rodrigo Melo Gallindo, Ana Leda Bertoncini Simões, Alan Coleman, José Luis Peiró, Lourenço Sbragia
BACKGROUND: Congenital diaphragmatic hernia (CDH) is associated with lung hypoplasia and pulmonary hypertension. Tracheal occlusion (TO) stimulates fetal lung growth and maturation and reverse vascular changes responsible for pulmonary hypertension, which are related to mechanisms involving nitric oxide (NO) in CDH. We aim to evaluate the effect of TO and ventilation on NO pathways. METHODS: Eight groups were created: (1) control; (2) control ventilated (CV); (3) CDH (CDH); (4) CDH ventilated (CDHV); (5) TO control; (6) TO ventilated; (7) TO + CDH; and (8) TO + CDH ventilated (CDHTOV)...
June 15, 2016: Journal of Surgical Research
Wang Yu, Liu Jianhong, Wang Weili, Shen Peng, Shen Zhongyang
OBJECTIVE: To investigate the changes in cyclophilin A (CyPA) signal pathway in rat myocardial tissue after cardiopulmonary resuscitation (CPR). METHODS: Sixty-eight healthy male Sprague-Dawley (SD) rats were randomly divided into sham operation group (n = 8), instantaneous CPR after cardiac arrest (CA), immediate CPR after CA (CRP), and 15, 30, 60 and 120 minutes after CPR groups, respectively, with 10 rats in each group. Asphyxia was simulated by occlusion of the tracheal tube at the end of exhalation...
December 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Francesca Maria Russo, Mary Patrice Eastwood, Richard Keijzer, Jamila Al-Maary, Jaan Toelen, Tim Van Mieghem, Jan A Deprest
OBJECTIVES: To identify antenatal predictors of persistent pulmonary hypertension (PPH) and need for extracorporeal membrane oxygenation (ECMO) in fetuses with congenital diaphragmatic hernia (CDH). MATERIAL AND METHODS: We performed a systematic literature review of antenatal diagnostic tests in fetuses with isolated CDH. The target conditions were PPH within 28 days of life and the need for ECMO. Quality of studies was assessed with the QUADAS-2 tool. Meta-analysis was performed when at least three studies reported on the same test...
June 17, 2016: Ultrasound in Obstetrics & Gynecology
Kamal Ali, Perraju Bendapudi, Satyamaanasa Polubothu, Gwendolyn Andradi, Mercy Ofuya, Janet Peacock, Ann Hickey, Mark Davenport, Kypros Nicolaides, Anne Greenough
UNLABELLED: The morbidity of infants with congenital diaphragmatic hernia (CDH) who had undergone foetal endoscopic tracheal occlusion (FETO) to those who had not was compared and predictors of survival regardless of antenatal intervention were identified. FETO was undertaken on the basis of the lung to head ratio or the position of the liver. A retrospective review of the records of 78 CDH infants was undertaken to determine the lung-head ratio (LHR) at referral and prior to birth, maximum oxygen saturation in the labour suite and neonatal outcomes...
August 2016: European Journal of Pediatrics
Raffaella Capasso, Mattia Carbone, Eugenio Rossi, Rosanna Mamone, Raffaele Zeccolini, Alfonso Reginelli, Massimo Zeccolini, Luca Brunese, Antonio Rotondo
BACKGROUND: Coughing is the most efficient mechanism for clearing mucus and fluid secretions from the airways and its reflex can be suppressed by sleep. Spontaneous tracheal ruptures are believed to result from raised intratracheal pressure against a closed glottis, such as for severe coughing. This is the first reported case of tracheal rupture presented on morning awakening after bronchial mucous plug formation during the nighttime sleep because of an ineffective cough reflex. CASE PRESENTATION: An otherwise healthy white 4-year-old child presented morning onset of dyspnea, chest pain and diffuse swelling of the neck...
2016: Journal of Medical Case Reports
Pål Aksel Næss, Kristian Engeseth, Ole Grøtta, Geir Øystein Andersen, Christine Gaarder
BACKGROUND: Life-threatening bleeding caused by liver injury due to chest compressions is a rare complication in otherwise successful cardiopulmonary resuscitation. Surgical intervention has been suggested to achieve bleeding control; however, reported mortality is high. In this report, we present a brief literature review and a case report in which use of a less invasive strategy was followed by an uneventful recovery. CASE PRESENTATION: A 37-year-old white woman was admitted after out-of-hospital cardiac arrest...
2016: Journal of Medical Case Reports
Chuanxiao Wang, Tian Xia, Ke Jiang, Xinwei Qiao, Xiayi Zhang, Jinsong Li, Jianjun Wang, Jun Nie
BACKGROUND: The long-term outcome of lung transplantation is impeded by the development of obliterative bronchiolitis (OB). We sought to investigate the relationship between the apoptosis of tracheal epithelial cells and bone marrow-derived myofibroblasts in the process of OB. METHODS: The mouse orthotopic tracheal transplant model was established. The allografts and syngrafts were harvested at 1, 2, 3, and 4 weeks after tracheal transplant. The percentage of tracheal lumen occlusion was assayed via histology and morphometry...
September 2016: Transplantation
Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Solange Patricia Nascimento, Bruno Verri, Fabio C Peralta, João Bennini Junior, Karina Jorge
BACKGROUND AND OBJECTIVES: The temporary fetal tracheal occlusion performed by fetoscopy accelerates lung development and reduces neonatal mortality. The aim of this paper is to present an anesthetic experience in pregnant women, whose fetuses have diaphragmatic hernia, undergoing fetoscopic tracheal occlusion (FETO). METHOD: Retrospective, descriptive study, approved by the Institutional Ethics Committee. Data were obtained from medical and anesthetic records. RESULTS: FETO was performed in 28 pregnant women...
May 4, 2016: Revista Brasileira de Anestesiologia
A Zamprakou, C Berg, B Strizek, A Müller, A Heydweiller, U Gembruch, A Geipel
BACKGROUND: Morgagni hernia presents a rare type of congenital diaphragmatic hernia (CDH, about 2-5 %) (Herman, J Perinatol 21:343-344, 2001), which is characterized by an anterior mainly right-sided defect of the diaphragm. Infrequently, this is combined with a herniation of the liver into the pericardial cavity (Aké, Prenat Diagn 11:719-724, 1991; Stevens, Pediatr Radiol 26:791-793, 1996). This may cause massive pericardial effusion and subsequently lung hypoplasia (Pober et al., Congenital diaphragmatic hernia overview, University of Washington, Seattle, 2015; Ikeda, J Perinat Med 30:336-340, 2002; Hara, J Obstet Gynaecol Res 33:561-565, 2007)...
April 28, 2016: Archives of Gynecology and Obstetrics
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