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Zahava C Farkas, Sevak Keshishyan, Raja Chandra Chakinala, Shalom Frager, Faisal Saeed, Yasmin Yusuf, Chaitanya Shilagani, Roxana Bodin, Kassem Harris, Wilbert S Aronow
Bronchopulmonary involvement is a rare but well documented extraintestinal manifestation of inflammatory bowel disease (IBD). IBD-related pulmonary disease can range from subglottic stenosis to tracheobronchitis to interstitial lung disease and is often misdiagnosed on initial presentation. We present a case of tracheobronchitis with stridor in a 23-year-old-woman with well controlled ulcerative colitis (UC).
November 2018: Annals of Translational Medicine
Guillaume Millot, Pauline Boddaert, Erika Parmentier-Decrucq, Aurore Palud, Malika Balduyck, Patrice Maboudou, Farid Zerimech, Frédéric Wallet, Sébastien Preau, Saad Nseir
Background: Microaspiration is a major factor in ventilator-associated pneumonia (VAP) pathophysiology. Subglottic secretion drainage (SSD) aims at reducing its incidence. Methods: Single-center prospective observational study, performed in a French intensive care unit (ICU) from March 2012 to April 2013, including adult patients mechanically ventilated for at least 24 hours divided in two groups: patients in the SSD group intubated using tracheal tubes allowing SSD and patients in the control group intubated with standard tracheal tubes...
November 2018: Annals of Translational Medicine
Rosanna Vaschetto, Federico Longhini, Paolo Persona, Carlo Ori, Giulia Stefani, Songqiao Liu, Yang Yi, Weihua Lu, Tao Yu, Xiaoming Luo, Rui Tang, Maoqin Li, Jiaqiong Li, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Zhaochen Jin, Jun Yan, Ruiqiang Zheng, Jingjing Yin, Stefania Guido, Francesco Della Corte, Tiziano Fontana, Cesare Gregoretti, Andrea Cortegiani, Antonino Giarratano, Claudia Montagnini, Silvio Cavuto, Haibo Qiu, Paolo Navalesi
PURPOSE: Noninvasive ventilation (NIV) may facilitate withdrawal of invasive mechanical ventilation (i-MV) and shorten intensive care unit (ICU) length of stay (LOS) in hypercapnic patients, while data are lacking on hypoxemic patients. We aim to determine whether NIV after early extubation reduces the duration of i-MV and ICU LOS in patients recovering from hypoxemic acute respiratory failure. METHODS: Highly selected non-hypercapnic hypoxemic patients were randomly assigned to receive NIV after early or standard extubation...
December 10, 2018: Intensive Care Medicine
Alberto Romero-Palacios, Oliva Mera Gallardo, Patricia Jiménez Aguilar, José Javier Borrallo Torrejón, Carmen Maza Ortega, Manuel A Rodriguez-Iglesias
BACKGROUND: Aspergillus tracheobronchitis (ATB) is an uncommon type of invasive pulmonary aspergillosis in which fungal involvement is limited to the tracheobronchial tree. While the more severe forms, such as pseudomembranous and ulcerative ATB, occur almost exclusively in immunocompromised patients, the milder obstructive form may occur in patients without immune deficiency. CASE REPORT: The case of a 32 year-old man with no previous history of illness, who was evaluated for recurrent right lower lobe pneumonia, is presented...
November 29, 2018: Revista Iberoamericana de Micología
Yolanda Peña-López, Sergio Ramirez-Estrada, Vandana Kalwaje Eshwara, Jordi Rello
Intubation is required to maintain the airways in comatose patients and enhance oxygenation in hypoxemic or ventilation in hypercapnic subjects. Recently, the Centers of Disease Control (CDC) created new surveillance definitions designed to identify complications associated with poor outcomes. Areas covered: The new framework proposed by CDC, Ventilator-Associated Events (VAE), has a range of definitions encompassing Ventilator-Associated Conditions (VAC), Infection-related Ventilator-Associated Complications (IVAC), or Possible Ventilator-Associated Pneumonia - suggesting replacing the traditional definitions of Ventilator-Associated Tracheobronchitis (VAT) and Ventilator-Associated Pneumonia (VAP)...
November 21, 2018: Expert Review of Respiratory Medicine
Fernando da Silveira, Wagner Luis Nedel, Renato Cassol, Patricia Reis Pereira, Caroline Deutschendorf, Thiago Lisboa
INTRODUCTION: Acinetobacter species treatment often represents a challenge. The main objective of this study is identify predictors of ICU mortality in patients submitted to mechanical ventilation (MV). MATERIALS AND METHODS: Retrospective cohort study. Patients with MV > 48 h who developed a respiratory tract positive culture for Acinetobacter were included, and distinguished among colonized, ventilator-associated pneumonia (VAP) or ventilator-associated tracheobronchitis (VAT) patients...
