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Stridor

Stridor is a high-pitched, wheezing sound that occurs during breathing, often indicating a blockage or narrowing in the upper airway.
It can be caused by a variety of conditions, including croup, laryngitis, foreign object inhalation, and vocal cord dysfunction.
Stridor is typically loudest during inhalation, but can also be present during exhalation.
Prompt medical evaluation is important to determine the underlying cause and appropriate treatment.
Effective management of stridor may involve medications, supportive care, or surgical intervention, depending on the specifics of the case.
Reseraching optimal protocols for identifying and managing stridor can help clinicians provide timely and effective care for patients experiencing this concerning respiratory symptom.

Most cited protocols related to «Stridor»

PBIDS household surveillance methods have been described previously [10] (link). Briefly, all households in both surveillance sites are offered enrollment. Eligible households are those located within 5 km and 1 km from the designated referral clinics for the project in Asembo and Kibera, respectively. Eligible persons must have resided permanently in these areas for 4 calendar months or be a child born to a woman enrolled in PBIDS. Enrollment was continuous in both sites since the project's beginning. Community interviewers visit enrolled households every two weeks (“fortnightly ” visits.) Participants are asked standardized questions, in local language, about recent illnesses. For certain key symptoms—cough, fever and diarrhea—the exact days of occurrence are recorded. For older children (approximately over 12 years old) and adults, interviews of that person are done. If not at home or unable to answer questions, a proxy who is knowledgeable about the participant's health is interviewed. For children unable to answer for themselves, the mother or other primary caretaker of the child is interviewed. Abbreviated physical exams are carried out on ill persons present during the visit, including axillary temperature, 1 minute respiratory rate, evaluation for lower chest wall indrawing and stridor in ill children, and observation for signs of dehydration. Community interviewers are secondary school graduates, who undergo extensive training on data collection and physical examination led by KEMRI/CDC clinicians, including WHO Integrated Management of Childhood Illness (IMCI) training videos [14] .
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Publication 2011
Adult Axilla Child Childbirth Cough Dehydration Diarrhea Fever Households Interviewers Mothers Physical Examination Respiratory Rate Stridor Wall, Chest Woman
Six- to 8-week-old male C57BL/6 mice served as recipients of donor trachea obtained from C57Bl/6 female mice of the same age and similar weight (Fig. 1).
Tracheas were harvested from female donors using an aseptic surgical technique. Mice were euthanized using a cocktail of ketamine (100 mg/kg), xylazine (10 mg/kg), and ketoprofen (5 mg/kg) via intraperitoneal injection. After obtaining a deep anesthetic plane, the surgical site was shaved and disinfected with alcohol and povidone iodine. A midline incision was made from the chin to the center of the chest, and subcutaneous fat pads were removed from the field. The strap muscles surrounding the trachea were separated and the trachea was dissected circumferentially. A 5-mm length of trachea was harvested and maintained in fresh phosphate-buffered saline (PBS) until implant.
Recipient male mice were prepared for transplant using the previously described surgical process for female mice. The native trachea was resected and replaced with donor female trachea using interrupted sutures of 9–0 nylon (AROS Surgical Instruments, Newport Beach, CA). After the transplanted trachea was secured in an air-tight fashion, the strap muscles were reapproximated, and the midline incision was closed using running stitches with 6–0 Vicryl suture (Ethicon, Somerville, NJ).
Postoperative care was the same as our previous study.4 Animals were evaluated daily during the first 2 weeks monitoring for weight loss >20%, stridor, and respiratory distress. Animals meeting the criteria were recommended for humane euthanasia prior to the planned endpoint and removed from the study.
Publication 2020
Anesthetics Animals Asepsis Chest Chin Donors Ethanol Euthanasia Females Injections, Intraperitoneal Ketamine Ketoprofen Males Mice, House Mice, Inbred C57BL Muscle Tissue Nylons Operative Surgical Procedures Pad, Fat Phosphates Postoperative Care Povidone Iodine Respiratory Rate Saline Solution Stridor Surgical Instruments Sutures Trachea Vicryl Xylazine

