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Internal Medicine (Tokyo, Japan) Jun 2023
Topics: Humans; Tracheitis; COVID-19; Trachea; Tracheal Stenosis
PubMed: 36948623
DOI: 10.2169/internalmedicine.1350-22 -
CMAJ : Canadian Medical Association... Jan 1989We examined the records of 14 patients aged 7 months to 10 1/4 years who were treated for bacterial tracheitis from May 1982 to December 1987; the management protocol... (Review)
Review
We examined the records of 14 patients aged 7 months to 10 1/4 years who were treated for bacterial tracheitis from May 1982 to December 1987; the management protocol for 13 of the patients included the use of nasotracheal intubation. The infection was caused by Staphylococcus aureus in seven, Haemophilus influenzae in three, Branhamella catarrhalis in one and Streptococcus pneumoniae in one. Both H. influenzae and B. catarrhalis were isolated in another patient, and no organism was found in the remaining patient. In addition to the bacteria, viruses were cultured from the tracheal secretions of two patients. The mean duration of intubation was 7.6 days and of hospital stay 9.2 days. Twelve of the cases occurred during the cold months of the year (October to March). Of the three deaths only one occurred in the pediatric intensive care unit and was due to severe bronchospasm and an air leak that caused bilateral pneumothorax and pneumomediastinum. In one patient subglottic stenosis developed that necessitated tracheostomy. Healing began 5 to 9 days after the onset of symptoms, as demonstrated with the use of repeated fibreoptic bronchoscopy. We found that the airway could be safely managed with the use of a nasotracheal tube. Bronchoscopy helped to confirm the diagnosis, to remove adherent secretions and to monitor the course of the disease. The ventilation tube can be removed after the patient's temperature returns to normal, if there is an air leak around the tube, if the quantity and viscosity of the secretions decrease and if healing is observed at bronchoscopy.
Topics: Airway Obstruction; Bacterial Infections; Bronchoscopy; Child; Child, Preschool; Female; Humans; Infant; Intubation, Intratracheal; Male; Retrospective Studies; Seasons; Tracheitis
PubMed: 2642395
DOI: No ID Found -
Ear, Nose, & Throat Journal Jul 2010
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Asthma; Gastroesophageal Reflux; Histamine H2 Antagonists; Humans; Male; Proton Pump Inhibitors; Temporomandibular Joint Disorders; Tracheitis
PubMed: 20628980
DOI: 10.1177/014556131008900710 -
MedEdPORTAL : the Journal of Teaching... Aug 2020Pediatric bacterial tracheitis is a rare but life-threatening upper airway infection with mortality rates estimated as high as 20%, typically affecting children between...
INTRODUCTION
Pediatric bacterial tracheitis is a rare but life-threatening upper airway infection with mortality rates estimated as high as 20%, typically affecting children between 6 months and 12 years old. Given such high mortality rates, we felt it was important to train medical personnel to evaluate and manage this condition.
METHODS
This simulation-based curriculum was developed for health care professionals involving the evaluation and management of an 8-year-old male with symptoms of fever, stridor, worsening barking cough, and increased work of breathing. Critical actions included identifying stridor and airway respiratory distress; monitoring and supporting airway, breathing, and circulation; administering racemic epinephrine and dexamethasone; and identifying and treating bacterial tracheitis as the underlying cause. Scenario-specific debriefing tools were put together to elicit scenario feedback and aid in formative learning.
RESULTS
The scenario was conducted with six fellows and 12 residents and medical students. Per the survey data, the case was rated as highly relevant (median = 5) and highly realistic (median = 5) by participants on a 5-point Likert scale.
DISCUSSION
Pediatric bacterial tracheitis is a low frequency, but high-risk scenario that was amenable to simulation as an educational modality and was well-received by participants. The debriefing tools were implemented as a means of helping instructors customize the scenario for learners based on respective educational backgrounds and learning styles.
Topics: Child; Curriculum; Humans; Learning; Male; Pediatric Emergency Medicine; Surveys and Questionnaires; Tracheitis
PubMed: 32875092
DOI: 10.15766/mep_2374-8265.10946 -
Medicina (Kaunas, Lithuania) Oct 2021Clinically significant isolated viral tracheitis is scarce in adults, and upper airway obstruction caused by viral tracheitis is even more infrequent. A 74-year-old...
