Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040586 (tracheobronchitis)
 449 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A lifelong non-smoker who was the victim of a massive accidental exposure to anhydrous ammonia gas was followed up for 10 years. In the acute phase the patient presented with severe tracheobronchitis and respiratory failure, caused by very severe burns of the respiratory mucosa. After some improvement he was left with severe and fixed airways obstruction. Isotope studies of mucociliary clearance, computed tomography, and bronchography showed mild bronchiectasis. It is concluded that acute exposure to high concentrations of ammonia may lead to acute respiratory injury but also to long term impairment of respiratory function.
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PMID:Acute and long term respiratory damage following inhalation of ammonia. 144 Apr 75

Respiration was tested in 66 patients with middle (15) and lower (51) esophageal cancer. In 32 patients damages in respiration biomechanics before surgery have been observed. In 26 patients respiratory failure was associated with concomitant diseases (pneumosclerosis, lung emphysema, cardiovascular diseases, etc.). 28 patients developed postoperative complications, in 22 of them lungs were affected (pneumonia, tracheobronchitis, pleuritis, pleural emphysema). Those complications were more frequently encountered in patients with signs of respiratory failure before surgery (72.7% of cases). It has been shown that with PEF less than 65%, FVC less than 85%, MEF 75% less than 65%, MEF50% less than 70%, MMF less than 70% and MVV less than 65% of due values, the likelihood of pulmonary complications in the postoperative period is enhanced.
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PMID:[The function of the external respiration in patients with cancer of the esophagus before and after surgery]. 152 48

Clinical, roentgenographic and pathologic findings are described in 9 patients with fungal tracheobronchitis and comparison is made with 25 additional cases in the literature. Two morphologic patterns were identified: the first appears as a pseudomembrane of necrotic tissue, exudate, and fungal hyphae involving more-or-less the entire circumference of the bronchial wall or as mucus/fungus plugs completely occluding the airway lumen; the second consists of single or multiple discrete plaques on the airway wall, sometimes associated with invasion of the adjacent lung parenchyma or pulmonary artery. As with more invasive forms of fungal infection, a compromise in host defenses is probably the most important factor leading to fungal colonization and subsequent local invasion. Malignancies of the hematologic and lymphoreticular systems, solid neoplasms, granulocytopenia, and a history of a protracted course of broad-spectrum antibiotics, corticosteroids, and chemotherapy were present in most of our patients and in those reported in the literature. Despite this, there is some evidence that tracheobronchitis may occur in individuals with a relatively lesser degree of host defense impairment. Local damage to the airway wall such as occurs with prolonged mechanical ventilatory support, neoplastic infiltration, or nonfungal infection may also be a factor predisposing to fungal colonization and invasion. In 4 of our patients, the fungal infection of the tracheobronchial tree probably contributed significantly to the development of terminal respiratory failure. Although recognition of the infection may not have altered the course of the underlying disease in some of our patients, in others identification and early treatment might have been life-saving. Thus, culture and histologic examination of bronchoscopically identified tracheobronchial mucus plugs and necrotic material should be performed in all immunocompromised individuals.
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PMID:Fungal tracheobronchitis. Report of 9 cases and review of the literature. 198 63

A comparative, prospective study was made of the incidence of infection in the lower airway (purulent tracheobronchitis and pneumonia) in long-term patients who were mechanically ventilated due to respiratory failure of noninfectious origin. Twenty-eight patients were randomly allocated into a study group (A, n = 13) in which a nonabsorbable paste containing 2% tobramycin, 2% amphotericin B, and 2% polymyxin E was administered locally to decontaminate the oropharynx, and a control group (B, n = 15) in which a paste without antibiotics was also applied to the oropharynx. We studied the effectiveness of the prophylactic technique in decontaminating the oropharynx and trachea of organisms potentially pathogenic for the respiratory system. Decontamination was successful in ten of 13 patients in group A vs. one of 15 patients in group B (p less than .001). The results demonstrated a lower rate of infection in the lower respiratory tract in the study group (three patients with tracheobronchitis and no pneumonias) than in the control group (three patients with tracheobronchitis and 11 with pneumonia), the difference between both being highly significant (p less than .001). Two (15%) patients in group B developed sepsis of pulmonary origin. None of the patients on prophylactic treatment developed this complication. Although the overall mortality was similar in both groups (group A, 30% vs. group B, 33%), we believe that infection contributed to a great extent to the death of two of five patients in group B. We conclude that nosocomial pneumonia, which is a frequent complication in critically ill patients on mechanical ventilation, could be prevented by local application of nonabsorbable antibiotics to the oropharynx.
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PMID:Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. 222 93