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Publication 2019
Anesthetics Animals Body Weight Buprenorphine Clavicle Cricoid Cartilage Euthanasia Formalin Grafts Hyoid Bone Ibuprofen Ketamine Ketoprofen Mice, House Mice, Inbred C57BL Muscle Tissue Ovum Implantation Respiratory Rate Sedatives Stridor Sutures Thyroid Cartilage Tissues Trachea Transplantation Transplant Recipients Xylazine
After institutional ethical review board approval by the Medical Faculty of the Technical University of Dresden (EK DD 270 06 2015) we used a database representing 500 consecutive patients treated by Helicopter Emergency Medical Service (HEMS). Both the electronic emergency documentation and the hand-written documentations were used for the database. Eight patients were already dead when arriving on the scene. These were excluded for this study, so that 492 patients were used for further evaluation. Each patient was allocated a triage category (T1/red, T2/yellow, T3/green) by a group of experienced doctors in disaster medicine, independent of any algorithm merely regarding the definition of the triage categories according to the 6th Triage-Consensus conference of the German Federal Office of Civil Protection and Disaster Assistance as shown in Table 1 [4 ].

Description of triage categories

This procedure has already been published in more detail by our group [5 ]. The triage algorithms “modified Simple Triage and Rapid Treatment” (mSTaRT, Version 2013), Amberg-Schwandorf-Algorithmus (ASAV), Field Triage Score (FTS), Care Flight (CF), “Model Bavaria” (based on mSTaRT) [8 (link)–11 (link)] and two Norwegian algorithms, one used by personnel without further medical education (TAS) [12 (link)] and one used by medical professionals (in this Paper called “Nor”) [13 ], both based on the algorithm Triage Sieve by MIMMS, were translated into Microsoft Excel commands. The exact Excel commands are available from the corresponding author upon request. Every algorithm requests at a certain position whether or not pulse is palpable. In order to decide yes or no, we defined the limits for the systolic blood pressure being ≥ 130 mmHg, ≥ 110 mmHg, ≥ 100 mmHg, ≥ 80 mmHg or ≥ 60 mmHg [14 (link)]. This made it possible to calculate the triage categories for every patient automatically depending on each defined limit.
The 2013 version of mSTaRT contains a second triage procedure for patients who were classified as “green” (T3). As there were no clearly defined criteria for this second triage, we decided to test the initially “green” classified patients for the criteria of category “red” in the same algorithm. Patients who had no “red”-criterion during secondary survey were left in T3. All other patients were not allowed to stay in this category and were passed on to the next steps of the algorithm. Both mSTaRT 2013 and “Model Bavaria” ask if the patient suffers from an “Inhalation Trauma with Stridor”. No patient of our cohort showed this trauma in the documentation, so we decided to skip this question in the algorithms.
As the Field Triage Score can reach the values 0, 1 and 2, we calculated +1 to be comparable to the triage categories I to III.
Statistical analyses were done with respect to sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive/negative Likelihood Ratio (LR+, LR-) and the Youden Index (J), representing a marker that combines sensitivity and specificity and ranging from −1 to +1 [15 (link)], making the results of the Receiver Operating Characteristics (ROC) easier to compare.
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Publication 2017
Conferences Disasters Education, Medical Emergencies Ethics Committees, Research Faculty, Medical Hypersensitivity Inhalation Patients Physicians Pulse Rate Service, Emergency Medical Stridor Systolic Pressure Wounds and Injuries