February 2019: Journal of Critical Care
M L Cantón-Bulnes, J Garnacho-Montero
Lower respiratory tract infections in the intubated patient constitute a serious health problem due to their associated morbidity and mortality. Microaspiration of the buccopharyngeal secretions is the main physiopathological mechanism underlying the development of pneumonia and tracheobronchitis in intubated patients. All care bundles designed to prevent these infections include the use of antiseptics to reduce buccopharyngeal colonization. Chlorhexidine is the antiseptic most frequently assessed in clinical trials and meta-analyses that conclude that oral hygiene with chlorhexidine reduces the incidence of ventilator-associated pneumonia - maximum effectiveness being achieved when the product is administered at a concentration of 2%...
November 2, 2018: Medicina Intensiva
Sean Keane, Maria Sole Vallecoccia, Saad Nseir, Ignacio Martin-Loeches
Ventilator-associated tracheobronchitis (VAT) might represent an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia (VAP), or even a less severe spectrum of VAP. There is an urgent need for new concepts in the arena of ventilator-associated lower respiratory tract infections. Ideally, the gold standard of care is based on prevention rather than treatment of respiratory infection. However, despite numerous and sometimes imaginative efforts to validate the benefit of these measures, most clinicians now accept that currently available measures have failed to eradicate VAP...
December 2018: Clinics in Chest Medicine
Suela Demiri, Christine Lorut, Antoine Rabbat, Daniel Luu van Lang, Aurelie Lefebvre, Jean-François Regnard, Charles-Marc Samama, Daniel Dusser, Nicolas Roche, Marco Alifano
Chronic obstructive pulmonary disease (COPD) is a risk factor of post-operative complications after lung cancer resection. The influence of the "frequent exacerbator (FE)" phenotype (at least three exacerbations per year) is unknown. Postoperative outcomes of frequent exacerbators (POFE) was a prospective observational study of patients with COPD undergoing lung resection for cancer. The inclusion criteria were: age >40 years, FEV1/FVC <70%, non-urgent surgery for lung cancer, filled out self-questionnaires...
October 30, 2018: COPD
Luis Coelho, Ligia Rabello, Jorge Salluh, Ignacio Martin-Loeches, Alejandro Rodriguez, Saad Nseir, José Andrade Gomes, Pedro Povoa
PURPOSE: Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. METHODS: Pre-planned analysis of the prospective multinational TAVeM database, performed on 2960 patients receiving mechanical ventilation for >48 h, including 689 patients with VA-LRTI...
December 2018: Journal of Critical Care
Itzhak Brook
BACKGROUND: Laryngectomees run the risk of developing severe respiratory tract infections especially during the winter and when they do not wear a stoma cover. A case of severe tracheobronchitis in a laryngectomee is presented that illustrates the risks and difficulties encountered in managing this infection in a neck breather. CASE PRESENTATION: A 76-year-old Caucasian man, a laryngectomee, presented with bacterial tracheobronchitis and conjunctivitis due to beta-lactamase-producing nontypeable Haemophilus influenzae...
August 20, 2018: Journal of Medical Case Reports
Saeko Takahashi, Morio Nakamura
No abstract text is available yet for this article.
October 2018: Infection
Sergio Ramírez-Estrada, Leonel Lagunes, Yolanda Peña-López, Amir Vahedian-Azimi, Saad Nseir, Kostoula Arvaniti, Aliye Bastug, Izarne Totorika, Nefise Oztoprak, Lilla Bouadma, Despoina Koulenti, Jordi Rello
PURPOSE: To analyze the impact on patient outcome of ventilator-associated events (VAEs) as defined by the Centers for Disease Control and Prevention (CDC) in 2008, 2013, and the correlation with ventilator-associated pneumonia (VAP) or tracheobronchitis (VAT). METHODS: This was a prospective, observational, multicenter, international study conducted at 13 intensive care units (ICUs); thirty consecutive adults mechanically ventilated for ≥ 48 h per site were eligible, with daily follow-up being recorded in a collaborative web database; VAEs were assessed using the 2013 CDC classification and its 2015 update...
