scholarly journals Use of lignocaine nebulization in post bronchoscopy patients: a study of 150 cases

2020 ◽  
Vol 8 (12) ◽  
pp. 4258
Author(s):  
Naveed Gul ◽  
Monica Manhas ◽  
Parmod Kalsotra ◽  
Mehak Taban Mir
Keyword(s):  
Cardiac Arrest ◽  
Foreign Body ◽  
Postoperative Period ◽  
Respiratory Arrest ◽  
Rigid Bronchoscopy ◽  
Morbidity And Mortality ◽  
Laryngeal Edema ◽  
Laryngeal Oedema

Background: To see the role of lignocaine nebulisation and to compare its role with use of steroids and bronchodilators alone in post bronchoscopy patients.Methods: In the present study, 150 patients, who underwent rigid bronchoscopy for removal of foreign body, were taken into consideration. Immediately after the rigid bronchoscopy, 100 patients were given nebulization and 50 patients were not nebulized. Out of 100 patients, 50 patients were given nebulization with steroids (budesonide) and bronchodilators (salbutamol) and 50 patients received nebulization with lignocaine 4%, steroids (budesonide) and bronchodilator (salbutamol).Results: In the present study, 38 patients (25.3%) were having complications like laryngobronchial spasm, laryngeal edema, cardiac arrest and respiratory arrest. Out of the 38 patients, 15 patients (39.5%) were having laryngobronchial spasm and 23 patients (60.5%) were having laryngeal edema. Out of 15 patients who had laryngobronchial spasm only 2 (13.3%) patients, who were nebulised developed this complication, while 86.7% cases of laryngobronchial spasm developed in non-nebulised patients. Out of 23 patients who developed laryngeal oedema, only 6 (26%) patients who were nebulised developed this complication, while 74% cases of laryngeal oedema developed in non-nebulised patients.Conclusions: In the present study it is concluded that both morbidity and mortality can be reduced by the use of nebulisation in the postoperative period after rigid bronchoscopy. Addition of lignocaine in nebulisation along with steroids and bronchodilators further reduces the morbidity and mortality in the postoperative period.

scholarly journals ROLE OF RIGID BRONCHOSCOPY IN MANAGEMENT OF TRACHEOBRONCHIAL FOREIGN BODY ASPIRATION

2020 ◽  
Vol 28 (4) ◽  
pp. 345-347
Author(s):  
Israr ud Din ◽  
Muhammad Hafeez ◽  
Muhammad Junaid ◽  
Arif Raza Khan ◽  
Imran Khan
Keyword(s):  
Foreign Body ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Foreign Body Bronchus ◽  
Number Of Patients ◽  
Tracheobronchial Foreign Body ◽  
History Of ◽  
Male Patients ◽  
One Year

Objective: To determine the role of Rigid Bronchoscopy in Management of Tracheobronchial Foreign Body Aspiration. Material and Methods: This study was conducted in otolaryngology department, Khyber teaching hospital, Peshawar of one year duration from January 2018 to December 2019. Total 90 Patients of age 4 months to 14 years on clinical suspicion of foreign body bronchus were included, while patients with history of bronchial asthma, pulmonary tuberculosis and radio opaque foreign body bronchus were excluded. Results: Total number of patients was 90 in which male patients were 60 (66.67 %) and female patients were 30 (33.33 %), patients with foreign body bronchus were 80 (88.89%). Male patients with foreign body bronchus was 53 (58.89%) and female 27 (30.00%). In age range from 4 months to 3 years, 35(39%) Patients underwent bronchoscopy in which foreign body bronchus retrieved in 30(37.5%) patients. Conclusion: Patients with history of repeated chest infection, relieved by medicines for some time should not be over look, as vegetative foreign body bronchus are radiolucent and patients usually present late in respiratory compromised state, the clinician must urge, for prompt treatment as rigid bronchoscopy.

scholarly journals KETERLAMBATAN TINDAKAN BRONKOSKOPI PADA SUSPEK BENDA ASING DI BRONKUS

2011 ◽  
Vol 35 (2) ◽  
pp. 159
Author(s):  
Fachzi Fitri ◽  
Yelvita Roza
Keyword(s):  
Foreign Body ◽  
Respiratory Distress ◽  
General Anesthesia ◽  
Delayed Diagnosis ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Morbidity And Mortality ◽  
Emergency Case ◽  
Organic Product ◽  
Diagnosis And Management

