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Medicina (Kaunas, Lithuania) 2006Epinephrine is an adrenergic agonist used to treat bronchospasm, anaphylactic reactions, bradycardia, cardiac arrest, and hypotension. Its toxicity is usually caused by... (Review)
Review
Epinephrine is an adrenergic agonist used to treat bronchospasm, anaphylactic reactions, bradycardia, cardiac arrest, and hypotension. Its toxicity is usually caused by iatrogenic errors. In overdose there is a typical rapid onset of agitation, hypertension, tachycardia, and dysrhythmias. This review article focuses on the causes of overdose, signs and symptoms, treatment and expected course, and prognosis of this iatrogenic pathology.
Topics: Adrenergic Agonists; Anaphylaxis; Arrhythmias, Cardiac; Bradycardia; Bronchial Spasm; Drug Overdose; Epinephrine; Heart Arrest; Humans; Hypertension; Hypotension; Iatrogenic Disease; Prognosis; Pulmonary Edema; Shock, Cardiogenic; Tachycardia
PubMed: 16861845
DOI: No ID Found -
British Journal of Anaesthesia Dec 2009The incidence of asthma is increasing worldwide, but morbidity and mortality are decreasing because of improvements in medical care. Although the incidence of severe... (Review)
Review
The incidence of asthma is increasing worldwide, but morbidity and mortality are decreasing because of improvements in medical care. Although the incidence of severe perioperative bronchospasm is relatively low in asthmatics undergoing anaesthesia, when it does occur it may be life-threatening. The keys to an uncomplicated perioperative course are assiduous attention to detail in preoperative assessment, and maintenance of the anti-inflammatory and bronchodilatory regimens through the perioperative period. Potential trigger agents should be identified and avoided. Many routinely used anaesthetic agents have an ameliorative effect on airway constriction. Nonetheless, acute bronchospasm can still occur, especially at induction and emergence, and should be promptly and methodically managed.
Topics: Anesthesia; Asthma; Bronchial Spasm; Bronchodilator Agents; Humans; Intraoperative Complications; Perioperative Care
PubMed: 20007991
DOI: 10.1093/bja/aep271 -
Therapeutic Advances in Respiratory... 2018Asthma is characterized by hyperresponsiveness of the airways, and exercise-induced bronchospasm (EIB) is a symptom that limits a large proportion of asthmatic patients,... (Randomized Controlled Trial)
Randomized Controlled Trial
Noninvasive ventilation and respiratory physical therapy reduce exercise-induced bronchospasm and pulmonary inflammation in children with asthma: randomized clinical trial.
BACKGROUND
Asthma is characterized by hyperresponsiveness of the airways, and exercise-induced bronchospasm (EIB) is a symptom that limits a large proportion of asthmatic patients, especially children. Continuous positive airway pressure (CPAP) leads to a reduction in the reactivity of the airways. The aim of this study was to evaluate the effect of outpatient treatment with CPAP and bilevel pressure combined with respiratory physical therapy for children and adolescents with asthma following bronchial hyperresponsiveness caused by an exercise bronchoprovocation test.
METHODS
A randomized, controlled, blind, clinical trial was conducted involving 68 asthmatic children and adolescents aged 4 to 16 years divided into three groups: G1, treated with bilevel pressure (inspiratory positive airway pressure: 12 cm HO; expiratory positive airway pressure: 8 cm HO), G2, treated with CPAP (8 cm HO) and G3, treated with respiratory muscle training (RMT), considered as the control group. All groups were treated at an outpatient clinic and submitted to 10 1-hour sessions, each of which also included respiratory exercises. Evaluations were performed before and after treatment and involved spirometry, an exercise bronchoprovocation test, respiratory pressures, fraction of nitric oxide (FeNO), the Asthma Control Questionnaire (ACQ6) and anthropometric variables. This study received approval from the local ethics committee (certificate number: 1487225/2016) and is registered with ClinicalTrials [ ClinicalTrials.gov identifier: NCT02939625].
