Local Delivery of Mometasone Furoate from an Eluting Endotracheal Tube Reduces Airway Morbidity Following Long-Term Animal Intubation

2021 ◽  
Author(s):  
Forsan Jahshan ◽  
Aiman Abu Ammar ◽  
Offir Ertracht ◽  
Netanel Eisenbach ◽  
Amani Daoud ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Local Delivery ◽  
Mometasone Furoate

Local delivery of mometasone furoate from an eluting endotracheal tube

2018 ◽  
Vol 272 ◽  
pp. 54-61 ◽  
Author(s):  
Aiman Abu Ammar ◽  
Maayan Gruber ◽  
Patrick Martin ◽  
Ohad Stern ◽  
Forsan Jahshan ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Local Delivery ◽  
Mometasone Furoate

Management of the Extubation Problem in the Premature Child

1980 ◽  
Vol 89 (6) ◽  
pp. 508-511 ◽  
Author(s):  
Robin T. Cotton ◽  
Allan B. Seid
Keyword(s):  
Endotracheal Tube ◽  
Ventilatory Support ◽  
Disease Process ◽  
Upper Respiratory Tract ◽  
Endoscopic Evaluation ◽  
Newborn Period ◽  
Edema Formation ◽  
Premature Child ◽  
Upper Respiratory

Long-term endotracheal intubation is a widely established means of giving ventilatory support in the newborn period. Though such long-term intubation is well tolerated by the premature infant, laryngeal complications do occur and extubation may be impossible even though the initial disease process for which the intubation was performed has resolved. In such a situation, careful endoscopic evaluation of the upper respiratory tract is advocated to identify the site of the problem. If subglottic edema or mucosal ulceration in the subglottic area is the site of the damage and if, during endoscopic evaluation immediately following removal of the endotracheal tube, the subglottic area starts to narrow because of edema formation or edema fluid filling up compressed granulation tissue, then a split of the cricoid in the midline anteriorly, leaving the endotracheal tube in as a stent, appears to be a preferable alternative to performing a tracheotomy. Of 12 consecutive patients, 9 have been successfully extubated.

Endotracheal and Enteric Tubes

Chest Imaging ◽  
2019 ◽  
pp. 35-39
Author(s):  
Tyler H. Ternes
Keyword(s):  
Mechanical Ventilation ◽  
Gas Exchange ◽  
Endotracheal Tube ◽  
Medical Devices ◽  
Esophageal Intubation ◽  
Ideal Position ◽  
Tracheostomy Tubes ◽  
Tube Malposition ◽  
The Ideal

The Endotracheal and Enteric Tubes chapter addresses these frequently used medical devices. An endotracheal tube (ETT) is a catheter placed into the airway for mechanical ventilation. It serves to protect the airway and provide adequate gas exchange. The ideal position of the endotracheal tube tip is approximately 5 cm above the carina. Complications of ETT placement include inadequate ventilation if placed too high or too low, esophageal intubation and tracheal injury. Tracheostomy tubes are used in patients who require long-term intubation. Enteric tubes are thin flexible hollow catheters that course into the stomach and beyond. They may be placed via nasal (nasogastic) or oral (orogastric) approach. When used for suctioning, the ideal position of the tube tip is within the stomach. When used for administration of drugs or nutrition, the tube tip is ideally advanced beyond the pylorus. Enteric tube malposition may be due to coiling within the esophagus or inadvertent malposition within the airway. Malpositioning could result in aspiration, lung injury, and pneumothorax.

Subglottic Ulceration and Healing following Endotracheal Intubation in the Neonate: A Morphometric Study

1992 ◽  
Vol 101 (10) ◽  
pp. 815-820 ◽  
Author(s):  
Stephen J. Gould ◽  
Martin Young
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Ulcer Healing ◽  
Squamous Epithelium ◽  
Subglottic Stenosis ◽  
Acute Injury ◽  
Morphometric Study

In neonates, acquired subglottic stenosis is the most serious long-term complication of endotracheal intubation and is due primarily to posttraumatic fibrosis of the infant larynx. We have examined 78 larynges, 75 of which were intubated, from infants ranging in gestation from 22 to 40 weeks, and who survived from a few hours to up to 300 days. Each larynx was morphometrically assessed for the extent of acute injury, indicated by the percentage of epithelial loss, and healing, indicated by the percentage of a subglottic ulcer covered by metaplastic squamous epithelium. Results show that acute injury is almost invariable, and up to 100% of the subglottic epithelium may be lost within a few hours of intubation, but that progression of injury is relatively short-lived. Ulcer healing starts after a few days, rapidly progresses from day 10, and in the majority of cases is complete after 30 days. This study suggests that long-standing acute injury in the subglottis is the exception rather than the rule, even with the endotracheal tube remaining in place.

