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Avaliação por meio da tomografia computadorizada por feixe cônico de vias aéreas superiores de pacientes com atresia de palato, que possuem mordida cruzada posterior; Evaluation by means of cone beam computed tomography of the upper airways of patients with atresia of the palate, which have posterior crossbite

Hernandez-Zanet, Angelica Maria
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 24/07/2012 Português
Relevância na Pesquisa
56.3%
A atresia do palato ou deficiência maxilar transversa tem comprovado a sua influência na relação craniofacial e respiratória, por isso, diversos métodos de expansão palatina têm sido estudados para que haja uma melhora significativa, principalmente dos fatores respiratórios destes pacientes. O uso da tomografia por feixe cônico iniciou um novo conceito de estudo cefalométrico em terceira dimensão, no qual se consegue avaliar o paciente em todos os planos, sem que haja sobreposições de estruturas, podendo avaliar com precisão as relações craniofaciais, as vias aéreas e a relação destas estruturas. Portanto, o uso da tomografia computadorizada com ênfase na área ortodôntica, nos permite realizar um diagnóstico completo pré-tratamento ortodôntico, no qual objetivamos avaliar a correlação entre mordida cruzada posterior e a obstrução das vias aéreas superiores por meio de tomografia computadorizada por feixe cônico (TCFC). Foram utilizadas TCFC de arquivo de 32 pacientes com idade entre 6 e 14 anos, divididos em dois grupos: um grupo de 16 crianças com mordida cruzada posterior e o grupo controle . O critério de exclusão da amostra foi a realização de tratamento ortodôntico prévio, ter realizado cirurgia no complexo maxilo mandibular ou ser portador de alterações patológicas na região. Foi realizada a comparação das medidas da largura e da altura do palato em relação às medidas lineares e ao volume segmentado e total das vias aéreas superiores dos pacientes com e sem mordida cruzada posterior. No grupo com mordida cruzada...

Regulation of ventilation in the caiman (Caiman latirostris): effects of inspired CO2 on pulmonary and upper airway chemoreceptors

Tattersall, G. J.; de Andrade, D. V.; Brito, S. P.; Abe, Augusto Shinya; Milsom, W. K.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica Formato: 125-138
Português
Relevância na Pesquisa
66.32%
In order to study the relative roles of receptors in the upper airways, lungs and systemic circulation in modulating the ventilatory response of caiman (Caiman latirostris) to inhaled CO2, gas mixtures of varying concentrations of CO2 Were administered to animals breathing through an intact respiratory system, via a tracheal cannula by-passing the upper airways (before and after vagotomy), or via a cannula delivering gas to the upper airways alone. While increasing levels of hypercarbia led to a progressive increase in tidal volume in animals with intact respiratory systems (Series 1), breathing frequency did not change until the CO2 level reached 7%, at which time it decreased. Despite this, at the higher levels of hypercarbia, the net effect was a large and progressive increase in total ventilation. There were no associated changes in heart rate or arterial blood pressure. on return to air, there was an immediate change in breathing pattern; breathing frequency increased above air-breathing values, roughly to the same maximum level regardless of the level of CO2 the animal had been previously breathing, and tidal volume returned rapidly toward resting (baseline) values. Total ventilation slowly returned to air breathing values. Administration of CO2 via different routes indicated that inhaled CO2 acted at both upper airway and pulmonary CO2-sensitive receptors to modify breathing pattern without inhibiting breathing overall. Our data suggest that in caiman...

Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion

Pereira-Filho, V. A.; Monnazzi, M. S.; Gabrielli, M. A. C.; Spin-Neto, R.; Watanabe, E. R.; Gimenez, C. M. M.; Santos-Pinto, A.; Gabrielli, M. F. R.
Fonte: Churchill Livingstone Publicador: Churchill Livingstone
Tipo: Artigo de Revista Científica Formato: 581-586
Português
Relevância na Pesquisa
56.26%
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP); Transverse maxillary deficiency is commonly found in patients with sleep apnea and is also related to abnomial breathing patterns. Maxillary expansion procedures promote widening of the nasal floor and reduce the resistance to airflow, and have a positive influence on nasopharynx function. In order to evaluate volume changes in the upper airway, 15 adult patients with transverse maxillary deficiency underwent surgically assisted rapid maxillary expansion (RME) until a slight overcorrection of the crossbite was obtained. Cone beam computed tomography (CBCT) volumetric images were obtained at three predefined time points. The mean age of the patients was 30.2 (+/- 7.4) years; nine were females and six were males. The area, volume, and the smallest transverse section area of the airway were assessed using Dolphin Imaging 3D software. Statistical comparisons were made of the changes between time periods. No statistically significant differences were found for volume or area. However a significant difference was found between the preoperative and immediate postoperative smallest transverse section area (P < 0.05). Maxillary expansion, as an isolated procedure, does not result in a statistically significant improvement in the airway dimensions and results in an inferior relocation of the smallest transverse section area.

