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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute superior laryngeal palsy is often clinically unrecognized and frequently overlooked. Yet, this motor paralysis occurs more frequently than facial paralysis. Like acute facial paralysis, superior laryngeal palsy often occurs as part of a cranial polyneuritis that is probably related to herpes simplex virus reactivation. Rotation of the larynx and shortening of one vocal cord have been found in such diverse syndromes as vestibular neuronitis, migraine and tension headaches, unexplained cough, tinnitus aurium, globus hystericus, and carotidynia. Electromyographic studies suggest that laryngeal spasm may be caused by faulty regeneration of the superior, rather than the recurrent, laryngeal nerve.
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PMID:Acute superior laryngeal nerve palsy: analysis of 78 cases. 682 26

An intensive treatment of patients undergoing thoracic surgery is important, foremost because of the extensity of the surgical procedures and the generally poor condition of the patients. As a first stage of preoperative preparation an evaluation of the functional capacity of the vital organs (heart, lungs and kidneys) is performed, and the most important infection's focci of the oro-pharynx, tracheobronchial tree, urinary tract and skin have to be detected and treated. Respiratory physiotherapy before the surgery improves the ventilatory function, enabling the patient to breath regularly and effectively cough, wherewith a bronchial spasm is prevented and bronchopulmonary infection limited. Before surgery any hypovolaemia, anaemia, hypoproteinemia and dysproteinaemia should also be corrected; in such patients the parenteral alimentation (hyperalimentation) through the central venous catheter, is also important. Immediately following the operation a continuous supervision of vital functions (usually managed by well-experienced surgical nurses) is very essential. Isothermia, isovolemia, a correct oxygenation and analgesia should be maintained permanently. To loose sight of hypoventilation and hypoxia can likely induce respiratory insufficiency. Symptoms indicating tracheal intubation and mechanical ventilation should be watched for and treated at the right moment. Following the surgery, prevention of pulmonary atelectasis and pneumonia, providing an effective thoracic drainage, and respiratory physiotherapy is of utmost importance. The prophylaxis of postoperative pulmonary embolism in particularly jeopardized patients consists in the administration of heparin. Antibiotics in accordance with antibiogram (material: samples taken by a catheter or by bronchoscope from the lung directly).
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PMID:[Intensive care of thoracic surgery patients]. 688 May 35

The role of the fiberscope in the management of difficult and failed intubations has been well established and the importance of learning this valuable skill has been emphasized. Nonetheless, the fiberscope is underutilized in anesthesia and critical care practices because of a high rate of intubation failure. The main cause of failure is lack of expertise in maneuvering the fiberscope. Other technical causes of failure include fogging or clouding of the fiberscope's lens, drifting off the midline, and inability to advance the endotracheal tube or withdraw the fiberscope after completing intubation. Proper selection of the size of the fiberscope in relation to the size of the endotracheal tube, adequate lubrication, and careful passage of the fiberscope through the distal opening of the tracheal tube (not the Murphy eye) prevent difficulties encountered during advancement of the tube or upon withdrawal of the bronchoscope. Patient-related causes include inadequate topical anesthesia, which leads to abrupt movement of the larynx, laryngeal spasm, coughing, and copious secretions; a large floppy epiglottis; and tumor and edema of the upper airway, which also interfere with exposure of the larynx. Various approaches for learning and applying fiberoptic endoscopy have been instituted. The key to increased success involves initial training and practice with an intubation model and tracheobronchial tree. These models enable the learner to develop the eye-hand coordination skills needed to use the fiberscope properly. The fiberscope is best used in patients after learning to perform three simultaneous movements--advancing the fiberscope, coordinated rotation of the insertion cord, and bending the tip of the fiberscope while traversing the airway. After the technical skills of the fiberscope become second nature, the endoscopist can give more attention to patient-related factors to improve the success rate of tracheal intubation. Expert use of the fiberscope can be a life-saving measure through alleviating major airway complications and unnecessary tracheostomies.
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PMID:The role of the fiberscope in the critically ill patient. 773 70

