scholarly journals The role of bedside ultrasound during tracheal intubation procedure

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
José Luis Vázquez Martínez ◽  
◽  
Rocío Tapia Moreno ◽  
César Pérez-Caballero Macarrón ◽  
Ana Coca Pérez ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Left Lung ◽  
Upper Airway ◽  
Hemodynamic Instability ◽  
Bedside Ultrasound ◽  
Suprasternal Notch ◽  
Notch 3 ◽  
Bronchial Intubation ◽  
Complex Settings

Tracheal intubation in complex settings (i.e. difficult airway, hemodynamic instability) means a challenging procedure [1]. It must be performed very quickly, being obviously essential to confirm the adequate positioning of the tube tip as soon as possible. Capnography is the most recommended tool in spite proper evaluation also includes clinical exam and X-ray, which implies some delay [2]. When capnography is not available and/ or misleading readings are present, bedside ultrasound can be extremely useful. The T.R.U.E. (Tracheal Rapid Ultrasound Exam) protocol consists on performing transverse bedside upper airway ultrasonography, by placing a linear transducer over the suprasternal notch [3]. At this level, tracheal and oesophagus are easily identified. In case of unnoticed oesophageal intubation, a gas art fact emerges in the oesophagus lumen. To definitively confirm the optimal tracheal tube position, regardless the absence of oesophageal gas artifact, left lung sliding must be checked in order to rule in/out a selective bronchial intubation.

scholarly journals Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review

2021 ◽  
Vol 22 (5) ◽  
pp. 2627
Author(s):  
Francisco Galeano-Valle ◽  
Lucía Ordieres-Ortega ◽  
Crhistian Mario Oblitas ◽  
Jorge del-Toro-Cervera ◽  
Luis Alvarez-Sala-Walther ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Risk Stratification ◽  
Hemodynamic Instability ◽  
Inflammatory Biomarkers ◽  
Right Ventricle Dysfunction ◽  
Reactive Protein ◽  
Cancer Associated Thrombosis ◽  
The Relationship ◽  
Acute Pe

The relationship between inflammation and venous thrombosis is not well understood. An inflammatory response may be both the cause and consequence of venous thromboembolism (VTE). In fact, several risk factors of VTE modulate thrombosis through inflammatory markers. Acute pulmonary embolism (PE) is burdened by a remarkable mortality rate, up to 34% in severely ill patients presenting with hemodynamic instability. Initial mortality risk stratification is based on hemodynamic instability. Patients with a situation of hemodynamic stability require immediate further risk assessment based on clinical, imaging, and circulating biomarkers, as well as the presence of comorbidities. Some inflammatory biomarkers have shown potential usefulness in the risk stratification of patients with VTE, especially acute PE. C-reactive protein on admission is associated with 30-day mortality and bleeding in VTE patients. P-selectin is associated with right ventricle dysfunction in PE patients and might be associated with VTE recurrences and the extension of thrombosis. Tissue factor microparticles are associated with VTE recurrence in cancer-associated thrombosis. Other inflammatory biomarkers present scarce evidence (inflammatory cytokines, erythrocyte sedimentation rate, fibrinogen, leukocyte count). In this manuscript, we will review the prognostic role of different inflammatory biomarkers available both for clinical practice and research in VTE patients.

scholarly journals Computed tomographic evaluation of the role of craniofacial and upper airway morphology in obstructive sleep apnea in Chinese

2004 ◽  
Vol 98 (4) ◽  
pp. 301-307 ◽  
Author(s):  
Bing Lam ◽  
Clara G.C Ooi ◽  
Wilfred C.G Peh ◽  
I Lauder ◽  
Kenneth W.T Tsang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Computed Tomographic ◽  
Obstructive Sleep ◽  
Airway Morphology

The Role of Vascular Tone in the Control of Upper Airway Collapsibility

1990 ◽  
Vol 141 (6) ◽  
pp. 1569-1577 ◽  
Author(s):  
Michael J. Wasicko ◽  
Douglas A. Hutt ◽  
Richard A. Parisi ◽  
Judith A. Neubauer ◽  
Reuben Mezrich ◽  
...  
Keyword(s):  
Vascular Tone ◽  
Upper Airway ◽  
Airway Collapsibility ◽  
Upper Airway Collapsibility

Sleep and Violence*

1984 ◽  
Vol 29 (2) ◽  
pp. 132-134 ◽  
Author(s):  
L.B. Raschka
Keyword(s):  
Differential Diagnosis ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Upper Airway ◽  
Violent Behaviour ◽  
Car Accidents ◽  
Prevention And Treatment ◽  
Respiratory Pathology ◽  
The Brain

Most violence connected with sleep disorder is assumed to be related to sleep walking. It is less well known that other sleep disorders can also give rise to violence. The role of narcolepsy in car accidents is mentioned. Sleep drunkenness can lead to confusion resulting in violent behaviour especially on forced awakening. This condition is associated to sleep apnea. Primary or central sleep apnea is caused by disorders of the brain stem affecting the respiratory center. Secondary or upper airway sleep apnea can be caused by virtually any condition that results in cessation of the airflow due to occlusion of the upper airway. The author describes one patient who engaged in assaultive behaviour on forced awakening following earlier alcohol consumption. The pathomechanism of violent behaviour generated by a combination of sleep apnea and respiratory pathology is described. The differential diagnosis, prevention and treatment is outlined. The use of polysomnography in diagnosis and the potentially dangerous effects of drugs with respiratory depressing effects is highlighted.

