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

Three different low pressure cuffed endotracheal tubes (Lanz, Portex soft-seal, Kamen-Wilkinson) were studied in cadaver tracheas and patients in our intensive care unit during ventilation. In the air filled low pressure cuffs without controlled pressure system the cuff pressure and the ventilation pressure are almost identical. Rises of intrathoracic pressure during mechanical ventilation are reflected by increased cuff pressure. Tubes with controlled pressure system or foam-filled cuffs have lower peak cuff pressures, especially during sighing, coughing and suctioning.
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PMID:[Measurements of cuff pressure of different low pressure cuffed endotracheal tubes under mechanical ventilation (author's transl)]. 27 25

We studied the influence of changes in pressure applied to the isolated upper airway of four conscious dogs on tracheal smooth muscle tone and breathing pattern. The dogs were prepared with a permanent side-hole tracheal stoma and were trained to sleep with a snout mask hermetically sealed in place while breathing through a cuffed endotracheal tube inserted distally into the tracheal stoma. Changes in tracheal smooth muscle tone were continuously monitored by measuring the pressure in the water-filled cuff that distended the tracheal airway while pressure changes were introduced in the upper airway independently of breathing. Increases or decreases of upper airway pressure (+/- 10 cmH2O) had little effect on tracheal airway smooth muscle tone. In contrast, an oscillating pressure wave at 30 Hz and +/- 3 cmH2O amplitude (or -3 to -7 cmH2O amplitude) caused a marked increase in tracheal airway smooth muscle tone. An elevated tracheal airway tone could be maintained over many minutes when the oscillating pressure stimulus was pulsed so that there was a cycle of 0.5 s on, 0.5 s off. This stimulus did not change the functional residual capacity but resulted in coughing, swallowing, or sighing in 54% of the tests. In the remaining tests, the pressure stimulus produced a rapid, shallow, and erratic breathing pattern. The tracheal airway constrictor response (but not the ventilatory response) was completely abolished by intravenous atropine. We suggest that upper airway vibration is a potentially powerful mechanism of reflex airway smooth muscle constriction.
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PMID:Tracheal smooth muscle responses to upper airway pressure in conscious dogs. 218 62

Patients with myasthenia gravis (MG) face major pulmonary problems as a part of the disease process. In this descriptive study, changes in selected pulmonary functions (respiratory rate, negative inspiratory force, tidal volume and forced vital capacity) in 14 patients diagnosed with mild or moderate MG were measured every two hours from 8:00 a.m. to 8:00 p.m. Females comprised 64% of the sample while 36% were males. All subjects received anticholinesterase medication, and some subjects received additional treatment modalities. Most of the subjects were nonsmokers or previous smokers, but two subjects continued to smoke. Ninety-three percent of the sample had forced vital capacities less than 60% of their predicted values. Myasthenic forced vital capacities were significantly lower (p = .0000) than those predicted for normal subjects. The inspiratory force for the sample was low at 8:00 a.m. as well as in females over 55 years of age. There was a wide variation in tidal volume. The comparison of myasthenic values for respiratory rate, inspiratory force and tidal volume to normal values derived from random tables and prediction equations was not significant. The major implications from this study are the need to assess pulmonary function in the hospitalized myasthenic every two hours, and the need for a program of coughing, deep breathing and sighing after medication administration when muscles are strongest.
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PMID:Changes in selected pulmonary functions in patients diagnosed with myasthenia gravis. 253 72

A four-week-old male infant who had been exclusively breast-fed by his mother developed acute respiratory failure with intermittent arrest of breathing for up to 15 sec, in between sighing breaths and normal ones. For two weeks his mother had been taking pentoxyverine-containing cough drops for an upper respiratory tract infection. Pentoxyverine was demonstrated in maternal serum and breast milk, as well as the child's serum and urine, in some in very high concentrations. The course of the illness and comparison with reported instances of pentoxyverine poisoning in infants makes it likely that this, too, was such a case.
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PMID:[Pentoxyverine poisoning via maternal milk in a fully breast-fed newborn infant]. 337 Dec 22

Individuals with neuromuscular dysfunction are at increased risk for secretion retention. Their underlying disease process compromises or prevents ability to cough effectively. Although their lung function may remain normal, neuromuscular disease predisposes to breathing at low lung volumes and to elimination of sighing respirations, a breathing pattern which predisposes to development of airway and alveolar collapse. As ventilatory reserve decreases, risk of progressive atelectasis and secretion retention is increased. Prompt recognition of the signs and symptoms of this nursing diagnosis can prevent or reverse problems relating to ineffective airway clearance. Nursing management thus becomes the cornerstone of the individual's regimen of care.
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PMID:Ineffective airway clearance related to neuromuscular dysfunction. 364 87

Myoclonic jerks involving the proximal limb musculature and tic-like movements (sniffing, coughing, or sighing) were observed in an 11-year-old boy with benign occipital epilepsy treated with carbamazepine (CBZ). The involuntary movements disappeared a few days after withdrawal of CBZ and reappeared with CBZ reintroduction. Plasma CBZ levels were always within the therapeutic range. Polygraphic studies failed to show any electroencephalogram (EEG) changes during myoclonic jerks. Appearance of nonepileptic myoclonus in epileptic children treated with CBZ should be carefully evaluated to prevent worsening of the clinical picture. The coexistence of other involuntary movements (tics) could suggest the correct diagnosis.
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PMID:Carbamazepine-induced nonepileptic myoclonus in a child with benign epilepsy. 365 53

