Avaliação da inflamação das vias aéreas. Vias áreas superiores e compartimento broncopulmonar

Abstract

It is done a review of evaluation methods of the inflammation in upper airways and bronchi used for diagnosis, therapeutic approach and prognosis of pathologies like rhinosinusitis and asthma. It is also analysed methods that supply relevant information of inflammation in COPD. The chronic inflammation of the airways is associated to respiratory distress, obstruction in basal lung function tests and to bronchial and nasal hyperreactivity. Computerized tomography informs about lumen dimensions, bronchial walls thickness and pulmonary density. These changes are associated to inflammation and to remodelling of the airways. Localized inflammation in respiratory tract can be detected by modifications of systemic inflammatory markers. The direct evaluation of inflammatory airways changes are based on immune, histological and chemical analysis of lung tissue obtained by biopsies and by fluids recoil in basal conditions or after stimulation. The eosinophils are increased in biopsies and in nasal and bronchoalveolar lavage in asthma and rhinitis and can change with therapy. Proteins and mRNA expression of cellular activation mediators are also observed. The induced sputum identifies eosinophilic inflammation that is inversely associated with lung function parameters. In each respiratory cycle the air is enriched in organic volatile compounds produced by cellular breathing. FENO is the bio marker more deeply studied in asthma and its increase is well documented in this disorder. In the exhaled air condensed, reactive oxygen species, membrane mediators, cytokines, and chemokines are identified. If the non invasive evaluation of inflammation became reliable and reproducible it will be indispensable in monitoring the airways diseases.

Machine Learning Methods Applied to Predict Ventilator-Associated Pneumonia with Pseudomonas aeruginosa Infection via Sensor Array of Electronic Nose in Intensive Care Unit

“…Pneumonia can be identified more easily by detecting odors [20]. Analysis of Volatile Organic Compounds (VOCs) in exhaled breath, and thermal desorption with gas chromatography coupled to mass spectrometry (TD-GC-MS) can be used to identify VOCs and the causative pathogen in patients suspected of VAP [21,22,23]. However, researchers have found that a variety of bacteria such as Klebsiella pneumoniae, Acinetobacter baumanii, Escherichia coli, Staphylococcus aureus , and Pseudomonas aeruginosa contribute to VAP, and it is very crucial to find a way to recognize these different types.…”