The primary outcome was duration of mechanical ventilation, beginning on Day 0 at the time of endotracheal intubation, initiation of assisted breathing for patients with tracheostomies, or PICU admission for patients intubated at an outside hospital, and continuing until the first time the endotracheal tube was continuously absent for at least 24 hours or, in patients with tracheostomies, the first time pressure support was <5 cm H2O (continuous or bi-level) for at least 24 hours. Patients were assigned 28 days if they remained intubated or were transferred or died prior to Day 28 without remaining extubated for >24 hours, therefore making the primary outcome equivalent to ventilator- 21 (link) free days. 21 (link)All secondary outcomes were selected a priori and included time to recovery from acute respiratory failure, duration of weaning from mechanical ventilation, neurological testing, PICU and hospital lengths of stay, in-hospital mortality, sedation-related adverse events, sedative exposure, and occurrence of iatrogenic withdrawal (eTable 4). Sedative exposure and sedation outcomes included measures of wakefulness, pain, and agitation; specifically, percentage of study days awake and calm (daily modal SBS=-1 [responsive to gentle touch or voice] or 0 [awake and able to calm]), days to first awake/calm, percentage of study days with modal pain score <4, and percentage of study days with any episode of pain (highest daily pain score ≥4) or agitation (highest daily SBS=+1/+2 [restless and difficult to calm/agitated]).
Sedation-related adverse events were also defined a priori and prospectively monitored 22 (link)(eTable 4). These included inadequate pain management (pain score>4 [or pain assumed present if receiving neuromuscular blockade] for 2 consecutive hours), inadequate sedation management (SBS>0 [or agitation assumed present if receiving neuromuscular blockade] for 2 consecutive hours), clinically significant iatrogenic withdrawal in patients weaning from ≥5 days of opioids (rescue therapy to manage an increase in WAT-1 symptoms), extubation failure (reintubation within 24 hours), post-extubation stridor, unplanned extubation, unplanned removal of any invasive tube, ventilator-associated pneumonia, catheter-associated bloodstream infection, immobility-related stage 2+ pressure ulcers, and new tracheostomy.
The primary analysis compared the duration of mechanical ventilation in intervention vs. control patients using Kaplan-Meier curves and proportional hazards regression adjusting for age group (2 weeks to 1.99 years, 2.00 to 5.99 years, 6.00 to 17.99 years), Pediatric Risk of Mortality (PRISM) III-12 score, 23 (link) and Pediatric Overall Performance Category (POPC)>1 24 (link) at enrollment and accounting for PICU as a cluster variable with generalized estimating equations. 25 Exploratory analyses of secondary outcomes used logistic, multinomial logistic, cumulative logit, linear, and Poisson regression accounting for PICU as a cluster variable using generalized estimating equations for binary, nominal, ordinal, continuous, and rate variables, respectively. Statistical analyses were performed with SAS software (Version 9.4, SAS Institute), using two-sided 0.05 level tests.
A priori, the study team determined that a 20% reduction in the duration of mechanical ventilation, or a hazard ratio of 1.25, was clinically important for patients managed with the sedation protocol and plausible based on our pilot study. 26 Assuming independent observations, proportional hazards between groups, and that up to 15% of patients would not be successfully extubated by Day 28, 26 ,27 (link) 1050 patients were required for a two-sided 0.05 level log-rank test to achieve 90% power to detect a 20% reduction assuming three interim analyses to assess efficacy or futility using an O’Brien-Fleming 28 (link) stopping rule (East, Version 5.3, Cytel Statistical Software). To account for the intraclass correlation coefficient (ICC) in our cluster-randomized design and using ICC=0.01 from previous experience 26 ,27 (link) and conservatively assuming 22 sites, 1990 patients were required. 29 (link),30 We chose 2448 patients as our target sample size to guarantee 90% power to detect a 20% reduction in length of ventilation controlling for patients not successfully extubated by Day 28, three formal interim analyses, and modest within-site correlations. This allowed for moderate site-to-site variability in cluster sizes and adjustment for age group, PRISM III-12 score, and POPC>1.
Publication 2015
Age Groups Catheters Intubation, Intratracheal Management, Pain Mechanical Ventilation Neuromuscular Block Opioids Pain Patient Admission Patients Pneumonia, Ventilator-Associated Pressure Pressure Ulcer Respiratory Failure Sedatives Sepsis Stridor Therapeutics Touch Tracheostomy Wakefulness

Most recents protocols related to «Stridor»

