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Respiratory Physiology & Neurobiology Jan 2022The association between airflow obstruction and bronchial dilation has been researched in bronchiectasis. However, the impact of bronchial wall thickening on airflow...
The association between airflow obstruction and bronchial dilation has been researched in bronchiectasis. However, the impact of bronchial wall thickening on airflow obstruction has not been thoroughly investigated. This study assessed the underlying mechanism of airflow obstruction in bronchiectasis due to abnormal bronchial wall thickening using oscillometry. A total of 98 patients with bronchiectasis were retrospectively reviewed. At the time of diagnosis, spirometric and oscillometric parameters, high-resolution computed tomography scores, and clinical characteristics were collected. The bronchial diameter, bronchial wall thickness, and extent of emphysema were evaluated semi-quantitatively. Correlations between patient data and characteristics were analyzed. Thirty-three patients with airflow obstruction showed higher respiratory resistance, more negative respiratory reactance (Xrs) at 5 Hz (X5), and higher bronchial wall thickness score than those without airflow obstruction. The bronchial wall thickness score negatively affected forced expiration volume in 1 s /forced vital capacity and X5. Abnormal bronchial wall thickening might make Xrs more negative and progress airflow obstruction in bronchiectasis.
Topics: Aged; Bronchi; Bronchiectasis; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Pulmonary Ventilation; Retrospective Studies; Spirometry; Tomography, X-Ray Computed
PubMed: 34555525
DOI: 10.1016/j.resp.2021.103788 -
Der Internist Apr 2006Bronchial obstruction due to one of the major pulmonary diseases asthma, COPD, or emphysema are a common problem in intensive care medicine as the leading cause or as... (Review)
Review
Bronchial obstruction due to one of the major pulmonary diseases asthma, COPD, or emphysema are a common problem in intensive care medicine as the leading cause or as comorbidity. While in pharmacological therapy no major changes have occurred during the last few years, two major advances have been reached in ventilation therapy which are in the focus of this review. First the non invasive ventilation (NIV) has been shown to prove efficient in treating acute on chronic respiratory failure in COPD patients and is capable of shortening the duration of hospital stay. In addition NIV can be used successfully in weaning after long time ventilator therapy and improve prognosis in COPD patients. Secondly the strategy of invasive ventilation therapy has changed significantly. "Permissive hypercapnia" is unequivocally established in severe bronchial obstruction in situations of limited ventilation. When intrinsic PEEP and elevated airway resistance are present PEEP may be useful and the upper limit of airways peak pressure that we are used to in "protective ventilation" of ARDS patients can be necessary and useful to exceed.
Topics: Airway Obstruction; Asthma; Bronchial Diseases; Critical Care; Emphysema; Humans; Practice Guidelines as Topic; Pulmonary Disease, Chronic Obstructive; Respiration, Artificial
PubMed: 16532282
DOI: 10.1007/s00108-006-1589-8 -
The Mississippi Doctor Mar 1948
Topics: Airway Obstruction; Bronchi; Bronchial Diseases; Humans
PubMed: 18858836
DOI: No ID Found -
Respiration; International Review of... 2018In patients with bronchial obstruction estimating the location of the maximal obstruction is crucial for guiding interventional bronchoscopy. However, flow-volume curves... (Clinical Trial)
Clinical Trial
BACKGROUND
In patients with bronchial obstruction estimating the location of the maximal obstruction is crucial for guiding interventional bronchoscopy. However, flow-volume curves cannot discriminate between the right and left lungs.
OBJECTIVES
The aim of this study was to physiologically evaluate bronchial obstruction during interventional bronchoscopy.
METHODS
We prospectively measured lateral airway pressure (Plat) at either side of the obstruction using a double-lumen catheter (pressure-pressure [P-P] curve) simultaneously to assess the degree of bronchial obstruction in 22 patients. The shape of the P-P curve was assessed to confirm the site of maximal obstruction.
