sodium-pertechnetate-tc-99m and Bronchitis

Topics: Asthma; Bronchitis; Humans; Krypton; Lung; Pulmonary Ventilation; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Xenon Radioisotopes

On theoretical grounds it is assumed that positive expiratory pressure mask physiotherapy (PEP) as a means of promoting mucus clearance is especially effective in the more distal airways. In a randomized cross-over trial including a control measurement the effect of PEP and of the forced expiration technique combined with postural drainage (FET/PD) on regional lung clearance was evaluated in seven patients with chronic bronchitis and abundant sputum production (mean 32 g.day-1). PEP consisted of positive expiratory pressure mask breathing interspersed with breathing exercises, forced expiration manoeuvres (huffing) and, if necessary, coughing. FET consisted of breathing exercises, huffing and also, if necessary, coughing. FET was combined with PD. Following inhalation of a radio-aerosol regional lung clearance was estimated by means of gamma camera imaging. The results after PEP appeared to be not significantly different from control. The mean clearance in all three lung zones (peripheral, intermediate and inner) was largest after FET/PD as compared with PEP and control. Statistical significance (p less than 0.02) was reached only for clearance in the inner region. It is concluded that PEP has no demonstrable effect on regional lung clearance in these patients.

Topics: Breathing Exercises; Bronchitis; Cough; Drainage, Postural; Female; Humans; Lung; Male; Masks; Middle Aged; Mucociliary Clearance; Radionuclide Imaging; Respiratory Therapy; Sodium Pertechnetate Tc 99m

Topics: Aged; Albumins; Betacoronavirus; Bronchitis; Clinical Laboratory Techniques; Coronavirus Infections; COVID-19; COVID-19 Testing; Humans; Male; Pandemics; Pneumonia, Viral; Radiopharmaceuticals; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Single Photon Emission Computed Tomography Computed Tomography; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin; Tracheitis; Ventilation-Perfusion Scan

Evaporation of Tc-99m pertechnetate at about 2500 degrees C on a carbon surface generates an ultrafine aerosol of Tc-99m-labeled carbon clusters (Technegas). The small particle size of about 100 nm enables the aerosol to behave similarly to a gas in its ability to penetrate. After inhalation, the radioactive particles adhere to the walls of the respiratory bronchioles and alveoli, or to the greater bronchial tubes if the airflow is not laminar. The high concentration of radioactivity in the argon carrier gas makes it possible to perform inhalation scintigraphy after only a few breaths. The authors investigated 24 infants with multiple events of bronchitis, most of whom had pneumonia. Seventeen patients had inhalation scintigraphy and bronchoscopy. Of these, 11 had scans diagnostic of bronchial stenosis and 6 had normal scans. Except for two pathologic scans, all scintigraphic findings matched well with the results of bronchoscopy. Seven patients had scintigraphy only, of which four were normal. Inhalation scintigraphy with Technegas is a reliable, nonhazardous procedure to preselect young patients for directed bronchoscopy.

Topics: Aerosols; Bronchial Diseases; Bronchitis; Bronchoscopy; Child; Constriction, Pathologic; Graphite; Humans; Infant; Lung; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Evaporation of 99mTc-pertechnetate at about 2500 degrees C on a carbon surface generates an ultrafine aerosol of labelled carbon clusters. Its particle size of about 2-5 nm enables the aerosol to behave similarly to a gas regarding the ability of penetration. After inhalation, the radioactive particles adhere to the walls of the respiratory bronchioli and alveoli. The high concentration of the radioactivity in the argon carrier gas makes it possible to record a scintigram after a single deep breath. We studied four healthy volunteers and 79 patients including 34 with a tentative diagnosis of pulmonary embolism, 20 with bronchus carcinoma, and 15 with various other lung diseases. Ten of these patients were infants, the youngest being nine months old. All patients also had a perfusion scintigraphy.

Topics: Administration, Inhalation; Adult; Aerosols; Aged; Bronchitis; Carcinoma, Bronchogenic; Female; Humans; Infant; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Pulmonary Embolism; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

While gravity-assisted positions (postural drainage) and the forced expiratory technique are known to promote sputum clearance, the additional value of percussion, vibratory-shaking and breathing exercises individually in chest physiotherapy is uncertain. These modalities have been evaluated in 8 patients with copious sputum production (mean: 44 g/day), using an inhaled radioaerosol technique. Tracheobronchial clearance was unaffected by the addition of either vibratory-shaking or percussion with and without breathing exercises to postural drainage. There was however a significant (p less than 0.01) increase in the dry weight of sputum produced during each of these treatments. The combination of postural drainage used in conjunction with the forced expiration technique is responsible for the majority of mucus mobilisation and should form the basis of routine chest physiotherapy programmes; the other modes appear to be of lesser value.

Topics: Breathing Exercises; Bronchial Diseases; Bronchiectasis; Bronchitis; Cystic Fibrosis; Drainage; Forced Expiratory Volume; Humans; Microspheres; Percussion; Posture; Sodium Pertechnetate Tc 99m; Sputum; Vibration; Vital Capacity