Long-term Effects of Different Humidification Systems on Endotracheal Tube Patency

2004 ◽  
Vol 100 (4) ◽  
pp. 782-788 ◽  
Author(s):  
Samir Jaber ◽  
Jérôme Pigeot ◽  
Redouane Fodil ◽  
Salvatore Maggiore ◽  
Alain Harf ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Endotracheal Tube ◽  
Heated Humidifier ◽  
Long Term Effects ◽  
Moisture Exchanger ◽  
Acoustic Reflection ◽  
Heat And Moisture ◽  
The Impact

Background Accumulation of mucous secretions in an endotracheal tube (ETT) increases its resistance, and the amount of deposit may be affected by the quality of humidification and heating of the inspired gas. Methods The authors assessed the impact of two humidification systems, a heated humidifier (HH) and a hygroscopic-hydrophobic heat and moisture exchanger (HME), on the ETT patency in patients selected to require mechanical ventilation for more than 48 h. This comparison was performed over two consecutive periods and used the acoustic reflection method, which characterizes the amount and site of ETT obstruction and allows estimating ETT inner volume and resistance. Measurements were performed three times a week over the period of mechanical ventilation. Comparisons were performed at mid duration and at the end of the mechanical ventilation period. Results The HH was used in 34 patients, and the HME was used in 26 patients. The two groups had similar severity and duration of mechanical ventilation. At mid duration of mechanical ventilation (5.5 +/- 3.3 vs. 4.8 +/- 3.3 days; P = 0.4), no difference was observed in ETT volume and resistance between the two groups. At the end of the study period (10.5 +/- 5.8 vs. 9.6 +/- 6.3 days of mechanical ventilation; P = 0.4), ETT volume was reduced to a greater extent with HME than with HH (-3.3 +/- 2.9 vs. -5.1 +/- 2.5%; P = 0.008), and ETT resistance increased significantly more with the HME than with the HH (8.4 +/- 12.2 vs. 19.4 +/- 17.7%; P = 0.001). Conclusion Prolonged use of humidification systems results in progressive reduction of ETT patency, and to a greater extent with HMEs than with HHs.

Assessment by nasal biopsy of long-term use of mometasone furoate aqueous nasal spray (Nasonex) in the treatment of perennial rhinitis☆☆☆★★★

1998 ◽  
Vol 118 (5) ◽  
pp. 648-654 ◽  
Author(s):  
E. MINSHALL ◽  
O. GHAFFAR ◽  
L. CAMERON ◽  
F. O’BRIEN ◽  
H. QUINN ◽  
...  
Keyword(s):  
Nasal Spray ◽  
Mometasone Furoate ◽  
Perennial Rhinitis ◽  
Nasal Biopsy

Assessment by Nasal Biopsy of Long-Term Use of Mometasone Furoate Aqueous Nasal Spray (Nasonex) in the Treatment of Perennial Rhinitis

1998 ◽  
Vol 118 (5) ◽  
pp. 648-654 ◽  
Author(s):  
E. Minshall ◽  
O. Ghaffar ◽  
L. Cameron ◽  
F. O'Brien ◽  
H. Quinn ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Spray ◽  
Nasal Mucosa ◽  
Squamous Metaplasia ◽  
Mometasone Furoate ◽  
Biopsy Specimens ◽  
Tissue Changes ◽  
Perennial Rhinitis ◽  
Nasal Biopsy

Allergic rhinitis is associated with specific histopathologic changes in the nasal mucosa including squamous metaplasia and local eosinophilia. Previous studies have shown that mometasone furoate aqueous nasal spray is effective and well tolerated in reducing perennial rhinitis and seasonal allergic rhinitis symptoms. We undertook a multicenter, open-label study to evaluate, by nasal biopsy, the tissue changes associated with mometasone furoate use (200 μg/day) during a 12-month treatment period in patients with perennial rhinitis. Of the 69 patients enrolled in the study, 52 completed all 12 months of treatment. Nasal biopsy specimens obtained from patients at baseline and after treatment were evaluated in a blinded fashion by computerized image analysis, qualitative histologic examination, and immunocytochemistry. Morphologic examination of nasal biopsy specimens showed a decrease in focal metaplasia, no change in epithelial thickness, and no sign of atrophy after treatment with mometasone furoate. Immunocytochemical analyses of nasal biopsy specimens obtained before and after treatment revealed a significant decrease in major basic protein-positive eosinophils and tryptase-positive mast cells in the epithelium and lamina propria after treatment. Mometasone furoate appeared to attenuate the inflammatory process by reducing the extent of inflammatory cell infiltration, particularly of eosinophils. This study demonstrated that long-term administration of mometasone furoate is not associated with adverse tissue changes in the nasal mucosa of patients with perennial rhinitis. (Otolaryngol Head Neck Surg 1998;118:648–54.)

Sign in / Sign up

Export Citation Format

Share Document