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Altered airway anatomy but challenges remains same.

ABSTRACT: The altered pediatric airway is a nightmare for an anesthesiologist. Managing such cases with limited resources makes it more challenging. Here, we report a case of pediatric patient with altered airway anatomy posted for gastrotomy and feeding tube insertion. This case highlights the management of pediatric difficult airway and discusses the various choices of anesthesia technique.

SUBMITTER: Harshad LP

PROVIDER: S-EPMC7458027 | biostudies-literature | 2020 Jul-Sep

REPOSITORIES: biostudies-literature

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Altered airway anatomy but challenges remains same.

Harshad Leena P LP Pujari Vinayak V Balaji T T Navdeep K K

Saudi journal of anaesthesia 20200530 3

The altered pediatric airway is a nightmare for an anesthesiologist. Managing such cases with limited resources makes it more challenging. Here, we report a case of pediatric patient with altered airway anatomy posted for gastrotomy and feeding tube insertion. This case highlights the management of pediatric difficult airway and discusses the various choices of anesthesia technique. ...[more]

PMID: 32934638

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Project description:Changes in airway epithelial cell differentiation, driven in part by IL-13, are important in asthma. Micro-RNAs (miRNAs) regulate cell differentiation in many systems and could contribute to epithelial abnormalities in asthma.To determine whether airway epithelial miRNA expression is altered in asthma and identify IL-13-regulated miRNAs.We used miRNA microarrays to analyze bronchial epithelial brushings from 16 steroid-naive subjects with asthma before and after inhaled corticosteroids, 19 steroid-using subjects with asthma, and 12 healthy control subjects, and the effects of IL-13 and corticosteroids on cultured bronchial epithelial cells. We used quantitative polymerase chain reaction to confirm selected microarray results.Most (12 of 16) steroid-naive subjects with asthma had a markedly abnormal pattern of bronchial epithelial miRNA expression by microarray analysis. Compared with control subjects, 217 miRNAs were differentially expressed in steroid-naive subjects with asthma and 200 in steroid-using subjects with asthma (false discovery rate < 0.05). Treatment with inhaled corticosteroids had modest effects on miRNA expression in steroid-naive asthma, inducing a statistically significant (false discovery rate < 0.05) change for only nine miRNAs. qPCR analysis confirmed differential expression of 22 miRNAs that were highly differentially expressed by microarrays. IL-13 stimulation recapitulated changes in many differentially expressed miRNAs, including four members of the miR-34/449 family, and these changes in miR-34/449 family members were resistant to corticosteroids.Dramatic alterations of airway epithelial cell miRNA levels are a common feature of asthma. These alterations are only modestly corrected by inhaled corticosteroids. IL-13 effects may account for some of these alterations, including repression of miR-34/449 family members that have established roles in airway epithelial cell differentiation. Clinical trial registered with www.clinicaltrials.gov (NCT 00595153).

Dataset Information

Altered airway anatomy but challenges remains same.

Publications

Altered airway anatomy but challenges remains same.

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