Estimated carbon emissions and support cost savings to telemedicine for patients with tracheal diseases.

Objective: The patient's journey to the medical center for an outpatient visit can often mean hours of travel in their vehicle, leading to increased expenses and greater carbon dioxide (CO2) emissions into the environment. The study demonstrates the estimated carbon emission and cost savings associated with a telemedicine program dedicated to patients with tracheal disease in the Brazilian public health system.

Methods: Cross-sectional study of telemedicine visits for patients with tracheal disease referred to a public academic hospital between August 1, 2020, and December 30, 2023.

Comparison between contact diode laser with 980 nm and 1470 nm wavelengths for posterior laryngofissure in pigs.

To compare two different wavelengths of the surgical contact diode laser (CDL) for producing a posterior laryngofissure in in-vivo pigs. Anesthetized pigs underwent a tracheostomy and an anterior laryngofissure through a cervicotomy. They were randomly selected for the CDL wavelength and Power, according to the peak of Power set at device (980nm wavelength: Ppeak power of 10 W, 15 W, and 20 W, or 1470 nm wavelength: Ppeak 3 W, 5 W, 7 W, 10 W).

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.

Cold Atmospheric Helium Plasma in the Post-COVID-19 Era: A Promising Tool for the Disinfection of Silicone Endotracheal Prostheses.

Despite the excellent properties of silicone endotracheal prostheses, their main limitation is the formation of a polymicrobial biofilm on their surfaces. It can cause local inflammation, interfering with the local healing process and leading to further complications in the clinical scenario. The present study evaluated the inhibitory effect of cold atmospheric plasma (CAP) on multispecies biofilms grown on the silicone protheses' surfaces.

Evaluation of Structural Viability of Porcine Tracheal Scaffolds after 3 and 6 Months of Storage under Three Different Protocols.

Tracheal replacement with a bioengineered tracheal substitute has been developed for long-segment tracheal diseases. The decellularized tracheal scaffold is an alternative for cell seeding. It is not defined if the storage scaffold produces changes in the scaffold's biomechanical properties.

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.

Robotic Lung Volume Reduction Surgery With Extracorporeal Membrane Oxygenation.

Lobectomy for consolidation of failed endoscopic lung volume reduction for emphysema has been reported in selected patients with favorable results but with considerable morbidity. The challenging issues in such patients are frailty caused by severe emphysema itself, poor tolerance to single-lung ventilation, target lobe hyperinflation, and inability to use gas inflation for the minimally invasive resection. Careful planning, including use of a robotic platform and extracorporeal membrane oxygenation support, can circumvent such difficulties and ensure a safe, minimally invasive resection in the high-risk emphysematous patient.

Hybrid Desobstruction of Blind-end Subglottic Stenosis With Long-term Stenting.

Blind-end stenosis (Myer-Cotton IV) is an extreme response to airway injury, resulting in phonatory ablation and dependence on a tracheostomy. A minimally invasive airway desobstruction and stenting can be beneficial in such cases. We present 2 cases of Myer-Cotton IV stenosis that were treated with a minimally invasive desobstruction using a hybrid (endoscopic-surgical) approach followed by the placement of a silicone T-tube.

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.

Impact of fundoplication for gastroesophageal reflux in the outcome of benign tracheal stenosis.

Objective: This study focuses on the impact of antireflux surgery in the outcome of tracheal stenosis.

Methods: We performed a retrospective study including patients with benign tracheal stenosis who underwent esophageal manometry and dual-probe 24-hour ambulatory esophageal pH study. Patients with an abnormal pH study were managed with laparoscopic modified Nissen fundoplication or medically (omeprazole 80 mg/d, orally).

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.

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.