AbstrakAspirasi benda asing di bronkus adalah kasus emergensi THT-KL yang merupakan salah satu penyebab morbiditas dan mortalitas utama pada anak, terutama usia dibawah 3 tahun. Aspirasi benda asing yang tersering pada bayi dan anak adalah benda organik, sehingga membutuhkan penanganan yang cepat karena akan menimbulkan komplikasi serius apabila tindakannya terlambat. Keterlambatan diagnosis aspirasi benda asing dipengaruhi oleh faktor tingkat pengetahuan orang tua, ketidak tajaman diagnosis awal dan komplikasi dari benda asing di jalan nafas. Tindakan bronkoskopi tepat waktu akan menghindarkan komplikasi yang ireversibel.Dilaporkan satu kasus aspirasi benda asing biji jeruk pada seorang bayi laki-laki usia 7 bulan dengan gagal nafas akut karena keterlambatan diagnosis dan tatalaksana dan telah dilakukan bronkoskopi dalam anastesi umum dengan menggunakan bronkoskopi kaku.Kata kunci : aspirasi benda asing organik, gagal nafas akut, keterlambatan diagnosis, bronkoskopi kaku, anastesi umumAbstractForeign body aspiration in bronchus is an emergency case in ENT-HNS, representing one of the major cause of morbidity and mortality in childhood, especially in children younger than 3 years of age. The most foreign body aspirated in infant and toddler is an organic product, which can cause severe complication if the management was delay. Delayed diagnosis of foreign body aspiration was influenced by parenthal education, early misdiagnosis and complication of the foreign body. Timely bronchoscopy will prevent an irreversible complication.A case of foreign body orange seed aspiration in a boy 7 months old with acute breathing failure because of delayed diagnosis and management, the management was bronchoscopy using rigid bronchoscopy in general anesthesia.Key word : organic foreign body aspiration, acute respiratory distress, delayed diagnosis, rigid bronchoscopy, general anesthesia

scholarly journals Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Erol Karaaslan ◽  
Turan Yıldız
Keyword(s):  
Intensive Care ◽  
Foreign Body ◽  
Anesthetic Management ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Laryngeal Edema ◽  
Postoperative Intensive Care ◽  
Operative Complications ◽  
Tracheobronchial Foreign Body ◽  
Post Operative Complications

Objectives: Delayed diagnosis and treatment of tracheobronchial foreign body aspiration (FBA) in children may lead to morbidity and mortality. Our objective was to evaluate the anesthetic management, peri- and post-operative complications, and predisposing factors for postoperative intensive care unit (ICU) admission in children undergoing rigid bronchoscopy due to tracheobronchial FBA. Methods: This retrospective study included 81 children who underwent rigid bronchoscopy between January 2010 to July 2018 at Inonu University, Department of Pediatric Surgery, Turkey. Data regarding demographic characteristics, anesthetic management, length of ICU and hospital stays, and peri- and post-operative complications were retrieved from the hospital database. Results: The patients included 54 (66.7%) boys and 27 (33.3%) girls with a mean age of 29.6±31.2 months. The most common presenting symptom was the suspicion of FBA, followed by acute-onset cough, cyanosis, wheezing and respiratory distress. Mean duration of anesthesia was 44.40±14.72 min. Of the 81 patients, 18 (22.2%) were transferred to ICU and 63 (77.8%) patients were transferred to the ward postoperatively. Of the patients transferred to the ICU, 5 of them required mechanical ventilation. Some peri and postoperative complications, desaturation (n=16; 19.7%; p=0.001), mucosal bleeding (n=6; 7.4%; p=0.02), laryngeal edema (n=11; 13.6%; p<0.001), laryngospasm (n=13; 16.3%; p<0.001), were affected the frequency of intensive care transfer. Conclusion: Bronchoscopy with general anesthesia remains the golden standard for the management of tracheobronchial FBA. In such patients, a combination consisting of a detailed preoperative clinical evaluation of the patient, selection of short-acting anesthetic agents with minimal side effects for the induction and maintenance of anesthesia, and the administration of controlled ventilation can be recommended. Additionally, early diagnosis of peri- and post-operative complications, prediction of postoperative ICU requirement, and a close cooperation of anesthesiologists and surgeons are highly important. doi: https://doi.org/10.12669/pjms.35.6.1225 How to cite this:Karaaslan E, Yildiz T. Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration. Pak J Med Sci. 2019;35(6):1592-1597. doi: https://doi.org/10.12669/pjms.35.6.1225 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals A first-aid fast track channel for rescuing critically ill children with airway foreign bodies: our clinical experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong-chao Chen ◽  
Zhi-xiong Xian ◽  
Sai-hong Han ◽  
Lan Li ◽  
Yi-shu Teng
Keyword(s):  
Medical Records ◽  
Fast Track ◽  
Foreign Bodies ◽  
First Aid ◽  
Rigid Bronchoscopy ◽  
Common Type ◽  
Critically Ill Children ◽  
Laryngeal Oedema