This study analysed a historic cohort of children and adolescents who were examined at the Multidisciplinary Saliva Control Centre of the Radboud university medical centre Nijmegen, the Netherlands, between March 2005 and April 2016. Ninety-nine patients had SMDR with simultaneous excision of the sublingual glands for excessive drooling. We excluded 3 patients because of their age (>24 years) [4 (link)]. All participants were considered to have a safe pharyngeal phase of swallowing. None of the children had previous surgical procedures of the floor of the mouth or for saliva control. Information was collected concerning age at time of surgery, duration of surgery, postoperative management, duration of intubation, and duration of hospital stay. Occurrence of tongue or floor of the mouth swelling, stridor, postoperative pneumonia and atelectasis were reviewed. Any other complications occurring during surgery or postoperatively were also identified. Co-morbidity was assessed preoperatively by an anaesthesiologist using the ASA physical status.
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Publication 2023
Adolescent Anesthesiologist Atelectasis Child Intubation Operative Surgical Procedures Patients Pharynx Physical Examination Pneumonia Saliva Stridor Sublingual Gland Sublingual Region Tongue
The primary outcome measurement was the length of postoperative hospitalization stay. The secondary outcomes were the placement and positioning duration of SGA or ETT plus BB; the mean arterial pressure (MAP) and heart rate (HR) immediately after insertion of SGA plus BB or ETT plus BB; the peak airway pressure and tidal volume 5 min after OLV; the quality of lung isolation (evaluated by the surgeon blinded to the group assignment according to the lung collapse score); the duration from the end of surgery to the removal of laryngeal mask or endotracheal tube; the leukocyte count (WBC) and the value of C-reactive protein (CRP) on the first day of post-operation. Recorded adverse events included the incidence of hypoxemia or hypercapnia during surgery, incidences of laryngospasm, stridor and airway obstruction during awakening, and the incidences of hoarseness within three days after operation.
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Publication 2023
Airway Obstruction Atelectasis C Reactive Protein Hoarseness Hospitalization isolation Laryngeal Masks Laryngospasm Leukocyte Count Lung Operative Surgical Procedures Pressure Rate, Heart Stridor Surgeons Surgery, Day Tidal Volume
Data were collected by structured questionnaires from parents and children who had undergone surgery under general anesthesia. The information regarding the study was explained to both study participants and their parents before surgery. Information about the study’s benefit, harm, and objective of the study prepared in English and translated into Amharic was explained to the study participants and their parents. Two trained data collectors and one supervisor were involved in the data collection process.
Preoperatively pre-anesthetic evaluation information regarding any history of URTI, type of surgery, investigations, history of POST, and any pertinent physical examination were recorded. Written informed consent was obtained just before anesthesia from the study participant’s family. Intraoperatively airway technique used, type of airway material used, number of attempts, any difficulty during airway instrumentation, and any bleeding on airway equipment on extubation were recorded. Any intraoperative airway incidents such as accidental extubation and reintubation were recorded. Postoperatively duration of surgery and anesthesia, any incident during extubation such as coughing, laryngospasm, vomiting, and stridor were recorded. After the patient was discharged from Operation Theater; the presence or absence of POST was assessed by the data collector with yes or no questions. Children who documented suffering from a sore throat at any point since waking up went on to complete a more detailed questionnaire regarding the severity of POST. The severity of postoperative sore throat was assessed by a four-point categorical pain scale, where 0 = for no sore throat; 1 = mild (complains of sore throat only after asking); 2 = moderate (complains of sore throat on his/her own); 3 = severe (change of voice associated with throat pain).10 (link),20 ,21 (link)
Publication 2023
Accidents Airway Extubation Anesthesia Anesthetics Child Dysphonia General Anesthesia Laryngospasm Pain Parent Patients Pharyngitis Physical Examination Sore Throat Stridor Tracheal Extubation
