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Query: UMLS:C0040586 (tracheobronchitis)
 449 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A piglet model of acute respiratory failure was used to determine whether necrotizing tracheobronchitis (NTB) reported during high-frequency pneumatic flow interrupter (HFFI) ventilation could be minimized by a different ventilatory strategy. Twenty-one piglets (mean age 3.8 days, average weight 1.4 kg) were anesthetized with ketamine and given Pavulon prior to saline lung lavage. Femoral vessels were cannulated for measurements of blood pressures, arterial blood gases (ABG), and fluid administration. Airway pressures were measured 5 mm above the endotracheal tube tip. To allow for lung deflation, HFFI (10 Hz) was programmed to pause for 1 sec either 5 (HFFI5) or 12 times per min (HFFI12). Seven animals were assigned to each of the treatment groups and to a conventional mechanical ventilation (CMV) control. All animals were kept on 1.0 FIO2 with ventilators adjusted to maintain ABG (pO2 = 50-100 mmHg and pCO2 = 30-40 mmHg). After 6 h of ventilation, the animals were sacrificed and their lungs inflated with formalin to 40 cm H2O. Sections were obtained from trachea, carina, mainstem, and hilar bronchi. An airway injury score (AIS) was calculated after "blinded" microscopic evaluation. There was no difference in total AIS between CMV (2.4) and HFFI12 (8.6) but a statistically significant difference (p less than 0.05) existed between CMV and HFFI5 (14.1). NTB was limited to the trachea during HFFI12 but extended down to the hilar bronchi during HFFI5. More frequent lung deflations reduce the severity and distribution of NTB during HFFI ventilation.
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PMID:Necrotizing tracheobronchitis following high-frequency ventilation: effect of lung deflation. 322 3

Twelve pairs of fetal lambs were used to test the hypothesis that the necrotizing tracheobronchitis followed by squamous metaplasia seen in premature infants who develop chronic bronchopulmonary dysplasia might be related to low retinol stores and might, therefore, be reversed by retinol supplementation. Epidermal growth factor (EGF) was used to model the growth factor stimulus initiated by chronic wounding of the airways, and retinol was used as a differentiator of proliferating cells stimulated by EGF. Saline-treated animals were used as controls, as were fetal lambs receiving retinol alone or EGF alone. The effects of EGF on tracheal and bronchial epithelium consisted of proliferation of basal and intermediate cells, necrosis and slough of lining ciliated and mucous-producing cells, followed by squamous metaplasia. In fetal lambs given retinol, plasma, liver and lung retinol levels rose and mucous producing cells were increased in number. In the presence of EGF plus retinol, differentiation of mucous-producing cells was accelerated. We believe that this fetal lamb model with low initial levels of retinol in plasma, liver and lung, treated with EGF may mimic human premature infants with chronic bronchopulmonary dysplasia, and that the addition of retinol in amounts sufficient to raise their tissue levels produces a more normal surface epithelium in conducting airways.
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PMID:Effect of retinol on fetal lamb tracheal epithelium, with and without epidermal growth factor. A model for the effect of retinol on the healing lung of human premature infants. 326 Jun 40

Influenza virus-induced tracheobronchitis causes limited epithelial deciliation but markedly decreased mucociliary transport. This suggests that virus-induced alterations in airway mucus play a role in decreased mucociliary transport. Airway submucosal glands are a primary source of mucus. Therefore, we examined virus-gland cell interactions by exposing primary cultures of isolated feline tracheal gland cells to influenza A/Scotland/840/74 H3N2 virus for 1 h at a multiplicity of infection of 0.1. Virus production and release into the culture medium first occurred between 8 and 12 h postinfection and eventually reached a steady state that continued for at least 8 days. Virus which was produced and released by infected cells infected other monolayers, resulting in viral production similar to that after infection with stock virus. Hemadsorption assays conducted 24 h after infection demonstrated that most of the cells in a monolayer became infected. The infection was nonlytic according to cell morphology, trypan blue dye exclusion, and release of lactate dehydrogenase. Because lysis of a cell subpopulation could have been masked by subsequent cell division, we compared the uptake of [3H]thymidine by infected and control monolayers. There was no increase in uptake by infected monolayers. These results demonstrate that feline tracheal gland cells in primary culture undergo productive and nonlytic infection with influenza A virus. This model provides a unique system for the study of virus-gland interactions isolated from the influence of other tissues.
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PMID:Influenza virus infection of tracheal gland cells in culture. 335 4