Upper airway collapsibility evaluated by a negative expiratory pressure test in severe obstructive sleep apnea

Romano,Salvatore; Salvaggio,Adriana; Hirata,Raquel Pastrello; Lo Bue,Anna; Picciolo,Stefano; Oliveira,Luis Vicente Franco de; Insalaco,Giuseppe
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 Português
Relevância na Pesquisa
56.27%
OBJECTIVES: To investigate the usefulness of measuring upper airway collapsibility with a negative expiratory pressure application as a screening test for severe obstructive sleep apnea (OSA). INTRODUCTION: OSA is a risk factor for cardiovascular disease, and it may have serious consequences. Its recognition may have important implications during the perioperative period. Increased upper airway collapsibility is one of the main determinants of OSA, and its evaluation could be useful for identifying this condition. METHODS: Severe OSA and normal subjects (24 in each group) were matched by body mass index and referred to our sleep laboratory. The subjects were enrolled in an overnight sleep study, and a diurnal negative expiratory pressure test was performed. Flow drop (DV) and expiratory volume were measured in the first 0.2 s (V02) of the negative expiratory pressure test. RESULTS: DV (%) and V02 (%) values were statistically different between normal and OSA subjects. OSA patients showed a greater decrease in flow than normal subjects. In addition, severely OSA patients exhaled during the first 0.2 s of the negative expiratory pressure application was an average of only 11.2% of the inspired volume compared to 34.2% for the normal subjects. Analysis of the receiver operating characteristics showed that V02 (%) and DV (%) could accurately identify severe OSA in subjects with sensitivities of 95.8% and 91.7%...

Hemodynamic responses and upper airway morbidity following tracheal intubation in patients with hypertension: conventional laryngoscopy versus an intubating laryngeal mask airway

Sener,Elif Bengi; Ustun,Emre; Ustun,Burcu; Sarihasan,Binnur
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
Relevância na Pesquisa
56.44%
OBJECTIVES: We compared hemodynamic responses and upper airway morbidity following tracheal intubation via conventional laryngoscopy or intubating laryngeal mask airway in hypertensive patients. METHODS: Forty-two hypertensive patients received a conventional laryngoscopy or were intubated with a intubating laryngeal mask airway. Anesthesia was induced with propofol, fentanyl, and cis-atracurium. Measurements of systolic and diastolic blood pressures, heart rate, rate pressure product, and ST segment changes were made at baseline, preintubation, and every minute for the first 5 min following intubation. The number of intubation attempts, the duration of intubation, and airway complications were recorded. RESULTS: The intubation time was shorter in the conventional laryngoscopy group than in the intubating laryngeal mask airway group (16.33 ± 10.8 vs. 43.04±19.8 s, respectively) (p<0.001). The systolic and diastolic blood pressures in the intubating laryngeal mask airway group were higher than those in the conventional laryngoscopy group at 1 and 2 min following intubation (p<0.05). The rate pressure product values (heart rate x systolic blood pressure) at 1 and 2 min following intubation in the intubating laryngeal mask airway group (15970.90 ± 3750 and 13936.76 ± 2729...

The Role of Arousal Related Brainstem Reflexes in Causing Recovery from Upper Airway Occlusion in Infants

Wulbrand, Henning; McNamara, Frances; Thach, Bradley T.
Fonte: Associated Professional Sleep Societies, LLC Publicador: Associated Professional Sleep Societies, LLC
Tipo: Artigo de Revista Científica
Publicado em 01/06/2008 Português
Relevância na Pesquisa
66.29%
During obstructive sleep apnea (OSA) in adults upper airway reopening coincides with a sudden burst in activity of pharyngeal dilating muscles. This has been attributed to arousal from sleep as indicated by increased EEG activity. Recovery from OSA in infants often occurs in the absence of cortical arousal. To investigate mechanisms involved in recovery, we performed experimental airway occlusions in sleeping infants. Based on past work, our hypothesis was that a sleep startle combined with an augmented breath and heart rate acceleration would occur during the occlusion, and that such brainstem mediated reflexes might provide an explanation for recovery from OSA in the absence of cortical arousal. However, this is contrary to expectations, since lung inflation is believed to be necessary for occurrence of an augmented breath.

