Cases reported "Bronchial Spasm"

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1/39. Reactive airways dysfunction and systemic complaints after mass exposure to bromine.

    Occasionally children are the victims of mass poisoning from an environmental contaminant that occurs due to an unexpected common point source of exposure. In many cases the contaminant is a widely used chemical generally considered to be safe. In the following case, members of a sports team visiting a community for an athletic event were exposed to chemicals while staying at a local motel. bromine-based sanitizing agents and other chemicals such as hydrochloric acid, which were used in excess in the motel's swimming pool, may have accounted for symptoms experienced by the boy reported here and at least 16 other adolescents. Samples of pool water contained excess bromine (8.2 microg/mL; ideal pool bromine concentration is 2-4 microg/mL). Symptoms and signs attributable to bromine toxicity included irritative skin rashes; eye, nose, and throat irritation; bronchospasm; reduced exercise tolerance; fatigue; headache; gastrointestinal disturbances; and myalgias. While most of the victims recovered within a few days, the index case and several other adolescents had persistent or recurrent symptoms lasting weeks to months after the exposure.
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2/39. Bronchospasm induced by cardiopulmonary bypass.

    Severe bronchospasm during cardiopulmonary bypass (CPB) is an unusual event. A 16-year-old girl with pulmonary stenosis who underwent reconstruction of the right ventricle outflow tract experienced severe bronchospasm following CPB. Just after the initiation of the partial CPB, high inspiratory airway pressure was suddenly recognized. The lung had become too stiff for the anesthetic circuit bag to be squeezed by hand. Tracheobronchial obstruction was ruled out by investigation with a fiberoptic bronchoscope. A presumptive diagnosis of severe bronchospasm was made, and aggressive bronchodilator therapy was instituted. The attack was successfully treated with aggressive bronchodilator therapy. Although the exact causes for bronchospasm in our case are not clear, CPB factors, such as the release of complements and allergic reactions might have induced the attack under relatively light anesthetic state.
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ranking = 0.27951749310791
keywords = airway, obstruction
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3/39. Successful management of tracheotomized patients with chronic saliva aspiration by use of constant positive airway pressure.

    OBJECTIVE: Management of chronic aspiration of saliva is a challenge to clinicians. The purpose of this report is to review the clinical course of 3 patients with tracheotomy who we have followed for at least 1 year and who have received constant positive airway pressure (CPAP) as a primary treatment for ongoing aspiration of saliva. methods: Retrospective chart review. RESULTS: We present here 3 patients with chronic congestion and persistent hypoxemia in whom a diagnosis of chronic aspiration of saliva was established by use of radionuclide salivagram. Each of these children had tracheotomy for treatment of airway obstruction. In an attempt to decrease chronic aspiration of saliva, we instituted constant positive pressure via tracheotomy. Repeat radionuclide salivagram performed on CPAP demonstrated a marked decrease in saliva aspiration. All patients experienced improvement in clinical symptoms and required only rare subsequent hospitalizations for respiratory disease. CONCLUSION: We suggest, based on this case series, that CPAP administered via a tracheotomy is an acceptable means of managing chronic salivary aspiration and that it may decrease respiratory complications in such patients.
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ranking = 2.1589565833336
keywords = airway obstruction, airway, obstruction
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4/39. pulmonary edema and wheezing after pulmonary embolism.

    A young, pregnant woman with angiographically proved pulmonary emboli developed pulmonary edema and wheezing without evidence of left ventricular failure. This cast study points out the unusual association of pulmonary embolism with pulmonary edema, wheezing, and hyper-reactive airways in a patient with a positive family history of allergy, but no antecedent history of bronchospasm. Mechanisms for the occurrence of noncardiogenic pulmonary edema and wheezing after pulmonary embolism are reviewed.
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ranking = 0.25
keywords = airway
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5/39. Fiberoptic bronchoscopy in bronchial asthma. A word of caution.

    Three instances of intense laryngospasm and bronchospasm occurred as a result of fiberoptic bronchoscopic examination in three patients with quiescent bronchial asthma. The indications for the procedure were hemoptysis in one patient and lobar collapse in two. It is likely that vagally mediated reflex laryngospasm and bronchoconstriction occur when irritant receptors are mechanically stimulated by the bronchoscope. Therefore, in the asthmatic population with its increased airway reactivity, indications for fiberoptic bronchoscopy should be absolute, and the procedure should be performed under optimal conditions. A rationale for minimizing the risk of this procedure in patients with bronchial asthma is discussed.
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keywords = airway
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6/39. Spontaneous negative pressure changes: an unusual cause of noncardiogenic pulmonary edema.

    The principal physiologic mechanism underlying the formation of negative pressure pulmonary edema (NPPE) is thought to be the creation of excessive negative intrathoracic force from inspiration against a critical obstruction of the upper airway. The increased subatmospheric transpulmonary pressures result in transudation of fluid from the pulmonary capillaries to the interstitium and alveoli. The clinical picture is that of pulmonary edema. Aggressive diagnostic and therapeutic intervention can be avoided if the syndrome is recognized early. This report highlights the clinical features of NPPE and serves as a reminder to the clinician that although NPPE can cause significant morbidity, conservative supportive therapy typically results in a good outcome.
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ranking = 0.27951749310791
keywords = airway, obstruction
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7/39. Upper airway obstruction masquerading as exercise induced bronchospasm in an elite road cyclist.

    This case concerns an elite road cyclist who complained of occasional dyspnoea and inspiratory difficulty during intense exercise. Clinical examination was normal and the final diagnosis was vocal cord dysfunction, a paradoxical closure of the vocal cords during inspiration which is highly associated with inspiratory stridor at high rates of ventilation. awareness by the sports physician of this not uncommon condition is important to avoid misdiagnosis.
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ranking = 3.6358263333345
keywords = airway obstruction, airway, obstruction
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8/39. Acute obstruction of an endotracheal tube: a case report.

    This report describes a case of sudden ventilatory failure, originally diagnosed as bronchospasm, in a child during general anesthesia. A blood clot impaction in the nasotracheal tube was detected using flexible fiberoptic bronchoscopy. The clot was successfully treated as a result of its passage. We hope this report will stress to dental anesthesiologists the intraoperative importance of fiberoptic bronchoscopy not only as an intubation-aiding device but also as a diagnostic and therapeutic tool.
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ranking = 0.11806997243162
keywords = obstruction
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9/39. Unilateral bronchospasm following interpleural analgesia with bupivacaine.

    The interpleural block (IPB) is a relatively safe procedure and is commonly practised to provide analgesia. A local anaesthetic injected into the interpleural space spreads widely to block various neural structures. The IPB can initiate bronchospasm by interrupting the sympathetic outflow but sparing the parasympathetic outflow to the lungs. In addition, unilateral reduction of intercostal muscle tone with consequential selective reduction of the functional residual capacity of that lung may also mimic airflow obstruction. We report a case of unilateral bronchospasm encountered following IPB.
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ranking = 0.029517493107906
keywords = obstruction
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10/39. The effect of sedation with propofol on postoperative bronchoconstriction in patients with hyperreactive airway disease.

    Two patients with chronic obstructive pulmonary disease developed postoperatively bronchospasm after insertion of a prostetic aortic valve. Continuous sedation with propofol infusion was associated with a significant decline in peak inspiratory pressure suggesting that propofol may have bronchodilating properties.
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keywords = airway
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