We performed a brief bronchoscopy in 42 newborn infants with esophageal atresia and tracheoesophageal fistula (TEF). The procedure was carried out in the operating room, usually just prior to thoracotomy for repair of the anomaly. Most infants had a gastrostomy tube placed initially. Observations included: (1) level of fistula, (2) presence of unusual variants, eg, double fistula, trifurcation fistula, (3) presence and severity of tracheobronchitis, and (4) position of the aortic arch. The endoscopic findings influenced the operative technique or management of 24 of the 42 infants (57%), including 13 infants (31%) with crucial findings which dictated a change in operative technique or management. Examples of the latter were an unsuspected cervical fistula associated with esophageal atresia, repaired by a cervical approach; other unusual variants of TEF (proximal fistula, trifurcation or quadrifurcation TEF), requiring specific dissection at thoracotomy; congenital stenosis of the right mainstem bronchus, requiring postoperative dilatation; or severe tracheobronchitis, which contraindicated thoracotomy. Observations at bronchoscopy accurately predicted the position of the aortic arch in ten recent infants, although the side of dominant pulsation was indeterminate in three other infants. Only one minor complication was attributable to the bronchoscopy. The procedure appeared to be safe and beneficial, and should be considered for all infants with esophageal atresia and TEF.
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PMID:Crucial bronchoscopic findings in esophageal atresia and tracheoesophageal fistula. 337 53

Necrotizing tracheobronchitis (NTB) is characterized by acute episodes of airway obstruction, hypercarbia, and lack of chest movement in mechanically ventilated neonates. Emergency bronchoscopic removal of necrotic tissue is essential for survival. Although postmortem lesions extend into smaller bronchi, survivors have not demonstrated residual tracheobronchial abnormalities. Two infants were treated successfully for NTB but succumbed to diffuse tracheobronchial strictures with progressive pulmonary hyperinflation. A third neonate with esophageal atresia and left pulmonary agenesis developed NTB. Despite initial postbronchoscopic improvement, the infant died at age 6 weeks with diffuse obstructing NTB. All three infants required endotracheal intubation and mechanical ventilation. High-frequency jet ventilation was not used. Tracheal cultures for fungi, bacteria and viruses were negative. Successful treatment of NTB may be followed acutely by recurrence of NTB and chronically by diffuse tracheobronchial strictures and emphysema.
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PMID:Diffuse necrotizing tracheobronchitis: an acute and chronic disease. 337 55

The variant forms of bronchial asthma were studied. It was established that in 66.4% of the patients examined the bronchial obstructive syndrome was caused by bronchial asthma. In 50.30% of the patients bronchial asthma had an atypical course--variant (forme fruste) forms. Three types of variant forms of bronchial asthma are differentiated: allergic tracheobronchitis (47.23%), the so called "wet" asthma (3.27%) and the so called "dry" bronchial asthma (0.8%). The therapeutic conduct should take into consideration the presence of variant forms of bronchial asthma.
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PMID:[Variant (forme fruste) forms of bronchial asthma]. 341 7

This report describes a newly recognized iatrogenic lesion in newborns that we have termed necrotizing tracheobronchitis (NTB). Although it is related to assisted ventilation, it is different from previously described tracheal lesions in that it is most severe distal to the tip of the endotracheal tube and manifests a characteristic basophilic necrosis of the tracheal mucosa. Sloughing of tracheal mucosa, which occurs in the later stages, can cause respiratory obstruction. The lesion occurs over a wide range of gestational ages and birth weights as well as ventilatory rates, pressures, and supplemental oxygen concentrations. The severity of the lesion is related to the duration of ventilation. We believe NTB to be related to airflow through the endotracheal tube rather than to the effects of the tube itself because the lesion is worst beyond the end of the tube and extends into the major bronchi. A grading system is presented.
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PMID:Necrotizing tracheobronchitis in intubated newborns: a complication of assisted ventilation. 344 16