Narcotic administration and stenosing lesions of the upper airway - a potentially lethal combination

Byard, R.; Gilbert, J.
Fonte: Churchill Livingstone Publicador: Churchill Livingstone
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
Relevância na Pesquisa
56.51%
Two cases are reported where significant narrowing of the upper airway in association with narcotic administration resulted in respiratory compromise and death. Case 1: A 29-year-old woman with upper airway narrowing due to tonsillar enlargement from an Epstein-Barr infection was admitted to hospital, administered morphine and left in a room on her own with the door closed. She was found dead several hours later. At autopsy there was significant narrowing of the upper airway due to tonsillomegaly with a blood morphine level of 0.16 mg/L. Case 2: A 48-year-old woman with severe narrowing of her glottic inlet from recurrent squamous cell carcinoma and an intravenous drug taking history was found dead at her home. At autopsy there was evidence of recent and remote intravenous drug administration with marked narrowing of the glottis due to a recurrent tumor with a blood morphine level of 0.48 mg/L. In both cases, death was due to the effects of severe upper airway narrowing in combination with the respiratory depressant actions of morphine. Additional exacerbating factors may have included muscle weakness, drowsiness and reduced clearance of airway secretions from the effects of morphine. Narcotic administration in individuals with compromised upper airways should be undertaken extremely circumspectly and hospital protocols should ensure constant surveillance if this has been undertaken. Individuals who self administer narcotics should also be made aware of the dangers if there is coincidental upper airway narrowing. Toxicological evaluation in fatal cases of upper airway narrowing/stenosis may be extremely useful in revealing compounding factors such as opiate administration.

The control of respiration and upper airway muscle activity in healthy young men and women / by Amy Jordan.

Jordan, Amy Selina
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado Formato: 85995 bytes; application/pdf
Publicado em //2002 Português
Relevância na Pesquisa
56.17%
Aspects of the control of ventilation and an upper airway dilator muscle (genioglossus) are compared between healthy men and women, in an attempt to identify a gender difference that may contribute to the high male prevalence of sleep apnea.; Thesis (Ph.D.)--University of Adelaide, Dept. of Physiology, 2002; "May 2002."; Bibliography: leaves 123-144.; xiv, 144 leaves : ill. ; 30 cm.; Title page, contents and abstract only. The complete thesis in print form is available from the University Library.

Acute upper airway obstruction from acquired angioedema

Cheng, W.; Smith, W.; Russell, W.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
Relevância na Pesquisa
56.22%
C1 esterase inhibitor deficiency is an unusual cause of acute upper airway angioedema. This case of angioedema is secondary to acquired C1 esterase inhibitor deficiency associated with neoplastic disease and triggered by the use of angiotensin converting enzyme inhibitors. It was sufficiently severe to require emergency airway management. A guide to the evaluation and management of angioedema is presented.; William YC Cheng, William B Smith and W John Russell

Awake upper airway obstruction in children with spastic quadriplegic cerebral palsy

Wilkinson, D.; Baikie, G.; Berkowitz, R.; Reddihough, D.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2006 Português
Relevância na Pesquisa
56.29%
Objective: Some children with severe cerebral palsy develop symptoms of upper airway obstruction (UAO) while awake. The aetiology, natural history and treatment of this complication have not previously been systematically described. This study documents a case series of children with severe cerebral palsy admitted to hospital because of severe awake UAO and reviews the relevant literature. Methods: The case records of children admitted to hospital with UAO while awake over an 8-month period were reviewed. Details of antecedent illness, comorbidities, acute management and follow up were collated. One case is presented in detail. Results: Eight children were admitted with UAO. Seven children required intensive care admission. One child died, and two underwent tracheostomy. Nasendoscopy showed pharyngeal collapse without anatomical obstruction in the majority. One child was discovered to have a brainstem malignancy. Conclusions: Upper airway obstruction is a potentially severe and life-threatening complication of cerebral palsy. In this series, a majority of children had obstruction related to pharyngeal hypotonia and collapse. This can lead to prolonged hospitalization and intensive care admission. It may raise difficult management issues.; Dominic J Wilkinson...

