Jill Ohar

Indwelling Transbronchial Catheter Drainage of Pulmonary Abscess

Adequate cavitary drainage is of paramount importance in the treatment of pulmonary abscesses. Occasionally this cannot be achieved despite vigorous chest physical therapy and the utilization of bronchoscopy. Intermittent transbronchial catheterization under fluoroscopic guidance has been suggested as a method to facilitate drainage. We have modified this technique by placing an indwelling intracavitary catheter, which allows irrigation and drainage over a prolonged period. This report describes this technique and our experience with 3 patients managed in this fashion.

National Heart, Lung, and Blood Institute Guidelines: Treatment of Asthma

The goal of treatment of any disease is control. Elements of control include symptoms, pulmonary function, frequency of exacerbations, and disease progression. Asthma symptoms include chest tightness, wheezing, cough, dyspnea on exertion or at rest, nocturnal awakenings due to wheezing, cough, or shortness of breath, and limitation of activities of daily living. Elements of asthma that are associated with frequency of exacerbations are bronchial hyperresponsiveness, excessive peak flow variability, number of asthma-related hospitalizations, emergency room, or unscheduled physician visits, need for rescue short-acting β2-agonists, and, while relatively rare, asthma-related mortality or intensive care unit admission with intubation. Progression of asthma refers to loss of FEV1 (forced expiratory volume in 1 second) or anatomic remodeling of the airways in response to chronic or uncontrolled inflammation.