Necrotizing tracheobronchitis has recently been described as a complication of mechanical ventilation of newborns with respiratory failure. Despite the use of bronchoscopy, 45% of the reported patients to date have died. In this study, we report the use of extracorporeal membrane oxygenation (ECMO) to stabilize two patients with necrotizing tracheobronchitis. While supported by bypass, both patients underwent prolonged bronchoscopies with removal of extensive amounts of tracheal debris. ECMO provided efficient oxygenation in the face of near total airway occlusion, and permitted far more extensive bronchoscopic debridement and lavage than would have been possible if the lungs were required for oxygenation. In addition, ECMO provided a period of lung "rest" during which ventilator settings were reduced, thus minimizing further barotrauma and allowing for lung and airway healing. Both patients recovered without significant respiratory sequelae. ECMO and bronchoscopy are effective forms of therapy for patients with life-threatening necrotizing tracheobronchitis when conventional modalities of treatment have failed.
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PMID:Treatment of neonatal necrotizing tracheobronchitis with extracorporeal membrane oxygenation and bronchoscopy. 318 90

During a 4-year period, 34 neonates were treated with high-frequency jet ventilation (HFJV) using two different HFJV systems. Twenty-three of the neonates had severe pulmonary air leaks, five had congenital left-sided diaphragmatic hernias, and six had end-stage respiratory failure without pulmonary air leaks. The two HFJV systems performed similarly in all pathologic conditions. Following HFJV, arterial blood gas values improved in 28 of the 34 patients (82%). Eleven patients (32%) ultimately survived. Of 23 patients with pulmonary air leaks, 17 (74%) improved, nine (39%) survived. One infant with diaphragmatic hernia and one with end-stage respiratory failure survived. Ten of 12 patients (85%) who died following eight or more hours of HFJV had significant tracheal histopathology in the region of the endotracheal tube tip. The lesions ranged from moderate erythema to severe necrotizing tracheobronchitis with total tracheal obstruction. HFJV can be useful in the treatment of severe pulmonary air leaks in neonates and may prove useful in the treatment of congenital diaphragmatic hernias. However, HFJV produces inflammatory injuries in the proximal trachea. More clinical and laboratory studies are needed to define the relative risks and benefits of this new therapy.
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PMID:Neonatal high-frequency jet ventilation: four years' experience. 398 97

Incidence and extent of pulmonary complications were evaluated retrospectively in 101 patients with hepatic coma (34 patients with acute liver failure, 57 patients with hepatic encephalopathy and 10 patients with mixed forms). 76 patients (73.3%) had pulmonary complications (pulmonary edema 57 cases, pneumonia 20 cases, tracheobronchitis 30 cases). Lethality of the group with pulmonary complications was 97% as compared to 16% in the group without pulmonary complications. Pathogenesis of pulmonary complications is not completely clear; different mechanisms are being discussed like central mechanisms, vascular lesions caused by metabolic or toxic factors, cardiac failure, and increased susceptibility to infection. In 9 out of 59 cases (15.3%) with respiratory failure no morphological changes could be observed in the lungs; in these cases intrapulmonary shunts might have been the cause for the pulmonary complications. The incidence of pulmonary complications increased by a factor of 2.4 during intensive care unit treatment of the patients; this increase shows, that intensive care unit treatment still has to be improved.
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PMID:[Pulmonary complications in hepatic coma]. 682 Jun 75