Dynamic collapse of the upper respiratory tract: A review

Franklin, S.
Fonte: Equine Veterinary Journal Ltd Publicador: Equine Veterinary Journal Ltd
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
56.3%
Dynamic collapse of the upper respiratory tract is a common cause of poor performance in athletic horses. Most commonly, airway obstruction occurs during strenuous exercise when the upper respiratory tract is exposed to high pressure swings. In horses undertaking submaximal exercise, the pressures may also be increased due to flexion of the neck. The nasopharynx and larynx are particularly prone to dynamic collapse and a number of different forms of upper airway obstruction are now recognised. However, due to the dynamic nature of the collapse a definitive diagnosis is often not possible from resting observations alone.; S. H. Franklin

Postoperative cervical soft tissue hemorrhage with acute upper airway obstruction

Quick, E.; Byard, R.
Fonte: Amer Soc Testing Materials Publicador: Amer Soc Testing Materials
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
56.35%
Cervical surgery may be complicated by acute upper airway obstruction due to hematoma formation. Two cases are reported following cervical surgery where stridor, respiratory distress, and lethal airway occlusion resulted from hemorrhage that did not arise from large vessels. Case 1: A 50-year-old man who had an elective anterior fusion of C5-6 vertebrae developed marked neck swelling and stridor. At autopsy, there was significant cervical interstitial hemorrhage and edema. Major vessels were intact. Case 2: An 86-year-old man who underwent a carotid endarterectomy developed stridor and swelling of his neck. At autopsy, there was extensive interstitial hemorrhage and edema within the soft tissues of the neck. The endarterectomy site was intact. Both deaths were due to upper airway obstruction from postoperative cervical interstitial hemorrhage with no large vessel damage identified. Hemorrhage from small vessels may therefore lead to critical soft tissue hematoma formation and edema with airway obstruction and death.; Esther Quick and Roger W. Byard

Paediatric sleep-disordered breathing due to upper airway obstruction in the orthodontic setting: a review

Katyal, V.; Kennedy, D.; Martin, A.; Dreyer, C.; Sampson, W.
Fonte: Australian Society of Orthodontists Publicador: Australian Society of Orthodontists
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
56.32%
The essential feature of paediatric sleep-disordered breathing (SDB) is increased upper airway resistance during sleep presenting clinically as snoring. Paediatric SDB is a continuum ranging from primary snoring (PS), which is not associated with gas exchange abnormalities or significant sleep fragmentation, to obstructive sleep apnoea (OSA) with complete upper airway obstruction, hypoxaemia, and obstructive hypoventilation. Adenotonsillar hypertrophy, obesity and craniofacial disharmonies are important predisposing factors in the development and progression of paediatric SDB. Clinical symptoms are significant and domains affected include behaviour, neurocognition, cardiovascular morbidity and quality of life. Overnight polysomnography is the current diagnostic gold standard method to assess SDB severity while adenotonsillectomy is the recommended first line of treatment. Other treatments for managing paediatric SDB include nasal continuous airway pressure, the administration of nasal steroids, dentofacial orthopaedic treatment and surgery. However, there are insufficient long-term efficacy data using dentofacial orthopaedics to treat paediatric SDB. Further studies are warranted to define the characteristics of patients who may benefit most from orthodontic treatment.; Vandana Katyal...

Increased thoracoabdominal asynchrony during breathing periods free of discretely scored obstructive events in children with upper airway obstruction

Immanuel, S.; Kohler, M.; Martin, A.; Kennedy, J.; Pamula, Y.; Kabir, M.; Saint, D.; Baumert, M.
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
Relevância na Pesquisa
66.39%
Objective This study aims to investigate the impact of upper airway obstruction (UAO) in children by measuring thoracoabdominal asynchrony (TAA) during periods of sleep apnea/hypopnea and during scored-event-free (SEF) breathing periods. Methods Respiratory inductive plethysmographic signals were extracted from polysomnographic data, recorded before and after adenotonsillectomy in 40 children with UAO and 40 healthy, matched children at equivalent time points. Thoracoabdominal asynchrony was computed using a Hilbert transform-based phase difference estimation method in SEF periods during stage 2, stage 4 non-rapid eye movement (NREM), and rapid eye movement (REM) sleep and compared between the groups. Results At baseline, in the UAO group, TAA during obstructions were significantly higher than TAA during SEF periods in both stage 2 and REM sleep. Compared to controls, children with UAO had a significantly higher TAA during SEF periods in stage 2, stage 4 sleep, and REM sleep. This between-group difference was not significant post adenotonsillectomy. UAO group showed a significant decrease in TAA compared to their baseline during SEF stage 2 and 4 NREM, but not in REM. Conclusion Upper airway obstruction in children is associated with increased TAA during SEF periods...