Clinically significant isolated viral tracheitis is scarce in adults, and upper airway obstruction caused by viral tracheitis is even more infrequent. A 74-year-old woman, who was administered low-dose steroids for two months for chronic obstructive pulmonary disease (COPD), developed dyspnea with stridor and required mechanical ventilation for respiratory failure. Chest computed tomography showed a diffuse tracheal wall thickening with luminal narrowing and peribronchial consolidation in the right upper lobe. Bronchoscopy revealed a proximal tracheal narrowing with multiple ulcerations of the tracheal mucosa surrounded by an erythematous margin. Pathologic examinations of the tracheal mucosal tissue, including immunohistochemistry, revealed a cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Furthermore, the bronchial alveolar lavage fluid was positive on the CMV real-time polymerase chain reaction. The patient was treated with intravenous ganciclovir for 44 days. The follow-up bronchoscopy 49 days after the initiation of ganciclovir revealed improved multiple ulcerations with scars. We report a rare case of tracheitis caused by coinfection with CMV and HSV in a patient with COPD who had been taking low-dose steroids for months. The case showed that CMV and HSV are potential causes of serious tracheitis and respiratory failure.
Topics: Adult; Aged; Coinfection; Cytomegalovirus; Female; Herpes Simplex; Humans; Simplexvirus; Tracheitis
PubMed: 34833380
DOI: 10.3390/medicina57111162 -
Revista Brasileira de Terapia Intensiva Mar 2018The concept of ventilator-associated tracheobronchitis is controversial; its definition is not unanimously accepted and often overlaps with ventilator-associated... (Review)
Review
The concept of ventilator-associated tracheobronchitis is controversial; its definition is not unanimously accepted and often overlaps with ventilator-associated pneumonia. Ventilator-associated tracheobronchitis has an incidence similar to that of ventilator-associated pneumonia, with a high prevalence of isolated multiresistant agents, resulting in an increase in the time of mechanical ventilation and hospitalization but without an impact on mortality. The performance of quantitative cultures may allow better diagnostic definition of tracheobronchitis associated with mechanical ventilation, possibly avoiding the overdiagnosis of this condition. One of the major difficulties in differentiating between ventilator-associated tracheobronchitis and ventilator-associated pneumonia is the exclusion of a pulmonary infiltrate by chest radiography; thoracic computed tomography, thoracic ultrasonography, or invasive specimen collection may also be required. The institution of systemic antibiotic therapy does not improve the clinical impact of ventilator-associated tracheobronchitis, particularly in reducing time of mechanical ventilation, hospitalization or mortality, despite the possible reduced progression to ventilator-associated pneumonia. However, there are doubts regarding the methodology used. Thus, considering the high prevalence of tracheobronchitis associated with mechanical ventilation, routine treatment of this condition would result in high antibiotic usage without clear benefits. However, we suggest the institution of antibiotic therapy in patients with tracheobronchitis associated with mechanical ventilation and septic shock and/or worsening of oxygenation, and other auxiliary diagnostic tests should be simultaneously performed to exclude ventilator-associated pneumonia. This review provides a better understanding of the differentiation between tracheobronchitis associated with mechanical ventilation and pneumonia associated with mechanical ventilation, which can significantly decrease the use of antibiotics in critically ventilated patients.
Topics: Anti-Bacterial Agents; Bronchitis; Critical Illness; Diagnosis, Differential; Drug Resistance, Multiple, Bacterial; Humans; Pneumonia, Ventilator-Associated; Respiration, Artificial; Tracheitis
PubMed: 29742211
DOI: 10.5935/0103-507x.20180014 -
Respiratory Care Mar 2003Acute obstructive respiratory emergencies in children are a common cause of emergency department visits. The severity of these conditions ranges from mild, self-limited... (Review)
Review
Acute obstructive respiratory emergencies in children are a common cause of emergency department visits. The severity of these conditions ranges from mild, self-limited disease to life-threatening forms of rapidly progressive airway obstruction. A high index of suspicion is necessary for prompt diagnosis and treatment. This review discusses general principles of assessing and managing respiratory emergencies in children, as well as clinical characteristics and treatment of specific conditions such as croup, epiglottitis, bacterial tracheitis, retropharyngeal abscess, foreign bodies, and inhalational injuries.
Topics: Acute Disease; Child; Emergency Service, Hospital; Emergency Treatment; Humans; Pediatrics; Radiography; Respiratory Therapy; Respiratory Tract Diseases; United States
PubMed: 12667275
DOI: No ID Found -
Pediatric Quality & Safety 2021There is no consensus definition for ventilator-associated tracheitis and limited evidence to guide diagnosis and treatment. To improve acute tracheitis evaluation and...
