During a 2-year period, 7 children were seen with a severe form of laryngotracheobronchitis associated with sloughing of the respiratory epithelium and profuse mucopurulent secretions. We have called this condition pseudomembranous croup. The children had severe upper airways obstruction, appeared toxic with high fever, and were older than the typical age group for viral laryngotracheobronchiti...

BACKGROUND Ventilator-associated pneumonia is a common cause of morbidity in critically ill patients. Interventions beneficial to the prevention of ventilator-associated pneumonia would therefore have a significant impact on the care of these patients. PURPOSE To perform a literature review and synthesis of methods for prevention of ventilator-associated pneumonia. DATA SOURCES MEDLINE (196...

BACKGROUND Tracheobronchopathia osteochondroplastica is a rare benign and often indolent disease. We report the first case of tracheobronchopathia osteochondroplastica (TBO) presenting as acute hypercarbic respiratory failure due to superimposed subglottic submucosal abscess. CASE REPORT A 27-year-old man presented to the emergency department in respiratory distress that required mechanical v...

BACKGROUND Critically ill patients under mechanical ventilation require frequent suctioning of airway secretion. Closed suction permits suctioning without disconnection from ventilator; so it might decrease hypoxemia and infection rate. OBJECTIVES This study aimed to evaluate the effect of closed tracheal suction system (CTSS) versus open tracheal suction system (OTSS). PATIENTS AND METHODS...

Ventilator-associated pneumonia is common, difficult to diagnose, affects the most vulnerable of patients and carries a high mortality. During prolonged mechanical ventilation the oropharynx, sinuses, dentition and stomach of critically ill patients become colonised with pathogenic bacteria. Colonised secretions pool in the oropharynx and subglottic space. These secretions repeatedly gain acces...

PURPOSE OF REVIEW Ventilator-associated pneumonia (VAP) remains a frequent and severe complication in endotracheally intubated patients. Strict adherence to preventive measures reduces the risk of VAP. The objective of this paper is to review what has come forward in recent years in the nonpharmacological prevention of VAP. RECENT FINDINGS It seems advantageous to implement care bundles rathe...

OBJECTIVE To evaluate knowledge of nurses working in Yemen intensive care units (ICUs) on evidence-based strategies for preventing ventilator-associated pneumonia (VAP), and to determine if there is any association between certain nurses` as well as workplaces` characteristics and the knowledge scores of nurses. METHODS A descriptive cross-sectional survey was carried out in 37 ICUs of 23 hos...

because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of pneumonia, improved design of tracheal tubes with new cuff material and shape have reduced the size and number of folds, which together with the addition of suction ports above the cuff to drain pooled subglottic secretions leads to reduced aspiratio...

A series of sixty-one cases of prolonged pernasal intubation in children for conditions which would otherwise need tracheostomy is presented. One serious complication, namely subglottic cicatricial stenosis of the trachea, has occurred and is discussed. There is a definite place for prolonged pernasal intubation in children under 5 years of age as an alternative to tracheostomy. The most import...