RESULTS
A total of 64 patients concluded the protocol; the mean age of the patients was 10 years. All were in the ideal weight range and had adequate height ( z score: -2 to +2). The three groups demonstrated improved asthma control after the treatments, going from partial to complete control. A significant increase in maximal inspiratory pressure occurred in the three groups, with the greatest increase in the RMT group. A reduction in FeNO in the order of 17.4 parts per billion (effect size: 2.43) and a reduction in bronchial responsiveness on the exercise bronchoprovocation test occurred in the bilevel group. An improvement in FeNO on the order of 15.7 parts per billion (effect size: 2.46) and a reduction in bronchial responsiveness occurred in the CPAP group. No changes in lung function or responsiveness occurred in the RMT group.
CONCLUSION
Positive pressure and respiratory exercises were effective in reducing pulmonary inflammation, exercise-innduced bronchoespasm (EIB), and increased the clinical control of asthma, as well as RMT, which also resulted in improved clinical control.
Topics: Adolescent; Age Factors; Asthma, Exercise-Induced; Brazil; Breathing Exercises; Bronchial Spasm; Bronchoconstriction; Child; Child, Preschool; Combined Modality Therapy; Continuous Positive Airway Pressure; Female; Humans; Lung; Male; Noninvasive Ventilation; Pneumonia; Respiratory Therapy; Time Factors; Treatment Outcome
PubMed: 29865929
DOI: 10.1177/1753466618777723 -
Journal of Critical Care Oct 2023Nebulized colistin (NC) is a potential therapy for ventilator-associated pneumonia (VAP); however, the clinical efficacy and safety of NC remain unclear. This study... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Nebulized colistin (NC) is a potential therapy for ventilator-associated pneumonia (VAP); however, the clinical efficacy and safety of NC remain unclear. This study investigated whether NC is an effective therapy for patients with VAP.
MATERIALS AND METHODS
We performed a search in Web of Science, PubMed, Embase, and the Cochrane Library to retrieve randomized controlled trials (RCTs) and observational studies published at any time until February 6, 2023. The primary outcome was clinical response. Secondary outcomes included microbiological eradication, overall mortality, length of mechanical ventilation (MV), length of intensive care unit stay (ICU-LOS), nephrotoxicity, neurotoxicity, and bronchospasm.
RESULTS
Seven observational studies and three RCTs were included. Despite exhibiting a higher microbiological eradication rate (OR,2.21; 95%CI, 1.25-3.92) and the same nephrotoxicity risk (OR,0.86; 95%CI, 0.60-1.23), NC was not significantly different in clinical response (OR,1.39; 95%CI, 0.87-2.20), overall mortality (OR,0.74; 95%CI, 0.50-1.12), MV length (mean difference (MD),-2.5; 95%CI, -5.20-0.19), and the ICU-LOS (MD,-1.91; 95%CI, -6.66-2.84) than by the intravenous antibiotic. Besides, the risk of bronchospasm raised significantly (OR, 5.19; 95%CI, 1.05-25.52) among NC.
CONCLUSION
NC was associated with better microbiological outcomes but did not result in any remarkable changes in the prognosis of patients with VAP.
Topics: Humans; Pneumonia, Ventilator-Associated; Colistin; Bronchial Spasm; Respiration, Artificial; Anti-Bacterial Agents
PubMed: 37120926
DOI: 10.1016/j.jcrc.2023.154315 -
Cureus Jan 2022Exercise is one of the most common triggers of exercise-induced bronchospasm (EIB), with less trained athletes showing more symptoms. Exercise-induced bronchospasm is a... (Review)
Review
Exercise is one of the most common triggers of exercise-induced bronchospasm (EIB), with less trained athletes showing more symptoms. Exercise-induced bronchospasm is a common and frequent problem among elite athletes with obvious implications on competing performance, health, and quality of life. Classical pathways in the development of EIB in this population include the osmotic and the thermal theory as well as the presence of epithelial injury and inflammation in the airway. Moreover, neuronic stimulation has been suggested as a potential modulator of EIB in elite athletes. In this category of population, the diagnosis of EIB is a serious challenge, especially as spirometry before and after bronchodilation is not diagnostic and specific tests are required. To date, there is no organized screening in asymptomatic elite athletes to detect EIB. This review aims to summarize the pathophysiology, clinical manipulations, and therapeutic approach of EIB in elite athletes. We searched for published studies related to the aim of this study. Exercise-induced bronchospasm is a serious and common disorder in elite athletes, and its symptoms are nonspecific with a need to confirm the diagnosis with specific tests.