UNLABELLED
There is no consensus definition for ventilator-associated tracheitis and limited evidence to guide diagnosis and treatment. To improve acute tracheitis evaluation and management, this quality improvement project aimed to (1) improve the appropriateness of tracheal aspirate cultures while decreasing the number of unnecessary cultures by 20% and (2) decrease antibiotic use for acute tracheitis not consistent with local guidelines by 20% over 12 months among pediatric patients requiring mechanical ventilation.
METHODS
All patients admitted to the Medical Intensive Care Unit requiring mechanical ventilation via an artificial airway were included. Tracheal aspirate sampling criteria, technique, and minimum intervals were standardized. Primary outcome measures were the number of tracheal aspirate cultures obtained per 100 ETT/tracheostomy days and ventilator-associated antibiotic days per 100 ETT/tracheostomy days. Improvement cycles included: Implementation of tracheal aspirate sampling criteria, sampling technique standardization, limiting repeat cultures to >72-hour intervals, and standardizing empiric antibiotic therapy.
RESULTS
Tracheal aspirate culture rate decreased from 10.70 to 7.10 cultures per 100 ETT/tracheostomy days ( < 0.001). Cultures meeting sampling criteria increased from 28% to 80%. Ventilator-associated antibiotic use decreased from 24.88 to 7.30 ventilator-associated antibiotic days per 100 ETT/tracheostomy days. There were no associated increases in ventilator-associated events or days of mechanical ventilation.
CONCLUSIONS
Implementation of standardized criteria for tracheal aspirate sampling, improved tracheal aspirate sampling technique, limiting repeat tracheal aspirate cultures, and utilizing standardized antibiotic treatment guidelines safely decreased resource utilization and antibiotic use among critically ill children requiring mechanical ventilation.
PubMed: 33403314
DOI: 10.1097/pq9.0000000000000368 -
Frontiers in Pharmacology 2022(Lour.) Merr. () is a traditional herbal medicine that is used to treat constipation, fever, pneumonia, stomachache, tracheitis, rhinitis, cataract, acne, urticaria.... (Review)
Review
(Lour.) Merr. () is a traditional herbal medicine that is used to treat constipation, fever, pneumonia, stomachache, tracheitis, rhinitis, cataract, acne, urticaria. More than 90 compounds have been identified from different structural types in , including steroidal saponins, C-steroides, lignans, polysaccharides, amino acids, etc. These bioactive ingredients make remarkable for its pharmacological effects on anti-asthma, anti-inflammatory, anti-oxidation, anti-tumor, improving Alzheimer's disease, neuroprotection, gut health-promoting and so on. Moreover, also plays an important role in food, health product, cosmetic, and other fields. This review focused on the research publications of and aimed to summarize the advances in the botany, traditional uses, phytochemistry, pharmacology, and applications which will provide reference for the further studies and applications of
PubMed: 36532772
DOI: 10.3389/fphar.2022.1068858 -
Journal of Perinatology : Official... Mar 2021To describe characteristics associated with repeated unplanned extubations, short-term complications and outcomes, and longer-term morbidities including acquired...
OBJECTIVE
To describe characteristics associated with repeated unplanned extubations, short-term complications and outcomes, and longer-term morbidities including acquired subglottic stenosis.
STUDY DESIGN
Cohort study including neonates admitted to a tertiary care neonatal intensive care unit who experienced an unplanned extubation in a 5-year period.
RESULTS
We reviewed 588 events involving 300 patients. Ten percent had airway trauma with reintubation, 42% required ≥2 reintubation attempts, and 39% led to increased baseline oxygen. Increased odds of repeated events were seen in patients with bronchopulmonary dysplasia and were associated with higher rates of tracheostomy and longer length of stay. The 9% of patients diagnosed with acquired subglottic stenosis had more unplanned extubations, higher rates of airway trauma and tracheitis, and were an older gestational age at birth.
CONCLUSION
Unplanned extubations lead to short- and long-term morbidities. Certain patient characteristics are associated with increased odds of repeated events and the development of acquired subglottic stenosis.
Topics: Airway Extubation; Cohort Studies; Humans; Infant, Newborn; Intubation, Intratracheal; Morbidity; Respiration, Artificial
PubMed: 33547405
DOI: 10.1038/s41372-021-00927-9