Movement distribution: a new measure of sleep fragmentation in children with upper airway obstruction

Coussens, S.; Baumert, M.; Kohler, M.; Martin, J.; Kennedy, D.; Lushington, K.; Saint, D.; Pamula, Y.
Fonte: American Academy of Sleep Medicine Publicador: American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
Relevância na Pesquisa
66.39%
STUDY OBJECTIVES: To develop a measure of sleep fragmentation in children with upper airway obstruction based on survival curve analysis of sleep continuity. DESIGN: Prospective repeated measures. SETTING: Hospital sleep laboratory. PARTICIPANTS: 92 children aged 3.0 to 12.9 years undergoing 2 overnight polysomnographic (PSG) sleep studies, 6 months apart. Subjects were divided into 3 groups based on their obstructive apnea and hypopnea index (OAHI) and other upper airway obstruction (UAO) symptoms: primary snorers (PS; n = 24, OAHI <1), those with obstructive sleep apnea syndrome (OSAS; n = 20, OAHI ≥1) and non-snoring controls (C; n = 48, OAHI <1). INTERVENTIONS: Subjects in the PS and OSAS groups underwent tonsillectomy and adenoidectomy between PSG assessments. MEASUREMENTS AND RESULTS: Post hoc measures of movement and contiguous sleep epochs were exported and analyzed using Kaplan-Meier estimates of survival to generate survival curves for the 3 groups. Statistically significant differences were found between these group curves for sleep continuity (P < 0.05) when using movement events as the sleep fragmenting event, but not if stage 1 NREM sleep or awakenings were used. CONCLUSION: Using conventional indices of sleep fragmentation in survival curve analysis of sleep continuity does not provide a useful measure of sleep fragmentation in children with upper airway obstruction. However...

Obesity and risk of sleep related upper airway obstruction in Caucasian children

Kohler, M.; Lushington, K.; Couper, R.; Martin, A.; van den Heuvel, C.; Pamula, Y.; Kennedy, D.
Fonte: The American Academy of Sleep Medicine Publicador: The American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
56.49%
Obesity is thought to be a significant risk factor for upper airway obstruction during sleep in children. However, the moderating influences of age and ethnicity have not been well explored and the relative contribution of obesity per se to upper airway obstruction has yet to be quantified. Given the markedly increasing prevalence of childhood obesity, an objective understanding of the impact of obesity on upper airway obstruction is important. The purpose of the present study was to examine the interaction between obesity, age and upper airway obstruction in Australian Caucasian children referred for evaluation of snoring. METHODS: This was a retrospective case study involving 190 children (4-12 y) who were referred for evaluation of upper airway obstruction and underwent one night of polysomnography at the Adelaide Women's and Children's Hospital Sleep Disorders Unit. Children were classified as Infrequent Snorers (n = 80), Habitual Snorers (n = 68) or Obstructive Sleep Apnea Syndrome (OSAS) (n = 42) (i.e., obstructive apnea hypopnea index (OAHI) > or = 1). RESULTS: Thirty-five percent (66/190) of children were overweight or obese. Body mass index but not age was a significant but weak predictor of OAHI (< 5% of the variance). CONCLUSION: In Australian Caucasian children aged 4-12 years who snore...

Evaluation of C-reactive protein, Haptoglobin and cardiac Troponin 1 levels in brachycephalic dogs with upper airway obstructive syndrome.