PubMed: 35145802
DOI: 10.7759/cureus.20898 -
Anesthesiology May 2001
Topics: Bronchial Spasm; Humans; Neuromuscular Nondepolarizing Agents; Vecuronium Bromide
PubMed: 11388519
DOI: 10.1097/00000542-200105000-00006 -
Cureus Jun 2022Bronchospasm is acute narrowing of the airways of lungs, which gives rise to wheezing and shortness of breath. Commonly seen in obstructive lung disease, but a rare...
Bronchospasm is acute narrowing of the airways of lungs, which gives rise to wheezing and shortness of breath. Commonly seen in obstructive lung disease, but a rare finding in patients with hypocalcemia. This is a case that outlines a rare presentation of hypocalcemia induced bronchospasm in a patient with no known history of asthma or chronic obstructive pulmonary disease (COPD). In this report, we present a case of a 57 years old male with no history of asthma or COPD who presented with intractable bronchospasm. Initial work-up for common entities was negative. Patient was found to be profoundly hypocalcemic and treatment provided resolution of symptoms. Early recognition of hypocalcemia induced bronchospasm is important in clinical practice to optimize management and provide improvement in symptoms.
PubMed: 35903573
DOI: 10.7759/cureus.26339 -
Journal of Asthma and Allergy 2023Asthma remains a common comorbid condition in patients presenting for anesthetic care. As a chronic inflammatory disease of the airway, asthma is known to increase the... (Review)
Review
Asthma remains a common comorbid condition in patients presenting for anesthetic care. As a chronic inflammatory disease of the airway, asthma is known to increase the risk of intraoperative bronchospasm. As the incidence and severity of asthma and other chronic respiratory conditions that alter airway reactivity is increasing, a greater number of patients at risk for perioperative bronchospasm are presenting for anesthetic care. As bronchospasm remains one of the more common intraoperative adverse events, recognizing and mitigating preoperative risk factors and having a pre-determined treatment algorithm for acute events are essential to ensuring effective resolution of this intraoperative emergency. The following article reviews the perioperative care of pediatric patients with asthma, discusses modifiable risk factors for intraoperative bronchospasm, and outlines the differential diagnosis of intraoperative wheezing. Additionally, a treatment algorithm for intraoperative bronchospasm is suggested.
PubMed: 37384067
DOI: 10.2147/JAA.S414026 -
Internal Medicine (Tokyo, Japan) 2013We herein report the case of a 39-year-old man with recurrent asthma exacerbations preceded by abdominal cramps with the urge to defecate. The patient had a history of...
We herein report the case of a 39-year-old man with recurrent asthma exacerbations preceded by abdominal cramps with the urge to defecate. The patient had a history of near-fatal asthma associated with these gastrointestinal symptoms starting five years before his admission. He stated that, even when his daily asthma symptoms were under control, he suffered from attacks, especially when he had a strong urge to defecate. Although the contribution of increased parasympathetic tone to the onset of bronchospasms was likely, anticholinergics were not effective. Instead, the patient's symptoms successfully improved following the prophylactic use of laxatives, which might therefore be an appropriate therapeutic option for this type of asthma.
Topics: Abdominal Pain; Adult; Anti-Asthmatic Agents; Asthma; Bronchial Spasm; Bronchodilator Agents; Cholinergic Antagonists; Constipation; Defecation; Dexamethasone; Emergencies; Hernia, Inguinal; Herniorrhaphy; Humans; Laxatives; Male; Parasympathetic Nervous System; Postoperative Complications; Stomach Rupture
PubMed: 23503411
DOI: 10.2169/internalmedicine.52.8943