Abstract Objective To explore the role of a first-aid fast track channel in rescuing children with airway foreign bodies and to analyse and summarize the experience and lessons of the first-aid fast track channel in rescuing airway foreign bodies from patients in critical condition. Methods We retrospectively reviewed the medical records of children with airway foreign bodies rescued by first-aid fast track channels admitted to our hospital from January 2017 to December 2020. The corresponding clinical features, treatments, and prognoses were summarized. Results Clinical data from 21 cases of first-aid fast track channel patients were retrospectively collected, including 12 males and 9 females aged 9–18 months. Cough was the most frequently exhibited symptom (100.0%), followed by III inspiratory dyspnoea (71.4%). Regarding the location of foreign bodies, 5 cases (23.8%) had glottic foreign bodies, 10 cases (47.6%) had tracheal foreign bodies, and 6 cases (28.6%) had bilateral bronchial foreign bodies. The most common type of FB was organic. FB removal was performed by rigid bronchoscopy in every case, and there were no complications of laryngeal oedema, subcutaneous emphysema, or pneumothorax. No tracheotomy was performed in any of the children. Conclusion The first-aid fast track channel for airway foreign bodies saves a valuable time for rescue, highlights the purpose of rescue, improves the success rate of rescue and the quality of life of children, and is of great value for the treatment of critical tracheal foreign bodies. It is necessary to regularly summarize the experience of the first-aid fast track channel of airway foreign bodies and further optimize the setting of the first-aid fast track channel.

The role of matrix metalloproteinase 9 and its inhibitors in scarring processes following surgery for primary open-angle glaucoma

2019 ◽  
pp. 72-80
Author(s):  
Е.В. Маркелова ◽  
О.В. Овчинникова ◽  
А.С. Хохлова ◽  
Л.П. Догадова ◽  
А.В. Костюшко ◽  
...  
Keyword(s):  
Matrix Metalloproteinase ◽  
Postoperative Period ◽  
Open Angle Glaucoma ◽  
Matrix Metalloproteinase 9 ◽  
Tissue Inhibitors Of Metalloproteinases ◽  
Open Angle ◽  
Tissue Inhibitors ◽  
Surgery Outcome ◽  
Metalloproteinase 9