RESULTS
In the experimental study, Plat was uniform between both bronchi in the normal model. For the unilateral and bilateral obstruction models, a phase shift was only seen for the more obstructed side. In healthy subjects, the angle of the P-P curve was close to 45° and linear in shape. In patients with bronchial obstruction, the angle was much smaller but approached 45° after the bronchoscopic procedure. The degree of bronchial obstruction was significantly correlated with the angle of the P-P curve (r = -0.51, p < 0.01). Dyspnea significantly increased when the airway lumen was obstructed by more than 60% (p < 0.0001), and when the P-P curve appeared loop-shaped (p < 0.01).
CONCLUSIONS
The shape of the P-P curve could be used to detect the site of maximal obstruction for the optimal positioning of the stent and assess the need for additional procedures in real time in patients with bronchial obstruction.
Topics: Adult; Aged; Aged, 80 and over; Airway Obstruction; Bronchial Diseases; Bronchoscopy; Feasibility Studies; Female; Humans; Male; Middle Aged; Pressure
PubMed: 29190612
DOI: 10.1159/000481572 -
Journal of the American Animal Hospital... Mar 2022A feral, domestic shorthair was evaluated for palliative treatment of a pulmonary mass with secondary pneumonia. Because of the patient's temperament and extent of the...
A feral, domestic shorthair was evaluated for palliative treatment of a pulmonary mass with secondary pneumonia. Because of the patient's temperament and extent of the mass, tracheobronchoscopy, bronchial stenting, and biopsy were elected, followed by adjuvant radiation therapy. Stent placement across the malignantly obstructed bronchus permitted drainage and recruitment of the infected lung lobe. Uncomplicated radiation therapy, stent extension, and debulking due to tissue ingrowth were subsequently performed. Successful palliation was achieved for 323 days with subsequent progressive pulmonary and liver metastases.
Topics: Airway Obstruction; Animals; Bronchi; Carcinoma; Cat Diseases; Cats; Palliative Care; Stents; Treatment Outcome
PubMed: 35195709
DOI: 10.5326/JAAHA-MS-7172 -
Thoracic Surgery Clinics Feb 2018Pleural collections on the side of an obstructing bronchial cancer pose a particular challenge. All efforts should be placed into determining whether the collection is... (Review)
Review
Pleural collections on the side of an obstructing bronchial cancer pose a particular challenge. All efforts should be placed into determining whether the collection is malignant or para-malignant with its significant implications on cancer staging. This article discusses various diagnostic modalities and therapeutic interventions needed for the optimal management of patients presenting with this situation. The order of interventions is dictated by the individual circumstances that patients present with, often requiring the pleural interventions to take place ahead of the bronchial obstruction management.
Topics: Empyema, Pleural; Humans; Lung Neoplasms; Pleural Effusion, Malignant
PubMed: 29150042
DOI: 10.1016/j.thorsurg.2017.09.001 -
Respiration; International Review of... 1991The main obstructive components in bronchial asthma and chronic obstructive pulmonary disease (COPD) are discussed. It is underscored that bronchospasm plays a...
The main obstructive components in bronchial asthma and chronic obstructive pulmonary disease (COPD) are discussed. It is underscored that bronchospasm plays a significant role also in COPD, and that it merits specific treatment (beta 2-stimulants, antimuscarinics, theophylline) even when, in some cases, obstruction appears to be 'irreversible'. The majority of COPD patients react positively, although to a lower degree than asthmatics, not only to chemical agents (histamine, methacholine), but also to 'osmotic' stimuli, such as ultrasonically nebulized distilled water. Geometric factors seem to be in part responsible for the anomalous response. Considering the potent antireactive activity of bronchodilators (beta 2-stimulants in particular), this finding is a further indication for a regular bronchodilator treatment in COPD. Whether such a therapy serves also to improve the prognosis of COPD in the long run has not yet been established.