To compare high-frequency jet ventilation (HFJV) with pressure-limited time-cycled conventional ventilation (CV), we randomized 41 infants with clinical and radiographic evidence of respiratory distress syndrome during the first day of life to receive either HFJV or CV. Standardized ventilatory protocols were used for 48 hours, after which CV was administered to both groups. Despite comparable oxygenation (arterial/alveolar oxygen tension ratio), mean airway pressure was lower in the HFJV group (9 +/- 2 vs 13 +/- 2 cm H2O, P less than 0.001), and thus the arterial/alveolar oxygen tension ratio corrected for mean airway pressure was improved in the HFJV group (P less than 0.05). PaCO2 was lower during HFJV (37 +/- 3 vs 42 +/- 3 mm Hg, P less than 0.05) despite a comparable peak inspiratory pressure. The incidence of air leaks, progression of intraventricular hemorrhage, and mortality during the 48-hour period did not differ between the two groups. Bronchoscopies in eight infants given HFJV and five given CV revealed no microscopic evidence of necrotizing tracheobronchitis, but one infant given HFJV had evidence of necrotizing tracheitis at autopsy. We conclude that for 48 hours during the acute stage of respiratory distress syndrome, HFJV can maintain adequate gas exchange at lower mean airway pressure than during CV, without an increase in the incidence of side effects.
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PMID:Randomized trial of high-frequency jet ventilation versus conventional ventilation in respiratory distress syndrome. 354 78

Twenty patients with lower respiratory tract infections presumably caused by ciprofloxacin-susceptible bacteria were admitted to a non-comparative, prospective clinical study. All patients were hospitalized for chronic hepatitis at various stages of the disease. Ciprofloxacin was given orally at a dose of 250 mg every 12 hours for five to 10 days. Patients had either acute bronchitis, chronic bronchitis in the acute phase, or acute tracheobronchitis. In 19 of 20 patients treated, there was a favorable outcome (15 cures and four improvements). In 17 patients, the presumably causative pathogen was eradicated. No side effect was observed except for oral candidiasis, which occurred in two patients. This study demonstrates the clinical and bacteriologic efficacy of ciprofloxacin in pulmonary infection in patients with severe impairment of liver function.
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PMID:Efficacy and safety of oral ciprofloxacin in the treatment of respiratory tract infections associated with chronic hepatitis. 355 38

Pulmonary interstitial emphysema is one of the most serious complications of the respiratory distress syndrome. Its presence significantly increases morbidity and mortality. Preliminary reports have demonstrated the success of high-frequency ventilation in the treatment of pulmonary interstitial emphysema. In a previous investigation, we were able to develop a formula for predicting death in infants weighing less than 1,500 g with pulmonary interstitial emphysema. Using this subgroup of severely affected infants, we studied the efficacy of high-frequency ventilation in nine infants. Using the Volumetric Diffusive Respirator, we observed improvement in all respiratory values measured (pH, PCO2, and PO2), a significantly decreased mean airway pressure (MAP), and improvement in neonatal mortality. Complications of severe bleeding diatheses, hypotension, bronchopulmonary dysplasia, and necrotizing tracheobronchitis were observed. Our investigation was the first to systematically choose infants who might benefit from high-frequency ventilation and to compare them with similar infants with known outcomes. We realize that the study was rescue in nature using historical controls, but we felt compelled to assure the safety of the device before randomizing less sick infants. High-frequency ventilation appears to be effective in the acute management of low birth weight infants with pulmonary interstitial emphysema.
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PMID:High-frequency ventilation in the treatment of infants weighing less than 1,500 grams with pulmonary interstitial emphysema: a pilot study. 358 46


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