In treating chronic bronchitis, the effect of 13 Herbs Anti-Cough-Dyspnea decoction was better than that of other traditional prescriptions such as Ephedria-almond decoction etc. The effective rate of this decoction in relieving cough, sputum, bronchial spasm and eliminating wheezing sound were 98.6%, 98.32%, 91.52% and 85.35% respectively. The total effective rate was 98%. The animal experiment revealed that the decoction was given to isolated trachea after medication for 30 min, the effective rate in easing bronchial spasm was 99.1 +/- 30.2%, which was two times than that of other prescriptions.
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PMID:[Analysis of clinical effect and experimental study of 13 herbs anti-cough-dyspnea decoction in the treatment of chronic bronchitis]. 849 31

Clinical and physical data about laryngeal mask use in eye surgery were collected in 57 patients. We observed 4 failures which required endotracheal intubation, 3 leaks during operative field installation, 4 salvations but no laryngeal spasm and no cough. There were no significative differences between body weights in laryngeal mask groups no 3 and no 4. Insufflation pressures of patients without curarisation were more important. The duration of ventilation was not correlated with salivation, leaks or increase of insufflation pressure.
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PMID:[The laryngeal mask in ophthalmologic surgery. Criteria and limitations of use in adults (analysis of 57 cases)]. 856 80

Asthma is a chronic inflammatory disease of the lower respiratory tract which is triggered by exposure to allergens or other airway irritants. This inflammation results in airway hyperresponsiveness, bronchial muscle spasm, mucous gland hypersecretion and mucosal edema, which combine to create symptoms such as cough, wheezing and respiratory distress. Because the inflammatory process is highly variable, asthma is a disorder with many possible presentations. It may therefore proceed for years without clinical recognition, and may challenge the most astute diagnostician. It is important for otolaryngologists to be able to suspect, diagnose and treat asthma. This is so because asthma is a common disease in the otolaryngologic patient population, both as one of the options in the differential diagnosis of respiratory complaints, and as a comorbid condition which may complicate the treatment of other medical or surgical problems. Furthermore, both the understanding of asthma's pathophysiology, and its optimum treatment methods have undergone radical changes during the past decade. This three-part discussion reviews our modern understanding of asthma, and proposes diagnosis and treatment guidelines which can assist otolaryngologists in effectively managing their asthmatic patients. Part one summarizes current information on the pathophysiology and increasing prevalence of asthma, its clinical variability, the assessment of asthma sensitivity, and methods for diagnosis of asthma. Parts two and three cover the strategy for asthma management, and the use of both adjunctive and anti-inflammatory therapies for asthma control.
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PMID:Asthma: an important disease to otolaryngologists--Part I: Suspecting and diagnosing asthma. 871 22

We carried out a perspective study in order to assess the ease of insertion, the type and the incidence of perioperative complications connected with the use of the Laryngeal Mask Airway (LMA). We examined 300 consecutive patients, M/F 261/39, average age 4.2 yrs. (range 0.1-16), ASA I-II, who underwent surgical operations of short or average length not involving the pleural, the oropharyngeal or the peritoneum cavity. The choice about anesthesia was left to the discretion of the anesthesiologist. In 27 cases the position of the LM was controlled through a flexible fiberoptics. In 269 patients (89.6%) the LMA was correctly positioned during the first attempt. In 27 patients (9%), 2 or more attempts were necessary, and in 4 patients (1.4%) it was not possible to set the LMA. No differences of statistical significance were noticed between the different size of LMA, with regards to the facility of insertion. The control through fiberoptics showed a correct position, from an anatomical point of view, in 11 patients (41%), whereas in 13 patients (48%) some signs of partial obstruction were noticed (epiglottis interposing between the opening of LMA and larynx) and in 3 patients (11%) vocal cords are not visible. The following complications took place: laryngeal spasm on induction (2.3%), cough or movements on positioning (2.3%), hypoxia (4.3%), obstruction (1%), laryngeal spasm on awakening (1.7%), trauma (5%) and vomiting (0.3%). No connections were found between the size of LMA and total complications. Nevertheless, cough or movement during positioning and laryngeal spasm on awakening were significantly more frequent with LMA n. 3. In our experience, the LMA proved to be effectual and safe in the control of the airway during elective operations in pediatric surgery.
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PMID:[The laryngeal mask in pediatric anesthesia]. 876 51

