Plasma Surface Modification of the Inner Wall of Montgomery's Tracheal Implant (T-Tube).

Tracheal stenosis (i.e., the abnormal narrowing of the trachea) can occur due to a variety of inflammatory and infectious processes as well as due to therapeutic procedures undertaken by the patient.

Bio-Inspired Magnetically Responsive Silicone Cilia: Fabrication Strategy and Interaction with Biological Mucus.

Cilia are biological structures essential to drive the mobility of secretions and maintain the proper function of the respiratory airways. However, this motile self-cleaning process is significantly compromised in the presence of silicone tracheal prosthesis, leading to biofilm growth and impeding effective treatment. To address this challenge and enhance the performance of these devices, we propose the fabrication of magnetic silicone cilia, with the prospect of their integration onto silicone prostheses.

Brazilian airway surgery survey indicates low overall numbers and need for improved teaching skills.

Objectives: The Brazilian Society of Thoracic Surgeons conducted an online survey to determine the number of surgeons that perform adult and paediatric airway surgery and to understand the practice patterns along the country.

Methods: Active members were electronically invited to complete the questionnaire through the REDCapR platform. Invitations were sent from January to April 2020.

Decannulation: a retrospective cohort study of clinical and swallowing indicators of success.

Objective: To investigate the clinical and swallowing indicators related to a successful decannulation process during the hospital stay.

Methods: A retrospective cohort clinical study. The study sample comprised a heterogeneous patient population who had submitted to a tracheostomy procedure in a tertiary hospital.

Characteristics of postintubation dysphagia in ICU patients in the context of the COVID-19 outbreak: A report of 920 cases from a Brazilian reference center.

The purpose of this research was to identify risk factors that were independently related to the maintenance of a swallowing dysfunction in patients affected by critical COVID-19. We conducted a prospective observational cohort study of critical patients with COVID-19, who were admitted to a COVID-19 dedicated intensive care unit (ICU) and required prolonged orotracheal intubation (≥48 hours). Demographic and clinical data were collected at ICU admission and/or at hospital discharge or in-hospital death.

Treatment of tracheal stenosis with extracorporeal membrane oxygenation support in infants and newborns.

Tracheal stenosis in children is a challenge for the healthcare team, since it is a rare disease. Patients usually have other clinical comorbidities, mainly previous cardiac surgical interventions. This retrospective single-center study included infants with tracheal stenosis (congenital or acquired) operated between 2016 and 2020 on venoarterial extracorporeal membrane oxygenation (VA ECMO).

Early complications in flexible bronchoscopy at a university hospital.

Objective: To analyze the complications related to flexible bronchoscopy (FB) and its collection procedures in outpatients and inpatients with various lung and airway diseases treated at a university hospital.

Methods: This was a retrospective analysis of complications occurring during or within 2 h after FB performed between January of 2012 and December of 2013, as recorded in the database of the respiratory endoscopy department of a hospital complex in the city of São Paulo, Brazil.

Results: We analyzed 3,473 FBs.

Impact of gastroesophageal reflux in the pathogenesis of tracheal stenosis.

Benign airway stenosis is a multifactorial and heterogeneous disease often occurring after tracheal intubation. Despite the frequent finding of pathological gastroesophageal reflux (GER) in benign tracheal stenosis, the cause-and-effect relationship between these two entities and its impact on the outcome of the stenosis itself have not been established. The altered ventilatory dynamics caused by an increased thoracoabdominal pressure gradient in such patients has been proposed as a central cause.

An in vivo image acquisition system for the evaluation of tracheal mechanics in rats.

Mechanical evaluation of tracheal grafts is of great relevance for transplant research. Although there are some publications demonstrating different techniques of tracheal mechanical evaluation, there is still no definitive or preferred protocol available. Here, we present a simple image processing acquisition system that can be used for in vivo experiments.

Posterior laryngofissure using a surgical contact diode laser: an experimental feasibility study.

To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15-20 kg) were anesthetized, intubated, ventilated, and submitted to a cervical tracheostomy. An anterior and posterior midline longitudinal laryngofissure incision was created according to randomization-control (n = 4), posterior laryngofissure with a scalpel blade; electrocautery (n = 12), posterior laryngofissure by electrocautery (10, 15, 20, 25 W powers); CDL (n = 12), posterior laryngofissure by the CDL (10, 15, 20, 25 W peak powers in pulsed mode).

Health-related quality of life evaluation in patients with non-surgical benign tracheal stenosis.

Background: The primary objective of the study was to evaluate the health-related quality of life (HRQL) of patients with benign post-intubation tracheal stenosis considered as unfit for surgical treatment. Secondary objectives were: (I) to determine if clinical variables (gender, age, total treatment time, and type of tracheal device) could influence HRQL and (II) to compare the results with a normal standardized population.

Methods: Prospective study between August-2014 and December-2016 including patients with tracheal stenosis treated with silicone stents, T-Tubes or tracheostomy.

Surgery for intrathoracic tracheoesophageal and bronchoesophageal fistula.

Benign tracheoesophageal fistula (TEF) results from an abnormal communication between the posterior wall of the trachea or bronchi and the adjacent anterior wall of the esophagus. It can be acquired or congenital. The onset of the TEF has a negative impact on the patient's health status and quality of life because of swallowing difficulties, recurrent aspiration pneumonia, and severe weight loss.

A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE).

Rationale: This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 months.

Objectives: To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe.

Methods: Subjects were enrolled with a 2:1 randomization (EBV/standard of care [SoC]) at 24 sites.

Prophylaxis and Treatment of Complications After Tracheal Resection.

Tracheal resections are major surgical procedures with a complication rate as high as 44%. Early detection of complications followed by a structured and expedited course of action is critical for achieving a successful outcome. The prevention of complications after tracheal resection starts with a correct indication for resection.

Esophageal Manometry and Regional Transpulmonary Pressure in Lung Injury.

Rationale: Esophageal manometry is the clinically available method to estimate pleural pressure, thus enabling calculation of transpulmonary pressure (Pl). However, many concerns make it uncertain in which lung region esophageal manometry reflects local Pl.

Objectives: To determine the accuracy of esophageal pressure (Pes) and in which regions esophageal manometry reflects pleural pressure (Ppl) and Pl; to assess whether lung stress in nondependent regions can be estimated at end-inspiration from Pl.

Use of MDCT to Assess the Results of Bronchial Thermoplasty.

Objective: The purpose of this study was to evaluate the use of MDCT to assess response to bronchial thermoplasty treatment for severe persistent asthma.

Materials And Methods: MDCT data from 26 patients with severe persistent asthma who underwent imaging before and after bronchial thermoplasty were analyzed retrospectively. Changes in the following parameters were assessed: total lung volume, mean lung density, airway wall thickness, CT air trapping index (attenuation < -856 HU), and expiratory-inspiratory ratio of mean lung density (E/I index).

Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions.

Objective:: Conventional bronchoscopy has a low diagnostic yield for peripheral pulmonary lesions. Radial-probe EBUS employs a rotating ultrasound transducer at the end of a probe that is passed through the working channel of the bronchoscope. Radial-probe EBUS facilitates the localization of peripheral pulmonary nodules, thus increasing the diagnostic yield.