1/8. 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.- - - - - - - - - - ranking = 1keywords = aspiration (Clic here for more details about this article) |
2/8. Pathological study of bronchospasms/tracheomalasia in patients with severe motor and intellectual disabilities.This report concerns two autopsy cases of severe motor and intellectual disabilities (SMID) who died of bronchospasms or tracheomalasia. One case had no anatomical change in the tracheal wall except for an endotracheal granuloma, while the other showed softening of the tracheal wall. Since patients with SMID have risk factors for bronchospasms and tracheomalasia, such as gastro-esophageal reflux, aspiration, and thoracic deformities, it is important that we suspect the possibility of these conditions, when we see the respiratory distress in cases of SMID.- - - - - - - - - - ranking = 0.1keywords = aspiration (Clic here for more details about this article) |
3/8. The clinical management of the aspiration of gastric contents.The management of the aspiration of gastric contents is considered under five different headings - clearance of the airway, the problem of oxygenation, the use of steroids, the possible use of prophylactic antibiotics and the general measures applicable to the care of any seriously ill patient. An illustrative case report is presented.- - - - - - - - - - ranking = 2506.3674935218keywords = gastric content, aspiration, content (Clic here for more details about this article) |
4/8. Pulmonary complications of benign esophageal disease.Three patients with esophageal reflux and associated pulmonary complications are presented: one with a lung abscess, another with recurring pneumonitis that required hospitalization, and the third with bronchospasm or asthma secondary to reflux and chronic aspiration. Two were treated surgically by the repair of esophageal and pulmonary lesions. The third patient was treated medically, with resolution of pulmonary symptoms and improvement of pulmonary function. A review is presented of the association between esophageal and pulmonary problems and of the insidious complications that may result.- - - - - - - - - - ranking = 0.1keywords = aspiration (Clic here for more details about this article) |
5/8. Acute bronchoconstriction caused by Beclovent and not Vanceril.A 24-year-old asthmatic patient reported acute wheezing immediately after using an aerosol of beclomethasone dipropionate (Beclovent). She was hospitalised for bronchial challenges. Immediate bronchoconstriction was shown after two puffs of this aerosol and after inhalation of the placebo containing all the products of the aerosol less the beclomethasone. Another brand of beclomethasone aerosol, Vanceril, did not produce any reaction. Since the contents of these two beclomethasone aerosols are similar, the authors suggest that rubber or plastic derivative(s) present in the metering valve might have been responsible for the reaction.- - - - - - - - - - ranking = 0.067504919210839keywords = content (Clic here for more details about this article) |
6/8. Gastroesophageal fundoplication improves symptoms in refractory asthma.Gastroesophageal (GE) reflux has been etiologically linked to a number of pulmonary diseases. Subclinical pulmonary aspiration from nocturnal GE reflux has been proposed as a cause of asthma. A patient with severe asthma, refractory to conventional medical therapy, is presented. The asthma was presumed to be secondary to gastroesophageal reflux and indeed the patient became asymptomatic following a Nissen fundoplication procedure. This case report documents that surgical correction of GE reflux may be an appropriate therapeutic maneuver in asthmatics who subclinically aspirate as a consequence of GE reflux.- - - - - - - - - - ranking = 0.1keywords = aspiration (Clic here for more details about this article) |
7/8. Alcohol-induced bronchospasm in an asthmatic patient: pharmacologic evaluation of the mechanism.A 23-year-old Asian with histamine-reactive asthma complained of recurrent chest tightness, nasal congestion and flushing immediately after drinking minimal amounts of alcoholic beverages. He was extensively studied to determine the possible mechanism of his alcohol-induced respiratory symptoms. drinking of either beer or 95 percent ethanol in apple juice immediately provoked vasomotor signs and moderately severe bronchospasm (54 percent and 73 percent decreases in specific airway conductance, respectively), which spontaneously improved over 30 minutes and two hours, respectively. Intravenous and inhaled ethanol caused less bronchospasm than observed with oral ethanol, and recovery was rapid. Pretreatment with cromolyn sodium (inhaled or oral) and isoproterenol had no inhibitory effect on the alcohol-induced bronchoconstriction, whereas atropine, acetylsalicylic acid, cyproheptadine, and chlorpheniramine appeared to have a partial inhibitory effect. Approximately 70 percent inhibition was observed after chlorpheniramine. Observations in this patient suggest that the bronchoconstriction induced by alcoholic beverages is related to their ethanol content and may be related to formation or release of one or more bronchoconstrictor and vasoactive compounds, including a stimulant of histamine1-receptors. The route of ethanol administration may also influence the bronchospastic response.- - - - - - - - - - ranking = 0.067504919210839keywords = content (Clic here for more details about this article) |
8/8. Aspiration of activated charcoal and gastric contents.A case of aspiration of activated charcoal and gastric contents is reported. The patient developed immediate airway obstruction treated by endotracheal intubation and suctioning. Protracted respiratory insufficiency characterized by severe bronchospasm developed after airway obstruction was alleviated.- - - - - - - - - - ranking = 2505.9674935218keywords = gastric content, aspiration, content (Clic here for more details about this article) |