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tracheal occlusion

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https://www.readbyqxmd.com/read/28373918/successful-treatment-of-carcinomatous-central-airway-obstruction-with-bronchoscopic-electrocautery-using-hot-biopsy-forceps-during-mechanical-ventilation
#1
Motoi Ugajin, Hisanori Kani
We report the case of a 72-year-old man with occlusion of the left main bronchus due to squamous cell carcinoma of the lung. He required tracheal intubation and mechanical ventilation because of the aggravation of atelectasis and obstructive pneumonia. Electrocautery using hot biopsy forceps was performed during mechanical ventilation with a 40% fraction of inspired oxygen. He was extubated following improvement in the atelectasis and obstructive pneumonia and discharged with shrinkage of the tumor after chemotherapy...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#2
Julio A Jiménez, Elisenda Eixarch, Philip DeKoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion under local anesthesia...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28195963/mediastinitis-following-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#3
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28157247/congenital-diaphragmatic-hernia-pathogenesis-prenatal-diagnosis-and-management-literature-review
#4
Przemysław Kosiński, Mirosław Wielgoś
Congenital diaphragmatic hernia (CDH) is a developmental discontinuity of the diaphragm. It allows abdominal viscera to herniate into the chest and leads to lung hypoplasia. Congenital diaphragmatic hernia is one of the most severe birth defects, with extremely high neonatal mortality. This paper presents a review of the available literature on prenatal diagnosis, management and treatment options for CDH. In selected cases, a prenatal procedure to improve neonatal survival is possible. The authors of this manuscript believe their work might contribute to a better understanding of congenital diaphragmatic hernia and patient selection for the FETO (fetal endoscopic tracheal occlusion) surgery or expectant management...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28152192/effects-of-tracheal-occlusion-with-retinoic-acid-administration-on-normal-lung-development
#5
Amélie Delabaere, Geoffroy Marceau, Karen Coste, Loïc Blanchon, Pierre-Jean Déchelotte, Pierre Blanc, Vincent Sapin, Denis Gallot
INTRODUCTION: Tracheal occlusion (TO) is an investigational therapy for severe congenital diaphragmatic hernia that decreases pulmonary hypoplasia, but sustained TO also induces deficient surfactant synthesis. Intramuscular maternal administration of retinoic acid (RA) in a surgical rabbit model of congenital diaphragmatic hernia showed a beneficial effect on lung maturation. We evaluated the potential of RA delivery into the trachea and studied the combined effects of TO and RA on normal lung development...
February 2, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28144067/stenting-of-critical-tracheal-stenosis-with-adjuvant-cardio-pulmonary-bypass
#6
Himanshu Bhardwaj, Ahmed Awab, Houssein A Youness, Brent Brown
Severe and critical central airway obstruction causing impaired ventilation and/or oxygenation can impose tremendous challenges on the interventional pulmonologist. Near total airway obstruction can rapidly evolve into potentially fatal complete airway occlusion during bronchoscopic airway manipulation under moderate sedation; as well as during the induction of the general anesthesia. Although there are currently interventional pulmonary procedures available to tackle the critical airway obstruction in extreme situations, cardio-pulmonary bypass should be considered prior to the intervention to maintain the adequate gas exchange during the procedure...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28125664/velcro-like-system-used-to-fix-a-protective-faecal-shield-on-weevil-larvae
#7
Jiří Skuhrovec, Robert Stejskal, Filip Trnka, Andrea di Giulio
The last instar larva and pupa of Eucoeliodes mirabilis (A. Villa & G. B. Villa, 1835) (Curculionidae: Ceutorhynchini) are described using drawings and SEM images and are compared and keyed with already described larvae of 58 other ceutorhynchinae taxa. The larval body has an effective combination of morphological adaptations that assist a unique biological defensive strategy. All larval stages of E. mirabilis feed ectophytically on leaves of Euonymus europaeus L. (Celastraceae), and the larval body is covered with a thick faecal shield...
2017: PloS One
https://www.readbyqxmd.com/read/28050517/prosthodontic-approach-in-management-of-prolonged-neonatal-intubation
#8
Vikas B Kamble, Shital K Shah, Vishnu B Rathod, Priyanka S Ambadkar, Charudutt N Patil
Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049200/a-mouse-model-of-post-stroke-pneumonia-induced-by-intra-tracheal-inoculation-with-streptococcus-pneumoniae
#9
Eva Mracsko, Sabine Stegemann-Koniszewski, Shin-Young Na, Alexander Dalpke, Dunja Bruder, Felix Lasitschka, Roland Veltkamp
BACKGROUND: Stroke-induced immunodeficiency increases the risk of infectious complications, which adversely affects neurological outcome. Among those, pneumonia affects as many as one third of stroke patients and is the main contributor to mortality in the post-acute phase of stroke. Experimental findings on post-stroke susceptibility to spontaneous pneumonia in mice are contradictory. Here, we established a mouse model inducing standardized bacterial pneumonia and characterized the impaired pulmonary cellular and humoral immune responses after experimental stroke...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27951457/radiologic-assessment-of-fetal-tracheal-balloon-occlusion
#10
Eric J Jordan, Vickie A Feldstein, Willieford Moses, Andrew S Phelps
Fetal endoscopic tracheal occlusion (FETO) is a novel technique to treat cases of isolated severe congenital diaphragmatic hernia (CDH). Although there are benefits of MRI over ultrasound in assessing lung volumes, it is unknown whether there are benefits of MRI for localizing the tracheal balloon. This is a retrospective study reviewing the imaging characteristics of FETO in patients who underwent both MRI and ultrasound exams done to localize tracheal balloons.