scholarly journals Role of Taste Receptors as Sentinels of Innate Immunity in the Upper Airway

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Neil N. Patel ◽  
Alan D. Workman ◽  
Noam A. Cohen
Keyword(s):  
Airway Epithelium ◽  
Taste Receptor ◽  
Upper Airway ◽  
Airway Disease ◽  
G Protein Coupled Receptors ◽  
Innate Immune ◽  
Taste Receptors ◽  
Taste Sensation ◽  
G Protein Coupled

Evidence is emerging that shows taste receptors serve functions outside of taste sensation of the tongue. Taste receptors have been found in tissue across the human body, including the gastrointestinal tract, bladder, brain, and airway. These extraoral taste receptors appear to be important in modulating the innate immune response through detection of pathogens. This review discusses taste receptor signaling, focusing on the G-protein–coupled receptors that detect bitter and sweet compounds in the upper airway epithelium. Emphasis is given to recent studies which link the physiology of sinonasal taste receptors to clinical manifestation of upper airway disease.

Site-specific sensitization in a murine model of allergic rhinitis: Role of the upper airway in lower airways disease

2002 ◽  
Vol 110 (6) ◽  
pp. 891-898 ◽  
Author(s):  
Christine McCusker ◽  
Martin Chicoine ◽  
Qutayba Hamid ◽  
Bruce Mazer
Keyword(s):  
Allergic Rhinitis ◽  
Murine Model ◽  
Upper Airway ◽  
Site Specific ◽  
Lower Airways

scholarly journals Role of Perioperative TEE in Diagnosing and Management of a Case of Dynamic LVOT Obstruction/SAM

2015 ◽  
Vol 3 (2) ◽  
pp. 58-61
Author(s):  
GD Puri ◽  
V Rajkumar
Keyword(s):  
Transesophageal Echocardiography ◽  
Crucial Role ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hemodynamic Instability ◽  
Left Ventricular ◽  
Systolic Anterior Motion ◽  
Left Ventricular Outflow ◽  
Perioperative Transesophageal Echocardiography

ABSTRACT Systolic anterior motion (SAM) of the mitral leaflets can lead to hemodynamic instability in post bypass period. Perioperative transesophageal echocardiography (TEE) plays a crucial role in the management of SAM. Perioperative echocardiography helps to (a) identify cause of left ventricular outflow tract obstruction, (b) assess SAM and diagnose severity and (c) management of SAM. A case is presented illustrating identification and management of SAM in post bypass period. How to cite this article Kumar A, Rajkumar V, Kumar A, Puri GD. Role of Perioperative TEE in Diagnosing and Management of a Case of Dynamic LVOT Obstruction/SAM. J Perioper Echocardiogr 2015;3(2):58-61.

scholarly journals Role of ROS in ischemia-induced lung angiogenesis

2010 ◽  
Vol 299 (4) ◽  
pp. L535-L541 ◽  
Author(s):  
Julie Nijmeh ◽  
Aigul Moldobaeva ◽  
Elizabeth M. Wagner
Keyword(s):  
Pulmonary Artery ◽  
Left Lung ◽  
Left Pulmonary Artery ◽  
Wild Type ◽  
Systemic Blood Flow ◽  
Artery Ligation ◽  
Underlying Mechanisms ◽  
Pulmonary Artery Obstruction ◽  
Artery Obstruction

Pulmonary artery obstruction and subsequent lung ischemia have been shown to induce systemic angiogenesis despite preservation of normoxia. The underlying mechanisms, however, remain poorly understood. In a mouse model of lung ischemia induced by left pulmonary artery ligation (LPAL), we showed previously, the formation of a new systemic vasculature to the ischemic lung. We hypothesize that LPAL in the mouse increases reactive oxygen species (ROS) production, and these molecules play an initiating role in subsequent lung neovascularization. We used oxidant-sensitive dyes (DHE and H2DCF-DA) to quantify ROS and measured the antioxidant-reduced glutathione (GSH) and its oxidized form (GSSG) as indicators of ROS levels after LPAL. The magnitude of systemic neovascularization was determined by measuring systemic blood flow to the left lung with radiolabeled microspheres 14 days after LPAL. An increase in ROS was observed early (30 min: 55% increase in H2DCF-DA) after LPAL, with a return to baseline by 24 h. GSH/GSSG was decreased (∼50%) 4 h after LPAL, suggesting earlier ROS upregulation. Mice treated with the antioxidant N-acetylcysteine showed attenuated angiogenesis (62% of wild-type LPAL), and mice lacking Nrf2, a transcription factor important for antioxidant synthesis, resulted in increased neovascularization (207% of wild-type LPAL). Overall, GSH/GSSG was inversely associated with the magnitude of neovascularization. These results demonstrate that LPAL induces an early and transient ROS upregulation, and ROS appear to play a role in promoting ischemia-induced angiogenesis.

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