- Mucociliary Clearance
Mucociliary Clearance, also referred to as mucociliary apparatus or mucociliar clearance (MCC) , derived from "mucus" , "cilia " (cilia of the tracheal surface epithelium in the respiratory tract ) and "clearance" describes the self-clearing mechanism of the bronchi.
The main bronchi down to the alveoli are lined with a respiratory epithelium. On that cilium is existent, bearing hair-shaped structures on its surface (cilia). The cilia are surrounded by a thin fluid film of mucus. On top of that is a second viscous film of mucus, in which foreign particles and microorganisms get stuck. Within the thin fluid film of mucus the cilia act out movements coordinated in direction towards the Pharynx. Thereby the viscous film of mucus including its freight is transported off in direction towards the mouth, where it is either swallowed or coughed off.
Important for good mucociliary clearance are the number of cilia, their structure, activity, and coordinated movement. Optimum functionality of mucociliary clearance presuppose a temperature of 37 °C and an absolute humidity of 44 mg/dm³ corresponding to a relative humidity of 100 %. Under the condition of insufficient temperature and humidity, after a short time the ciliary cells suspend their transport function. Under such circumstances, bacterial germinal colonization is facilitated. Pulmonary infections and damaging of the pulmonic tissues may be the consequence.
humidityenhances the functionality of the mucociliary clearance. Two methods of supporting mucociliary clearance are the active and the passive respiratory gas humidification, which in particular are applied in mechanical ventilation.
* M.A. Sleigh, J.R. Blake, N. Liron: "The Propulsion of Mucus by Cilia." In: Am. Rev. Respir., Dis. 1988; 137: 726-41.
* R. Williams, N. Rankin, T. Smith, et al.: "Ralationship between humidity and temperature of inspired gas and the function of the airway mucosa." In: Crit. Care Med, 1996, Vol. 24, no11: 1920-1929.
* R. Estes, G. Meduri: "The Pathogenesis of Ventilator-Associated Pneumonia: 1. Mechnisms of Bacterial Transcolonization and Airway Innoculation." In: Intensive Care Medicine. 1995; 21: 365-383.
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