March 2017: Clinical Imaging
https://www.readbyqxmd.com/read/27926636/feasibility-and-outcomes-of-fetoscopic-tracheal-occlusion-for-severe-left-diaphragmatic-hernia
#11
Michael A Belfort, Oluyinka O Olutoye, Darrell L Cass, Olutoyin A Olutoye, Christopher I Cassady, Amy R Mehollin-Ray, Alireza A Shamshirsaz, Stephanie M Cruz, Timothy C Lee, David G Mann, Jimmy Espinoza, Stephen E Welty, Caraciolo J Fernandes, Rodrigo Ruano
OBJECTIVE: To evaluate feasibility and initial outcomes of fetoscopic tracheal occlusion for severe diaphragmatic hernia compared with a historical cohort who had not received fetal tracheal occlusion. METHODS: Outcomes in a prospective observational cohort who underwent fetoscopic tracheal occlusion for severe fetal left diaphragmatic hernia without associated anomalies were compared with our historical nontreated cohort of matched fetuses of similar severity. Fetuses were classified using the same ultrasonography and magnetic resonance imaging methodology-prospectively in the fetoscopic tracheal occlusion group and retrospectively in the historical nontreated cohort...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27891001/rigid-bronchoscopic-management-of-acute-respiratory-failure-in-a-30-year-old-woman
#12
Karan Madan, Ashesh Dhungana, Neha Kawatra Madan, Anant Mohan, Vijay Hadda, Rakesh Garg, Deepali Jain, Randeep Guleria
A 30-year-old woman presented with a history of progressive shortness of breath, cough, and hoarseness. Stridor was audible on examination. Chest X-ray showed normal lung fields and contrast-enhanced computed tomography thorax showed lower tracheal occlusion with endoluminal growth. Diagnostic flexible bronchoscopy demonstrated multiple whitish glistening nodules over both vocal cords and lower tracheal occlusion by whitish nodular growth. In view of critical central airway obstruction, rigid bronchoscopy and excision of the lower tracheal growth were performed...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27835782/laryngospasm-central-and-obstructive-apnea-during-seizures-defining-pathophysiology-for-sudden-death-in-a-rat-model
#13
K Nakase, R Kollmar, J Lazar, H Arjomandi, K Sundaram, J Silverman, R Orman, J Weedon, D Stefanov, E Savoca, L Tordjman, K Stiles, M Ihsan, A Nunez, L Guzman, M Stewart
Seizure spread into the autonomic nervous system can result in life-threatening cardiovascular and respiratory dysfunction. Here we report on a less-studied consequence of such autonomic derangements-the possibility of laryngospasm and upper-airway occlusion. We used parenteral kainic acid to induce recurring seizures in urethane-anesthetized Sprague Dawley rats. EEG recordings and combinations of cardiopulmonary monitoring, including video laryngoscopy, were performed during multi-unit recordings of recurrent laryngeal nerve (RLN) activity or head-out plethysmography with or without endotracheal intubation...
December 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27779353/mortality-following-congenital-diaphragmatic-hernia-repair-the-role-of-anesthesia
#14
Chulananda Goonasekera, Kamal Ali, Ann Hickey, Lekshmi Sasidharan, Malcolm Mathew, Mark Davenport, Anne Greenough
BACKGROUND: Mortality following surgical repair of congenital diaphragmatic hernia (CDH) remains high. The volume and type of perioperative intravenous fluid administered, baro-trauma, oxygen toxicity, and the duration of anesthesia are thought to affect outcome in surgical populations. AIMS: The aim of this retrospective observational study was to determine whether the perioperative volume or type of fluids and/or the duration of anesthesia were associated with postoperative mortality and if mortality was predicted by the oxygenation index (OI) prior to or following CDH surgical repair...
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27626241/myocardial-function-pre-and-post-fetal-endoscopic-tracheal%C3%A2-occlusion-feto-in-fetuses-with-left-sided-moderate-to-severe-congenital-diaphragmatic-hernia
#15
Jan Degenhardt, Christian Enzensberger, Aline Tenzer, Andrea Kawecki, Thomas Kohl, Ellydda Widriani, Roland 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...
January 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/27535564/micropatterned-endotracheal-tubes-reduce-secretion-related-lumen-occlusion
#16
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...
December 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27531619/ex-vivo-tracheomalacia-model-with-3d-printed-external-tracheal-splint
#17
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)...
April 2017: Laryngoscope
https://www.readbyqxmd.com/read/27514074/congenital-diaphragmatic-hernia-endotracheal-fluid-phospholipidic-profile-following-tracheal-occlusion-in-an-experimental-model
#18
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])...
February 1, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27492181/functional-measurement-of-respiratory-muscle-motor-behaviors-using-transdiaphragmatic-pressure
#19
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
https://www.readbyqxmd.com/read/27486655/fetoscopic-endoluminal-tracheal-occlusion-in-fetuses-with-severe-diaphragmatic-hernia-a-three-year-single-center-experience
#20
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
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