Оперативное вмешательство - один из основных методов лечения глаукомы. Однако развитие избыточного рубцевания созданных путей оттока определяет результат хирургического лечения в отдаленные сроки. Процессы рубцевания на данный момент недостаточно изучены. Цель исследования - оценка роли матриксной металлопротеиназы-9, ее ингибиторов в процессах рубцевания у больных с первичной открытоугольной глаукомой после оперативного лечения. Методика. Для выявления возможных маркеров избыточного рубцевания методом твердофазного иммуноферментного анализа определяли содержание матриксных металлопротеиназ-9, тканевых ингибиторов металлопротеиназ 2 и -3 в слезной жидкости у 37 пациентов с активной стадией первичной остроугольной глаукомы в динамике послеоперационного периода. Средний возраст пациентов составил 52,8 лет. В зависимости от исхода оперативного вмешательства все пациенты были разделены на 2 группы - с благоприятным исходом (без избыточного рубцевания) и с неблагоприятным исходом (с избыточным рубцеванием) на месте сформированных дополнительных путей оттока внутриглазной жидкости в послеоперационном периоде. Группа контроля включала 20 человек в возрасте от 50 до 66 лет без сопутствующей офтальмологической и соматической патологии в стадии обострения. Результаты. В динамике показано изменение концентрации матриксной металлопротеиназы-9 и ее ингибиторов в послеоперационном периоде. Анализ данных свидетельствует об обратной зависимости уровня матриксной металлопротеиназы-9 и тканевых ингибиторов металлопротеиназы 2 и 3 типов с исходом операции - чем выше концентрация металлопротеиназы-9 и ниже концентрация тканевых ингибиторов металлопротеиназ 2, -3 в слезной жидкости, тем выше вероятность неблагоприятного исхода в виде рубцевания сформированных дополнительных путей оттока внутриглазной жидкости в послеоперационном периоде. Заключение. Мониторинг уровня металлопротеиназ и их тканевых ингибиторов после проведения хирургического лечения пациентов с первичной открытоугольной глаукомой позволяет прогнозировать раннее рубцевание, дает возможность разработки новых методов лечения как в раннем, так и в позднем послеоперационном периоде. Surgery is one of the major treatments for glaucoma; however excessive scarring of created outflow patways affects the long-term outcome. At the present time, scarring processes are not sufficiently studied. Aim. To evaluate the role of matrix metalloproteinase 9 and its inhibitors in scarring after surgical treatment of open-angle glaucoma. Methods. Concentrations of matrix metalloproteinase 9 and tissue inhibitors of metalloproteinases 2 and 3 were measured in tear fluid of 37 patients (mean age, 52.8) with active primary open-angle glaucoma in dynamics during the postoperative period to identify possible markers of excessive scarring. Based on the surgery outcome, all patients were divided into two groups, with a favorable outcome (without excessive scarring) and an unfavorable outcome (with excessive scarring) in the created additional outflow pathways for the intraocular fluid in the postoperative period. The control group included 20 subjects aged 50-66 without eye disease or somatic disease at exacerbation stage. Results. Analysis of changes in concentrations of matrix metalloproteinase 9 and its inhibitors in the postoperative period showed their inverse relationship with the surgery outcome. The higher was the metalloproteinase 9 level and the lower the level of tissue inhibitors of metalloproteinases 2 and 3 the higher was the probability of unfavorable outcome evident as excessive scarring of the formed additional pathways for tear fluid outflow in the postoperative period. Conclusion. Postoperative monitoring of metalloproteinases and their tissue inhibitors allows to predict early scarring and to develop new treatments both in early and late postoperative periods.

The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020

2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii
Keyword(s):  
Foreign Body ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Human Life ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Site Infections ◽  
Coagulase Negative Staphylococci ◽  
Native Valve ◽  
Native Valve Endocarditis

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.

scholarly journals Clinical analysis of tracheobronchial foreign body aspiration in children: a focus on external and intrinsic factors

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weigang Gan ◽  
Ning Xiao ◽  
Yiyuan Feng ◽  
Danmei Zhou ◽  
Juanjuan Hu ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pediatric Patients ◽  
Treatment Delay ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
External Factors ◽  
Factors Affecting ◽  
Intrinsic Factors ◽  
Common Location ◽  
Tracheobronchial Foreign Body

Abstract Background Tracheobronchial foreign body aspiration (TFBA) is a critical disease in children and is extremely dangerous, even life-threatening. The factors affecting the occurrence and prognosis of TFBA are complex. The purpose of this study is to examine the external and intrinsic factors affecting clinical features of TFBA in West China and propose potential effective intervention measures. Methods We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA with foreign bodies (FBs) removed by rigid bronchoscopy under general anesthesia at the otolaryngology department from December 2017 to November 2018. The data included age, sex, clinical symptoms, type and location of FB, guardians, prehospital duration and residence of these pediatric patients. Results The ratio of males (72) to females (53) was 1.4:1. Children aged from 1 to 3 years accounted for 76% (95/125) of patients. Cough, continuous fever and dyspnea were the primary symptoms. The right primary bronchus was the most common location of FB detection by rigid bronchoscopy (67 cases, 53.6%). Organic FBs were most common in our study. Guardians of patients significantly differed in the rural (parents 16, grandparents 31) and urban (parents 52, grandparents 26) groups (χ2 = 12.583, p = 0.000). More children in the rural group than in the urban group had a treatment delay longer than 72 h. More children in the group with no history of FB aspiration (12, 25%) than in the group with prior FB aspiration had a treatment delay longer than 72 h. Conclusion Pediatric TFBA is a common emergency in otolaryngology. Age, sex, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FB species and prehospital time were defined as external factors of TFBA. External and intrinsic factors both influence the occurrence and progression of TFBA. It is extremely important to take effective measures to control external factors, which can decrease morbidity and mortality.

