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Respiratory Care Jun 2022
Topics: COVID-19; Humans; Intubation, Intratracheal; Respiratory Sounds; Risk Factors
PubMed: 35606000
DOI: 10.4187/respcare.10134 -
American Journal of Respiratory and... Sep 2021
Topics: Child; Child, Preschool; Humans; Phenotype; Respiratory Sounds
PubMed: 34181864
DOI: 10.1164/rccm.202105-1294ED -
Respiratory Care Sep 2016Obstructive fibrinous tracheal pseudomembrane (OFTP) is an uncommon complication that results after tracheal intubation. Herein, we perform a systematic review of the... (Review)
Review
Obstructive fibrinous tracheal pseudomembrane (OFTP) is an uncommon complication that results after tracheal intubation. Herein, we perform a systematic review of the PubMed and EmBase databases for all the cases describing OFTP. The systematic search yielded 28 citations describing 53 subjects with OFTP. The study population (61.1% females) comprised of both adults and pediatric subjects with a median (IQR) age of 40.5 (14.8-60.5) years. The median (IQR) size of endotracheal tube was 7.5 (6-9.3) mm with a median (IQR) duration of intubation of 36 (14-96) hours. The median (IQR) time to onset of symptoms after extubation was 24 (6-96) hours. Stridor was the most common symptom. The average delay in correctly identifying the OFTP was 26 hours. The diagnosis of tracheal pseudomembrane was confirmed by flexible bronchoscopy in 38 (70.4%) instances while rigid bronchoscopy was used in 46.3% subjects for removing the pseudomembrane. There were two deaths, one each in an adult and a pediatric subject. OFTP is a complication of tracheal intubation and presents with respiratory failure. The diagnosis can be confirmed by flexible bronchoscopy. Treatment involves removal of the obstructing membrane with either flexible or rigid bronchoscopy.
Topics: Airway Extubation; Airway Obstruction; Bronchoscopy; Humans; Intubation, Intratracheal; Respiratory Sounds; Tracheal Diseases
PubMed: 27247431
DOI: 10.4187/respcare.04662 -
Australian Journal of General Practice May 2022
Topics: Asthma; Child, Preschool; Humans; Recurrence; Respiratory Sounds
PubMed: 35491458
DOI: 10.31128/AJGP-07-21-6085 -
British Medical Journal (Clinical... Aug 1984
Topics: Female; Humans; Male; Middle Aged; Positive-Pressure Respiration; Respiratory Sounds; Sleep Apnea Syndromes; Snoring
PubMed: 6432085
DOI: 10.1136/bmj.289.6441.335 -
Sao Paulo Medical Journal = Revista... 2012Tracheobronchomalacia (TBM) results from structural and functional abnormalities of the respiratory system. It is characterized by excessive collapse: at least 50% of... (Review)
Review
CONTEXT
Tracheobronchomalacia (TBM) results from structural and functional abnormalities of the respiratory system. It is characterized by excessive collapse: at least 50% of the cross-sectional area of the trachea and main bronchi. In this paper, we present a rare case of a patient with TBM who first presented with stridor and respiratory failure due to exacerbation of chronic bronchitis.
CASE REPORT
An 81-year-old Caucasian man was admitted presenting coughing, purulent sputum, stridor and respiratory failure. He had a medical history of chronic obstructive pulmonary disease (COPD) and silicosis and was a former smoker. Axial computed tomography on the chest revealed marked collapse of the trachea in its middle third. Bronchoscopy showed characteristics compatible with TBM. He was treated with noninvasive ventilation, without any good response. Subsequently, a Dumon Y stent was placed by means of rigid bronchoscopy. After the procedure, he was discharged with a clinical improvement.
CONCLUSION
TBM is fatal and often underdiagnosed. In COPD patients, stridor and respiratory failure may be helpful signs that should alert physicians to consider TBM as an early diagnosis. Thus, these signs may be important for optimizing the treatment and evolution of such patients.