In a 71-year-old woman suffering from recurrent fever, dry cough, pain during sighing, hoarseness and later severe inflammation of the cartilage of both auricles 'relapsing polychondritis' was diagnosed. This is a rare disease of cartilage and connective tissue. Most frequent symptoms are inflammation of the auricles and nasal septum, joint disorders and inflammation of eye structures, larynx and trachea. The aetiology may be autoimmunity. The clinical diagnosis can be confirmed by a cartilage biopsy. The disease is recurrent and causes substantial morbidity and mortality. Therapy consists of NSAIDs, steroids, and sometimes immunosuppressive agents.
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PMID:[Chronic recurrent polychondritis]. 793 47

A 34-year-old man presented with a 30-year history of spasmodic dysphonia. He developed a speech disturbance 1 month after a closed head injury due to a fall. Sighing, coughing, and crying were normal. He had a tremor of the right hand when he drew a vertical line. His out-stretched right hand had a minimal dystonic posture with occasional jerks of the fingers. T1-weighted axial brain MRI study showed a low signal intensity lesion at the putamen; coronal and axial T2-weighted MRI brain scans showed a high and low signal intensity lesion confined to the middle part of the ventrolateral putamen. Damage to the ventrolateral putamen may have caused abnormal voluntary control of the laryngeal muscles.
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PMID:Spasmodic dysphonia associated with a left ventrolateral putaminal lesion. 879 90

1. We tested the hypothesis that the pattern and the intensity of autonomic mechanisms causing vasoconstriction in the resting bronchial circulation of awake dogs also exists in awake sheep. It was also postulated that sighing behaviour and the associated bronchovascular dilatation induced by non-adrenergic, non-cholinergic (NANC) mechanisms observed in the dog exist in sheep. 2. Bronchial arterial blood flow to lower airways of both lungs of awake sheep was measured continuously using pulsed Doppler flow probes mounted on the bronchial artery at prior thoracotomy. 3. Cumulative and factorial analysis of responses to randomized combinations of autonomic alpha 1-, alpha 2-, beta 1- and beta 2-adrenoceptors and cholinoceptor autonomic blockade suggests that resting vasoconstrictor activity is less in sheep than in dogs. At normal aortic pressure, the autonomic activity of these receptor groups in the sheep lowers bronchial blood flow and conductance by 30%, whereas in the awake dog, the corresponding autonomic effect is 50%. 4. Tonic autonomic control of bronchial conductance can be partitioned in sheep to show significant and separate alpha- and beta-adrenoceptor vasoconstrictor activity at a ratio of 1.8:1, an effect normally offset by a weaker vasodilator alpha-/beta-adrenoceptor interaction. In contrast to the situation in awake dogs, cholinoceptors do not play a role in awake sheep. 5. Nitric oxide (NO) synthase inhibition in sheep using NG-nitro-L-arginine following blockade of alpha- and beta-adrenoceptors and cholinoceptors causes hypertension, but minor changes, if any, in pulmonary pressures or heart rate. Bronchial flow and conductance, however, fall from a higher resting conductance by approximately 50%, suggesting that, normally, resting bronchial flow conductance is dominated by strong tonic NO vasodilator effects that interact with weaker tonic autonomic vasoconstrictor effects. 6. Superimposed (respiratory) behaviours of sighing, sneezing and coughing, which involve negative swings in intrathoracic pressure and the movement of inspired air, evoke large active bronchovascular dilator effects. These appear to be largely NANC in origin and appear to be dependent, in part, on mechanisms associated with NO release. It is postulated that the C-fibre axon reflex using substance P, calcitonin gene-related peptide and neurokinin A may be involved. Vocalization and eructation do not evoke bronchovascular effects.
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PMID:Autonomic control of bronchial circulation in awake sheep during rest and behaviour. 940 60

Mechanical stimulation of the pharyngeal mucosa in cats and some other mammals evokes the 'aspiration reflex' (AR) characterized by rapid and strong inspiratory efforts not followed by active expirations. It resembles other spasmodic inspiratory acts such as the sniff, the gasp, and the sigh in several aspects, e.g. reflex or semireflex triggering from the upper airways, the sudden onset and termination of such inspirations, the massive recruitment, steep rise and high-peak amplitude of inspiratory unit activity, analogous ventilatory pattern, and contribution to arousal. The similarity of these spasmodic acts is manifested mainly in enhanced speed and volume of inhalation, although of different intensity, which is determined by the varying degree of forced inspiratory activity and a concomitant inhibition of expiratory activity. The extent of the inspiratory dilation of the glottis and the timing and range of late-inspiratory and/or postinspiratory glottal narrowing modulate the depth of aspiration. Thus, the inhalation can be moderate as in sniffing, which provides a transfer of odorants to the olfactory mucosa. In AR the airstream is presumably strong enough to tear off the mechanical particles from the naso- and oropharynx and to convey them into the hypopharynx to allow their subsequent elimination by reflex swallowing or coughing. Prolonged glottal opening allows either the transfer of some additional air to the bronchi by sighing to prevent the development of atelectasis, or redistribution of a larger amount of fresh air into the lungs by gasping to support autoresuscitation. Should aspiration be a common effective component in these spasmodic processes, then the easily elicitable AR could be beneficial as a simple model for studying their properties in health and disease.
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PMID:Mechanisms and clinicophysiological implications of the sniff- and gasp-like aspiration reflex. 985 54


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