scholarly journals Genetic and epigenetic mechanisms in the development of congenital heart diseases

2021 ◽  
Vol 4 (2) ◽  
pp. e000196
Author(s):  
Yue Wu ◽  
Xiaosi Jin ◽  
Yuhao Zhang ◽  
Jing Zheng ◽  
Rulai Yang
Keyword(s):  
Congenital Heart ◽  
Heart Diseases ◽  
Gene Mutations ◽  
Morbidity And Mortality ◽  
Molecular Medicine ◽  
Epigenetic Mechanisms ◽  
Epigenetic Factors ◽  
Near Future

Congenital heart disease (CHD) is the most common of congenital cardiovascular malformations associated with birth defects, and it results in significant morbidity and mortality worldwide. The classification of CHD is still elusive owing to the complex pathogenesis of CHD. Advances in molecular medicine have revealed the genetic basis of some heart anomalies. Genes associated with CHD might be modulated by various epigenetic factors. Thus, the genetic and epigenetic factors are gradually accepted as important triggers in the pathogenesis of CHD. However, few literatures have comprehensively elaborated the genetic and epigenetic mechanisms of CHD. This review focuses on the etiology of CHD from genetics and epigenetics to discuss the role of these factors in the development of CHD. The interactions between genetic and epigenetic in the pathogenesis of CHD are also elaborated. Chromosome abnormalities and gene mutations in genetics, and DNA methylations, histone modifications and on-coding RNAs in epigenetics are summarized in detail. We hope the summative knowledge of these etiologies may be useful for improved diagnosis and further elucidation of CHD so that morbidity and mortality of children with CHD can be reduced in the near future.

scholarly journals Challenges in Management of Tracheobronchial Foreign Bodies with Delayed Presentation: An Institutional Experience

2021 ◽  
Author(s):  
Darwin Kaushal ◽  
Amit Goyal ◽  
Kapil Soni ◽  
Bikram Choudhury ◽  
Nithin Prakasan Nair ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Preoperative Planning ◽  
Rigid Bronchoscopy ◽  
Delayed Presentation ◽  
Betel Nut ◽  
Key Factors ◽  
Tracheobronchial Foreign Body ◽  
Institutional Experience ◽  
Definitive Management

Abstract Introduction Airway foreign bodies are emergencies involving multidisciplinary departments like Pediatrics, Aneasthesiology and Otorhinolaryngology. It is always a challenge to diagnose and manage patients who present late to our emergencies. Objective In the present study, we aim to analyze the various challenges faced during the management of tracheobronchial foreign bodies with delayed presentation. Methods A retrospective hospital record-based analysis of patients who presented to us with tracheobronchial foreign bodies from January 2017 to February 2020 was performed. All patients until the age of 16 years old were included in the present study. We assessed the demographics, preoperative, intraoperative and postoperative data of the patients. Results Seventeen patients were analyzed in the study. Among these, 44.4% of the patients had delayed presentation (> 1 month). The majority of the patients had an organic foreign body (Supari or betel nut). All patients underwent rigid bronchoscopy, followed by optical forceps-assisted removal of the foreign body. A total of 82% of the patients had granulations around the foreign body. Conclusion Management of delayed presentation tracheobronchial foreign body is a big challenge for Otorhinolaryngologists. The key factors for preventing complications in the definitive management of tracheobronchial foreign bodies are preoperative planning, multi-discipline teamwork, surgeon expertise and technique.

scholarly journals The role of hepaticojejunostomy leaks after pancreatoduodenectomy in the increase of morbidity and mortality

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S289
Author(s):  
O. Usenko ◽  
M. Nichitaylo ◽  
V. Kopchak ◽  
P. Ogorodnik ◽  
O. Lytvyn ◽  
...  
Keyword(s):  
Morbidity And Mortality
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