Hybrid intratracheal pulmonary ventilation (h-ITPV) is a continuous flow ventilatory technique that uses a "reverse thruster" catheter to redirect the flow of gas away from the carina. We report here the use of h-ITPV in a pediatric patient with acute sickle cell chest syndrome who required venoarterial ECMO support because of refractory hypoxemic respiratory failure. Her ECMO course was complicated by air leaks, coagulopathy, cardiac tamponade, and necrotizing tracheobronchitis. She could be weaned from ECMO only by maintaining high pressure conventional ventilatory support. To prevent ventilator induced barotrauma, we initiated h-ITPV and weaned her from ECMO bypass. After 12 days of h-ITPV, with tidal volumes of 2-3 ml/kg at carinal peak inspiratory pressures of 25-30 cm H2O, the air leaks ceased and h-ITPV was discontinued. Dead space ventilation fraction (VD/VT) as low as 0.29 was achieved with this technique. Post-h-ITPV bronchoscopy displayed a dramatic resolution of the necrotizing tracheobronchitis. The patient survived and was discharged from the hospital. We conclude that the use of hybrid ITPV may facilitate weaning from ECMO to low pressure conventional ventilation and prevent the development of pulmonary barotrauma.
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PMID:Rescue from pediatric ECMO with prolonged hybrid intratracheal pulmonary ventilation. A technique for reducing dead space ventilation and preventing ventilator induced lung injury. 826 24

Extracorporeal membrane oxygenation (ECMO) has been successful in rescuing near term or term infants in cardio-respiratory failure that results from a reversible disease process. In most cases, only one course of ECMO is needed to save these infants. However, a second course of ECMO may be beneficial in a select group of infants when recurrent persistent pulmonary hypertension develops. Other than abstract form, this is the first report of the use of a second course of ECMO in the literature. The authors report on three infants, two with recurrent persistent pulmonary hypertension secondary to congenital diaphragmatic hernia and one with necrotizing tracheobronchitis after Group B streptococcal sepsis who were treated at their institution with a second course of ECMO. Technical considerations in using a second course of ECMO depend upon the initial vessel cannulation site, time elapsed between cannulations, and the condition of the original artery and vein. By adopting a stenting procedure in those infants whose initial trial off was equivocal, a second cannulation may be prevented in neonatal patients with recurrent persistent pulmonary hypertension.
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PMID:The use of a second course of extracorporeal membrane oxygenation in neonatal patients. 872 96

Mucoid impaction and plastic bronchitis are relatively rare disorders caused by the formation of obstructive airway plugs. We observed from February 1999 to June 2000 seven patients with mucoid impaction and one with plastic bronchitis. In the group of mucoid impaction there were 4 patients with bronchial asthma and 3 without history of lung disease. At the admission to hospital all patients suffered from cough, chest pain and effort dyspnea. Two of them expectorated during cough "bronchial casts". The chest X-ray of 5 patients revealed atelectasis of one of the lung's lobes and diffuse opacities in 2 others. In 4 cases during bronchoscopy one bronchus and in another three--numerous bronchi were obstructed with mucoid casts. Removing of the casts caused both the improvement of the patients' condition and withdrawal of atelectasis in 4 cases. In 5 patients the final diagnosis was allergic bronchopulmonary aspergillosis and in two mucoid impaction in the course of asthma without aspergillosis. Plastic bronchitis was observed in 44 years old man, who expectorated white, branching, bronchial casts for three months. On admission he was in respiratory failure. The chest X-ray revealed diffuse alveolar infiltrates and HRCT glass-ground opacities in both lungs and bronchiectasis in the middle lobe. The bronchofiberoscopy disclosed diffuse tracheobronchitis with casts occluding the middle lobe bronchus. Microscopic examination of the removed casts showed aggregates of mucus, macrophages, neutrophils and cells of respiratory epithelium. Precipitins against Aspergillus fumigatus were not found. Staphyloccocus coagulase (-) was cultured from urine and sputum specimens. We administered Vancomycin with Netylmycin, acetylocysteine, oxygen therapy and humid inhalation and the patient recovered. HRCT made six months after admission revelated total withdrawal of glass-ground opacities. The pathogenesis of plastic bronchitis in this case was unclear.
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PMID:[Plastic bronchitis and mucoid impaction--uncommon disease syndromes with expectoration mucus plugs]. 1147 59


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