Topics: Aged, 80 and over; Bronchoscopy; Humans; Male; Pulmonary Disease, Chronic Obstructive; Rare Diseases; Respiratory Insufficiency; Respiratory Sounds; Stents; Tracheobronchomalacia
PubMed: 22344362
DOI: 10.1590/s1516-31802012000100011 -
Indian Journal of Cancer 2021
Topics: Adolescent; Bell Palsy; Humans; Male; Respiratory Sounds
PubMed: 33762491
DOI: 10.4103/ijc.IJC_385_20 -
Paediatric Respiratory Reviews Sep 2011Oral corticosteroids are the cornerstone of management of acute moderate or severe asthma whilst preventive inhaled corticosteroids are the mainstay of the preventive... (Review)
Review
Oral corticosteroids are the cornerstone of management of acute moderate or severe asthma whilst preventive inhaled corticosteroids are the mainstay of the preventive management of children with asthma. Yet, variation in the magnitude of response to corticosteroids has been observed. There is increasing evidence that preschool-aged children with viral-induced asthma may display a certain degree of corticosteroid resistance, requiring higher doses of corticosteroids to overcome it. The identification of determinants of responsiveness is complicated by design issues, including heterogeneous populations of children with asthma and bronchiolitis or of children with viral-induced and multi-trigger asthma phenotypes in published trials. Potential key determinants of responsiveness may include age, trigger, phenotype, tobacco smoke exposure and genotype. The mechanistic pathway for corticoresistance may originate from a gene-environment interaction, leading to non-eosinophilic airway inflammation. The clinician should carefully confirm the diagnosis of asthma and ascertain the phenotype to select appropriate phenotype-specific therapy.
Topics: Administration, Inhalation; Administration, Oral; Age Factors; Anti-Asthmatic Agents; Asthma; Child; Child, Preschool; Drug Resistance; Genotype; Glucocorticoids; Humans; Phenotype; Respiratory Sounds; Tobacco Smoke Pollution
PubMed: 21722845
DOI: 10.1016/j.prrv.2011.02.007 -
PloS One 2016Nocturnal stridor is a breathing disorder prevalent in patients with multiple system atrophy (MSA). An improved understanding of this breathing disorder is essential...
Nocturnal stridor is a breathing disorder prevalent in patients with multiple system atrophy (MSA). An improved understanding of this breathing disorder is essential since nocturnal stridor carries a poor prognosis (an increased risk of sudden death). In this study, we aimed to classify types of stridor by sound analysis and to reveal their clinical significance. Patients who met the criteria for probable MSA and had undergone polysomnography (PSG) were recruited. Patients were then assessed clinically with sleep questionnaires, including the Pittsburgh Sleep Quality Index, and the Hoehn and Yahr scale. Nocturnal stridor and snoring were analyzed with the Multi-Dimensional Voice Program. Nocturnal stridor was recorded in 22 patients and snoring in 18 patients using the PSG. Waveforms of stridors were classified into rhythmic or semirhythmic after analysis of the oscillogram. Formants and harmonics were observed in both types of stridor, but not in snoring. Of the 22 patients diagnosed with stridor during the present study, fifteen have subsequently died, with the time to death after the PSG study being 1.9 ± 1.4 years (range 0.8 to 5.0 years). The rhythmic waveform group presented higher scores on the Hoehn and Yahr scale and the survival outcome of this group was lower compared to the semirhythmic waveform group (p = 0.030, p = 0.014). In the Kaplan Meier's survival curve, the outcome of patients with rhythmic waveform was significantly less favorable than the outcome of patients with semirhythmic waveform (log-rank test, p < 0.001). Stridor in MSA can be classified into rhythmic and semirhythmic types and the rhythmic component signifies a poorer outcome.
Topics: Acoustics; Aged; Continuous Positive Airway Pressure; Female; Humans; Male; Middle Aged; Multiple System Atrophy; Polysomnography; Respiratory Sounds; Sleep Apnea, Obstructive; Snoring
PubMed: 27093692
DOI: 10.1371/journal.pone.0153935 -
The American Journal of Case Reports Feb 2019BACKGROUND Fibroepithelial polyps are benign lesions of mesodermal origin, which have been reported in the head and neck area. The aim of this study is to describe the...
BACKGROUND Fibroepithelial polyps are benign lesions of mesodermal origin, which have been reported in the head and neck area. The aim of this study is to describe the management of an oropharyngeal fibroepithelial polyp causing stridor. CASE REPORT A 39-year-old male presented with 24 hours of stridor and dysphagia. Flexible laryngoscopy revealed a pedunculated sessile polyp on the posterior oropharynx. The mass was excised using bipolar diathermy and histopathology revealed a fibroepithelial polyp. The differential diagnoses for stridor are extensive. Although uncommon, a fibroepithelial polyp should be considered. CONCLUSIONS We present a rare case of a fibroepithelial polyp causing stridor and imminent airway obstruction. We recommend the use of SponTaneous Respiration using IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) for general anaesthesia and resection of pharyngeal polyps.
Topics: Adult; Airway Obstruction; Dyspnea; Humans; Laryngeal Diseases; Male; Polyps; Respiratory Sounds
PubMed: 30778021
DOI: 10.12659/AJCR.914907