The aim of this investigation was to study the role of the nasal airway in mediating upper airway reflexes during induction of anaesthesia when the commonly used irritant inhalational anaesthetic agent enflurane is used. In a prospective randomised study, 40 ASA 1 & 2 day-case patients undergoing body surface surgery were recruited. Following intravenous induction using propofol, 20 patients received enflurane administered via a laryngeal mask airway (LMA), the anaesthetic vapour therefore bypassing the nasal airway. In the other group, 20 patients received enflurane anaesthesia administered using a face mask, the nasal airway therefore being exposed to inhalation anaesthetic. We were unable to demonstrate any significant (p < 0.05) differences between the two groups in relation to upper airway complications (cough, breath holding, laryngeal spasm, bronchospasm and excitement). Previous work has identified the nose as a possible important reflexogenic site for upper airway reflexes in humans during anaesthesia. We have been unable to demonstrate any difference in upper airway complications when the nasal airway was included or excluded from exposure to irritant anaesthetic vapours, when administered in a clinical setting.
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PMID:The site of airway irritation during induction of anaesthesia. 940 77

A high incidence of unsuccessful attempts and complications has been reported when emergency tracheal intubation (ETI) is performed outside the hospital in severely injured children. The aim of this prospective series was to analyse the incidence and related risk factors of complications of emergency tracheal intubation. The time to complete successful ETI and occurrence of incidents, e.g. cough reflex, hypoxia or spasm were related to the experience of the physician performing intubation and the use of drugs to facilitate ETI. The incidence of hypoxia, hypercarbia, postintubation complications such as extubation stridor and long-term sequelae were noted. Of the 188 children, 78% were successfully intubated at the site of the accident, 10% upon arrival at a local hospital from where they were secondarily transferred and 12% upon admission to our trauma centre. The most severely injured children were intubated in the field in 98% of cases without failure, nor life-threatening complications related to ETI. The experience of the operator influenced the number of attempts and the time to complete successful intubation. Immediate incidents were noted in 25% of children, e.g. cough in 18%. The regimen of drugs, but not level of consciousness, influenced the incidence of immediate incidents; without drugs, more than 67% experienced incidents. Early tracheal intubation and controlled ventilation resulted in adequate ventilation upon arrival (mean PaO2 of 35.8+/-24 kPa, mean PaCO2 of 4.35+/-1 kPa). Long-term complications, including transient stridor upon extubation in 33% of the cases, and laryngeal granuloma or tracheal stenosis, were comparable to those in other series. ETI in shocked patients and pulmonary infection in hospital, but not the technique of ETI, increased the risks of long-term complications. Emergency tracheal intubation can be performed safely in the field, and results in adequate ventilation during transportation of severely injured children, provided that it can be performed by trained physicians using adequate drugs to facilitate intubation.
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PMID:Complications of emergency tracheal intubation in severely head-injured children. 1079 40

A case of negative pressure bilateral pulmonary edema in a 28 years old healthy female patient, scheduled for diagnostic pelvic laparoscopy for infertility. Following extubation and apparent recovery from anesthesia, she had strong inspiratory efforts due to airway obstruction caused by coughing and laryngeal spasm, that lead to negative pressure bilateral pulmonary edema. The pulmonary edema disappeared within few hours. She was breathing spontaneously through CPAP system (mask-bag-expiratory valve). Diuretics and lungs physiotherapy helped in controlling patient's complication.
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PMID:Bilateral negative airway pressure pulmonary edema (NPPE)--a case report--. 1638 Dec 68


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