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Nebulized aminoglycosides for ventilator-associated pneumonia: Methodological considerations and lessons from experimental studies.
J Intensive Med
January 2025
Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona - SGR 911- Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.
View Article and Find Full Text PDFContribution of nebulized budesonide before bronchoscopy, a prospective clinical study.
Postgrad Med J
January 2025
Department of Respiratory and Critical Care Medicine, Tianjin University Chest Hospital, Thoracic Clinical College of Tianjin Medical University, Tianjin Chest Hospital, No. 261 Taier Zhuang Nan Road, Jinnan District, Tianjin 300051, China.
Purpose: This study evaluated the efficacy of adding budesonide to nebulized lidocaine in patients undergoing flexible bronchoscopy (FB) under topical anaesthesia.
Study Design: Patients aged ≥18 years, scheduled for FB under topical anaesthesia were randomized into two groups: the combination group received a pre-treatment of 2 ml 1 mg budesonide with 5 ml 2% lidocaine, whilst the lidocaine group received 5 ml 2% lidocaine with 2 ml saline solution, both administered via nebulization. Blood pressure (BP), heart rate, and percutaneous oxygen saturation were recorded before, during, and 10 min after FB.
Surgical and Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Systematic Review and Network Meta-analysis.
Lung
January 2025
Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Japan.
Article Synopsis
- The systematic review examines surgical and bronchoscopic options for lung volume reduction in patients with severe emphysema, comparing their effectiveness and associated risks.
- It includes data from 25 randomized controlled trials involving over 4,000 patients, revealing that lung volume reduction surgery (LVRS) led to significant improvements in lung function and exercise capacity but also increased mid-term mortality risks.
- The findings suggest that while endobronchial valve (EBV) and endobronchial coil (EBC) procedures showed notable benefits similar to LVRS in lung function improvements, they also carry a higher risk of pneumothorax and slightly increased mortality, highlighting the need for further long-term survival studies for bronchoscopic interventions.
Evaluation of the Adequacy of Using the Supraglottic Airway Device (i-gel®) in Cases With Epiglottic Masses: A Mannequin Simulation Study.
Cureus
November 2024
Anesthesiology and Critical Care, Kindai University Faculty of Medicine, Osaka, JPN.
Background: Epiglottic masses are often asymptomatic, making them difficult to detect during preoperative examinations. Consequently, anesthesiologists may face ventilation difficulties with no apparent cause. Epiglottic masses can sometimes obstruct laryngoscope insertion into the epiglottic vallecula, complicating general anesthesia induction.
View Article and Find Full Text PDFBronchoscopic biopsies - a novel source for primary airway epithelial cells in respiratory research.
Respir Res
December 2024
Department of Pulmonary Medicine, University Medical Center Essen, Ruhrlandklinik, Essen, Germany.
Background: Using primary airway epithelial cells (AEC) is essential to mimic more closely different types and stages of lung disease in humans while reducing or even replacing animal experiments. Access to lung tissue remains limited because these samples are generally obtained from patients who undergo lung transplantation for end-stage lung disease or thoracic surgery for (mostly) lung cancer. We investigated whether forceps or cryo biopsies are a viable alternative source of AEC compared to the conventional technique.
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