We included client-owned brachycephalic dogs of three breeds: FB, P, and BST. Dogs without signs of BOAS were diagnosed based on the absence of clinical signs (stertor, stridor, exercise, heat intolerance at rest and during daily activities, including running) and visible abnormalities such as stenotic nares. Dogs with signs of BOAS were classified based on clinical signs of exercise intolerance and other signs of BOAS. In dogs with signs of BOAS, abnormalities consistent with BOAS were confirmed under anesthesia by endoscopy by an experienced veterinary surgeon (VE) and the disease was graded as described previously [35 (link), 62 (link)]. The control group consisted of healthy non-brachycephalic dogs with normal cardiac auscultation invited to participate in the study. All owners signed an informed consent form to participate in the study.
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Publication 2023
Anesthesia Boa Brachycephaly Breeding Canis familiaris Congenital Abnormality Endoscopy, Gastrointestinal Heart Auscultation Stenosis Stridor Surgeons
ARTIs are defined as the presence of cough and cold with respiratory symptoms such as fast breathing, tachypnoea above age limit, and/or chest in-drawing and danger signs such as being unable to feed, persistent vomiting, lethargy, or stridor [17 (link)]. Symptomatic children with moderate to severe respiratory distress symptoms requiring non-invasive ventilation (NIV) were admitted, and nasopharyngeal aspirate (NPA) was usually taken to detect various common respiratory viruses. Direct fluorescent antibody (DFA) method using D3 Ultra DFA Respiratory Virus Screening and Identification Kits (Diagnostic Hybrids, USA) were utilized for the identification of RSV, adenovirus, influenza A and B and parainfluenza 1, 2, and 3 viruses, with the sensitivity of 95.5% and the specificity of 98.3%. Briefly, the nasopharyngeal cells obtained from NPA were added to the DFA screening reagent to determine the presence of viral antigens using fluorescence microscopy. Once the stained cells showed positive apple-green fluorescence, the particular virus was further identified using individual virus-specific DFA reagents [17 (link)]. In our study, our primary interest was to detect RSV, a single-stranded negative-sense RNA enveloped virus which commonly causes viral bronchiolitis and pneumonia in infants and children. There are two major subtypes, A and B, where B is characterized as an asymptomatic strain that the majority of patients experience. Usually, the more severe clinical illness predominantly involves the subtype A strain, especially in most outbreaks [18 ]. Over the years, RSV has been commonly detected directly in cells from the nasopharyngeal epithelium by staining with immunofluorescent reagents, although it can also be isolated in certain cell cultures.
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Publication 2023
Adenovirus Infections Antigens, Viral Bronchiolitis, Viral Cell Culture Techniques Cells Chest Child Common Cold Cough Diagnosis Disease Outbreaks Epithelium Fluorescence Fluorescent Antibody Technique Fluorescent Antibody Technique, Direct Hybrids Hypersensitivity Infant Influenza Lethargy Microscopy, Fluorescence Nasopharynx Negative-Sense RNA Viruses Noninvasive Ventilation Parainfluenza Patients Pneumonia Respiratory Rate Signs and Symptoms, Respiratory Strains Stridor Virus

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More about "Stridor"

Stridor is a distinctive high-pitched, wheezing sound that occurs during breathing, often indicating a blockage or narrowing in the upper airway.
This concerning respiratory symptom can be caused by a variety of conditions, including croup, laryngitis, foreign object inhalation, and vocal cord dysfunction.
Stridor is typically loudest during inhalation but may also be present during exhalation.
Prompt medical evaluation is crucial to determine the underlying cause and appropriate treatment.
Effective management of stridor may involve medications, supportive care, or even surgical intervention, depending on the specifics of the case.
Reserarching optimal protocols for identifying and managing stridor can help clinicians provide timely and effective care for patients experiencing this concerning respiratory issue.
Some related terms and concepts to consider include ELISA, a common laboratory technique, Littmann Cardiology III, a stethoscope used to auscultate breath sounds, SPSS statistical software for data analysis, Micromedex, a drug information database, SimBaby, a medical training simulator, Amphotericin B, an antifungal medication, ImmunoCAP, an allergy testing method, and Streptomycin, an antibiotic.
Staying up-to-date on the latest research and protocols related to stridor can help healthcare providers deliver the best possible care for patients.