Airway lesions caused by prolonged intubation with standard and with anatomically shaped tracheal tubes. A post‐mortem study

Eckerbom, B.; Lindholm, Carl‐Eric; Alexopoulos, C.

doi:10.1111/j.1399-6576.1986.tb02432.x

Cited by 18 publications

(8 citation statements)

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“…Airway epithelia can be injured by direct mechanical trauma, a defect in mucociliary clearance mechanism, damage as the result of exposure to toxic substances, or migrating inflammatory cells [7,8,10,17,19]. Inhaled noninfectious toxic materials generally exert their toxic effects on the pulmonary epithelium through direct action on the cell membrane, immunologic mediators, or inhibition of metabolic pathways [6,11,20].…”

Section: Introductionmentioning

confidence: 99%

Cellular sequence of tracheal repair in sheep after smoke inhalation injury

Barrow

Wang

Cox

et al. 1992

Lung

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The cellular repair process of injured tracheal epithelium is described for sheep after exposure to toxic smoke containing high concentrations of acrolein. Fourteen fasted 3-4-year-old ewes had a portion of their cervical trachea exposed to cotton smoke for 20 min and then were sacrificed at various time intervals ranging from 1 to 22 days after exposure. Within 1 day of injury, columnar epithelium sloughed intact from the trachea with a concomitant reduction of nearly 35% in the basal cell population. At 2 days of recovery, the cellularity of the epithelium had increased and mitotic figures were observed in some tracheal epithelial and gland cells. By 8 days, undifferentiated hyperplastic cells increased to 30/100 microns, differentiated nonciliated columnar cells first appeared, and the basal cell population returned to a normal count of 13 cells/100 microns. Thirteen days after exposure, the undifferentiated hyperplastic cell population had declined to 7 cells/100 microns, nonciliated columnar cells were at control values, and some ciliated cells were identified. At 18 and 22 days, epithelium was normal in appearance and the count was 13 cells/100 microns. Data suggest that because the columnar epithelium sloughs intact with the cilia remaining active, toxic smoke may affect their attachment to the basal lamina. Furthermore, the regeneration process involves differentiation of hyperplastic cells in which they elongate down to the basal lamina, thus re-establishing the integrity of tall epithelium in the sheep trachea.

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Section: Introductionmentioning

confidence: 99%

Cellular sequence of tracheal repair in sheep after smoke inhalation injury

Barrow

Wang

Cox

et al. 1992

Lung

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“…The principal cause of modification in zone H is the structural change in the head as a function of body position. This influence has already BRITISH JOURNAL OF ANAESTHESIA been reported by Alexopoulos and his colleagues in their work on a new intubation device [8][9][10][11][12][13]. The changes in cervicocephalic angle imply significant deformations in the pharyngolaryngeal structures.…”

Section: Discussionmentioning

confidence: 74%

Mathematical Analysis of the Upper Respiratory Tract From an Anthropometric Study

Janvier

Bordenave

Revel

et al. 1993

British Journal of Anaesthesia

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In order to design a new, performed tracheal tube adapted to the shape of the upper respiratory tract, we have undertaken an anthropometric study from lateral x-rays of the neck in 130 patients with the head in a fixed position. In order to assess different clinical situations, we studied three groups of patients: group 1 = sitting, no tracheal tube; group 2 = supine, no tracheal tube; group 3 = supine, trachea intubated. We defined a standard coordinate system and determined mathematical curves for segments of the upper respiratory tract by a polynomial regression method. With these data it was possible to study the effects of physiological variations on the shape of the curves. It was then possible to determine at which region changes occur and the factors influencing these changes. We found that the relative position of the larynx was constant, whereas the hypopharynx exhibited the greatest change with the position of the head. These observations should allow us to construct a new, performed tracheal tube with elastic compliance properties to fit the changes occurring in the region of the hypopharynx.

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“…A previously described standardized grading scale was used (Table 1) [6,14]. After this examination, transverse serial sections were made from the fixed specimens and the sections were stained with hematoxylin and eosin.…”

Section: Evaluation Of Laryngotracheal Damagementioning

confidence: 99%