Topics: Asthma; Bronchial Hyperreactivity; Bronchoconstriction; Humans; Lung Diseases, Obstructive; Pulmonary Ventilation; Smoking
PubMed: 1925075
DOI: 10.1159/000195967 -
Journal of Thoracic Disease Nov 2016Although tracheal stenosis and bronchial stenosis are relatively rare in the pediatric population, they are both associated with significant morbidity and mortality.... (Review)
Review
Although tracheal stenosis and bronchial stenosis are relatively rare in the pediatric population, they are both associated with significant morbidity and mortality. While most cases of congenital tracheal stenosis in children present as complete tracheal rings (CTRs), other congenital tracheal obstructions are also encountered in clinical practice. In addition, acquired obstructive tracheal conditions stemming from endotracheal trauma or previous surgical interventions may occur. Many affected children also have associated cardiovascular malformations, further complicating their management. Optimal management of children with tracheal or bronchial stenoses requires comprehensive diagnostic evaluation and optimization prior to surgery. Slide tracheoplasty has been the operative intervention of choice in the treatment of the majority of these children.
PubMed: 28066618
DOI: 10.21037/jtd.2016.11.74 -
Medicina (Kaunas, Lithuania) 2003Bronchial obstruction evaluation is usual problem of clinical practice. Solution of this problem sometimes becomes difficult regardless of obvious methods and new... (Comparative Study)
Comparative Study
Bronchial obstruction evaluation is usual problem of clinical practice. Solution of this problem sometimes becomes difficult regardless of obvious methods and new technologies introduction. Incorrect bronchial obstruction diagnostic may determine incorrect treatment, case prognosis and may determine loss of disease control. Clinic of Pulmonology of Vilnius University Hospital "Santariskiu klinikos"carried out study about this problem. Preliminary pilot data are presented. Aim of study was comparison of different methods of bronchial obstruction evaluation. In 2002 50 patients with bronchial obstruction diagnosis (bronchial asthma and COPD) were observed. The following tests were performed: standard questionnaire, physical examination, PFT - spirometry, body plethysmography, blood gas analysis. There were analyzed FEV(1)/FVC, FEV(1), FEF(25-75%), RV/TLC, Raw, PaO(2), PaCO(2), SpO(2), pH. This study data shows that for majority (88%) of patients bronchial obstruction can be evaluated by spirometry test, however overall evaluation of patient status (extensive anamnesis and objective evaluation) is also important while determining bronchial obstruction, since 84% of patients complain on dyspnea and for 72% of patients obstruction-specific symptoms are observed during evaluation. Part of patients requires extended lung function evaluation (12%), which confirmed obstruction for 94% of patients. Established strong correlation between measurements of extended lung function evaluation and spirometry measurement FEF(25-75%) shows high informativeness in evaluation of bronchial obstruction.
Topics: Asthma; Data Interpretation, Statistical; Dyspnea; Female; Humans; Linear Models; Male; Middle Aged; Pilot Projects; Plethysmography; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Spirometry
PubMed: 12829877
DOI: No ID Found -
Respiration; International Review of... 1986The aim of this study was to investigate the relation of viral respiratory infection with bronchial hyperreactivity and bronchial obstruction. A viral infection using a...
The aim of this study was to investigate the relation of viral respiratory infection with bronchial hyperreactivity and bronchial obstruction. A viral infection using a live attenuated influenza virus was induced successfully in 10 of 30 patients with chronic obstructive pulmonary disease (COPD) and in 3 subjects without COPD (non-COPD). No significant change in bronchial reactivity and lung function could be found in comparison with the baseline values.
Topics: Administration, Intranasal; Adolescent; Adult; Bronchial Provocation Tests; Double-Blind Method; Eosinophils; Female; Forced Expiratory Volume; Humans; Influenza Vaccines; Influenza, Human; Leukocyte Count; Lung Diseases, Obstructive; Male; Respiratory Tract Infections; Virus Diseases; Vital Capacity
PubMed: 3952374
DOI: 10.1159/000194852