July 12, 2018: Intensive Care Medicine
Cornelia Lass-Flörl
The Aspergillus terreus species complex is found in a wide variety of habitats, and the spectrum of diseases caused covers allergic bronchopulmonary aspergillosis, Aspergillus bronchitis and/or tracheobronchitis, and invasive and disseminated aspergillosis. Invasive infections are a significant cause of morbidity and mortality mainly in patients with hematological malignancy. The section Terrei covers a total of 16 accepted species of which most are amphotericin B resistant. Triazoles are the preferred agents for treatment and prevention of invasive aspergillosis...
July 9, 2018: Journal of Fungi (Basel, Switzerland)
Andrés Martín-Aspas, Francisca M Guerrero-Sánchez, Francisco García-Colchero, Sebastián Rodríguez-Roca, José-Antonio Girón-González
Objectives: The objectives of this study were to detect those characteristics that were specifically associated with infection or colonization by Acinetobacter baumannii , describe the clinical manifestations of those patients in whom the infection was detected in intensive care unit (ICU) or non-ICU wards, and analyze the prognosis-associated factors in patients from whom A. baumannii was isolated. Patients and methods: A sample of 122 patients from whom A. baumannii was recovered during an endemic period in a teaching hospital was included...
2018: Infection and Drug Resistance
Pradeep Vaideeswar, Supreet P Marathe
Nosocomial infection is a feared complication after any surgical procedure. Respiratory tract microbial colonization and development of ventilator-associated tracheobronchitis and/or pneumonia are unfortunate sequelae in mechanically ventilated patients, commonly caused by bacteria; viral etiology is seldom anticipated. We present a fatal case of fulminant herpetic tracheobronchitis in a 33-month-old patient following cardiac surgery. We intend to highlight the fact that herpetic viral etiology should be considered in post-operative respiratory infections...
May 25, 2018: Journal of Tropical Pediatrics
Abel Eduardo Alves, José Manuel Pereira
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...
March 2018: Revista Brasileira de Terapia Intensiva
Fernando G Zampieri, Pedro Póvoa, Jorge I Salluh, Alejandro Rodriguez, Sandrine Valade, José Andrade Gomes, Jean Reignier, Elena Molinos, Jordi Almirall, Nicolas Boussekey, Lorenzo Socias, Paula Ramirez, William N Viana, Anahita Rouzé, Saad Nseir, Ignacio Martin-Loeches
OBJECTIVE: To assess whether ventilator-associated lower respiratory tract infections (VA-LRTIs) are associated with mortality in critically ill patients with acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS: Post hoc analysis of prospective cohort study including mechanically ventilated patients from a multicenter prospective observational study (TAVeM study); VA-LRTI was defined as either ventilator-associated tracheobronchitis (VAT) or ventilator-associated pneumonia (VAP) based on clinical criteria and microbiological confirmation...
January 1, 2018: Journal of Intensive Care Medicine
Gnanaguru Vijay, Anirban Mandal, Jhuma Sankar, Arti Kapil, Rakesh Lodha, S K Kabra
OBJECTIVES: To study the incidence, etiology and risk factors associated with ventilator associated pneumonia (VAP) in children. METHODS: This prospective cohort study was conducted on patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary care institute of North India, from June 2012 through March 2014, who received mechanical ventilation for more than 24 h. All enrolled children were assessed daily for development of ventilator associated pneumonia (VAP) using the case definition given by Centers for Disease Control and Prevention (CDC)...
October 2018: Indian Journal of Pediatrics
Vu Quoc Dat, Ronald B Geskus, Marcel Wolbers, Huynh Thi Loan, Lam Minh Yen, Nguyen Thien Binh, Le Thanh Chien, Nguyen Thi Hoang Mai, Nguyen Hoan Phu, Nguyen Phu Huong Lan, Nguyen Van Hao, Hoang Bao Long, Tran Phuong Thuy, Nguyen Van Kinh, Nguyen Vu Trung, Vu Dinh Phu, Nguyen Trung Cap, Dao Tuyet Trinh, James Campbell, Evelyne Kestelyn, Heiman F L Wertheim, Duncan Wyncoll, Guy Edward Thwaites, H Rogier van Doorn, C Louise Thwaites, Behzad Nadjm
BACKGROUND: Ventilator-associated respiratory infection (VARI) comprises ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). Although their diagnostic criteria vary, together these are the most common hospital-acquired infections in intensive care units (ICUs) worldwide, responsible for a large proportion of antibiotic use within ICUs. Evidence-based strategies for the prevention of VARI in resource-limited settings are lacking. Preventing the leakage of oropharyngeal secretions into the lung using continuous endotracheal cuff pressure control is a promising strategy...
April 4, 2018: Trials
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