Planellas, Marta; Cuenca Valera, Rafaela; Tabar Rodríguez, María Dolores; Bertolani, Coralie; Poncet, Cyrill; Closa, Josep M.; Lorente Guerrero, Juan; Cerón, José Joaquín; Pastor Milan, Josep
Fonte: Universidade Autônoma de Barcelona Publicador: Universidade Autônoma de Barcelona
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em //2012 Português
Relevância na Pesquisa
66.27%
Background: Brachycephalic dogs have unique upper respiratory anatomy with abnormal breathing patterns similar to those in humans with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the correlation between anatomical components, clinical signs and several biomarkers, used to determine systemic inflammation and myocardial damage (C-reactive protein, CRP; Haptoglobin, Hp; cardiac troponin I, cTnI), in dogs with brachycephalic upper airway obstructive syndrome (BAOS). Results: Fifty brachycephalic dogs were included in the study and the following information was studied: signalment, clinical signs, thoracic radiographs, blood work, ECG, components of BAOS, and CRP, Hp and cTnI levels. A high proportion of dogs with BAOS (88%) had gastrointestinal signs. The prevalence of anatomic components of BAOS was: elongated soft palate (100%), stenotic nares (96%), everted laryngeal saccules (32%) and tracheal hypoplasia (29.1%). Increased serum levels of biomarkers were found in a variable proportion of dogs: 14% (7/50) had values of CRP > 20 mg/L, 22.9% (11/48) had values of Hp > 3 g/L and 47.8% (22/46) had levels of cTnI > 0.05 ng/dl. Dogs with everted laryngeal saccules had more severe respiratory signs (p<0.02) and higher values of CRP (p<0.044). No other statistical association between biomarkers levels and severity of clinical signs was found. Conclusions: According to the low percentage of patients with elevated levels of CRP and Hp...

Upper airway collapsibility evaluated by a negative expiratory pressure test in severe obstructive sleep apnea

Romano, Salvatore; Salvaggio, Adriana; Hirata, Raquel Pastrello; Lo Bue, Anna; Picciolo, Stefano; Oliveira, Luis Vicente Franco de; Insalaco, Giuseppe
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2011 Português
Relevância na Pesquisa
56.27%
OBJECTIVES: To investigate the usefulness of measuring upper airway collapsibility with a negative expiratory pressure application as a screening test for severe obstructive sleep apnea (OSA). INTRODUCTION: OSA is a risk factor for cardiovascular disease, and it may have serious consequences. Its recognition may have important implications during the perioperative period. Increased upper airway collapsibility is one of the main determinants of OSA, and its evaluation could be useful for identifying this condition. METHODS: Severe OSA and normal subjects (24 in each group) were matched by body mass index and referred to our sleep laboratory. The subjects were enrolled in an overnight sleep study, and a diurnal negative expiratory pressure test was performed. Flow drop (DV) and expiratory volume were measured in the first 0.2 s (V02) of the negative expiratory pressure test. RESULTS: DV (%) and V02 (%) values were statistically different between normal and OSA subjects. OSA patients showed a greater decrease in flow than normal subjects. In addition, severely OSA patients exhaled during the first 0.2 s of the negative expiratory pressure application was an average of only 11.2% of the inspired volume compared to 34.2% for the normal subjects. Analysis of the receiver operating characteristics showed that V02 (%) and DV (%) could accurately identify severe OSA in subjects with sensitivities of 95.8% and 91.7%...

Hemodynamic responses and upper airway morbidity following tracheal intubation in patients with hypertension: conventional laryngoscopy versus an intubating laryngeal mask airway

Sener, Elif Bengi; Ustun, Emre; Ustun, Burcu; Sarihasan, Binnur
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2012 Português
Relevância na Pesquisa
56.33%
OBJECTIVES: We compared hemodynamic responses and upper airway morbidity following tracheal intubation via conventional laryngoscopy or intubating laryngeal mask airway in hypertensive patients. METHODS: Forty-two hypertensive patients received a conventional laryngoscopy or were intubated with a intubating laryngeal mask airway. Anesthesia was induced with propofol, fentanyl, and cis-atracurium. Measurements of systolic and diastolic blood pressures, heart rate, rate pressure product, and ST segment changes were made at baseline, preintubation, and every minute for the first 5 min following intubation. The number of intubation attempts, the duration of intubation, and airway complications were recorded. RESULTS: The intubation time was shorter in the conventional laryngoscopy group than in the intubating laryngeal mask airway group (16.33 ± 10.8 vs. 43.04±19.8 s, respectively) (p

X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures

Chen,L-J; Zhao,M-C; Pan,X-F; Wei,Y-Q; Wang,D-Y
Fonte: West Indian Medical Journal Publicador: West Indian Medical Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2013 Português
Relevância na Pesquisa
66.46%
OBJECTIVE: This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. METHODS: Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. RESULTS: The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function ofpatients. CONCLUSIONS: Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.