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https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#1
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
November 17, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#2
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29144508/ly6g-neutrophil-derived-mir-223-inhibits-the-nlrp3-inflammasome-in-mitochondrial-damp-induced-acute-lung-injury
#3
Zunyong Feng, Shimei Qi, Yue Zhang, Zhilin Qi, Liang Yan, Jing Zhou, Fang He, Qianqian Li, Yanyan Yang, Qun Chen, Shi Xiao, Qiang Li, Yang Chen, Yao Zhang
MicroRNA (miRNA) mediates RNA interference to regulate a variety of innate immune processes, but how miRNAs coordinate the mechanisms underlying acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in patients with pulmonary inflammatory injury is still unknown. In this study, we demonstrated that miR-223 limits the number of Ly6G+ neutrophils and inhibits the activity of the NLRP3 inflammasome to alleviate ALI induced by mitochondrial damage-associated molecular patterns (DAMPs) (MTDs). miR-223 expression is increased in the lungs of MTD-induced mice or ARDS patients following trauma/transfusion or following the physiological remission of ALI/ARDS...
November 16, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/29143490/rock-glaciers-in-crystalline-catchments-hidden-permafrost-related-threats-to-alpine-headwater-lakes
#4
Boris P Ilyashuk, Elena A Ilyashuk, Roland Psenner, Richard Tessadri, Karin A Koinig
A global warming-induced transition from glacial to periglacial processes has been identified in mountainous regions around the world. Degrading permafrost in pristine periglacial environments can produce acid rock drainage (ARD) and cause severe ecological damage in areas underlain by sulfide-bearing bedrock. Limnological and paleolimnological approaches were used to assess and compare ARDs generated by rock glaciers, a typical landform of the mountain permafrost domain, and their effects on alpine headwater lakes with similar morphometric features and underlying bedrock geology, but characterized by different intensities of frost action in their catchments during the year...
November 15, 2017: Global Change Biology
https://www.readbyqxmd.com/read/29143168/limited-influence-of-blunt-aortic-injuries-on-the-outcome-of-polytraumatized-patients-a-matched-pair-analysis
#5
A Omar, C Macke, M Winkelmann, E Beckmann, P Mommsen, C Schröter, C Krettek, Christian Zeckey
INTRODUCTION: Traumatic lesions of great vessels such as the aorta are life-threatening injuries. There is limited evidence about the influence of traumatic aortic injuries in multiple trauma patients in particular with regard to posttraumatic complications. The aim of this study was to evaluate the influence of blunt thoracic aortic injuries in multiple trauma patients compared to a multiple trauma cohort without this specific injury. In addition, the safety of Thoracic Endovascular Aortic Repair (TEVAR) in multiple trauma patients was analyzed...
November 15, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29142003/disparities-in-environmental-exposures-to-endocrine-disrupting-chemicals-and-diabetes-risk-in-vulnerable-populations
#6
Daniel Ruiz, Marisol Becerra, Jyotsna S Jagai, Kerry Ard, Robert M Sargis
Burgeoning epidemiological, animal, and cellular data link environmental endocrine-disrupting chemicals (EDCs) to metabolic dysfunction. Disproportionate exposure to diabetes-associated EDCs may be an underappreciated contributor to disparities in metabolic disease risk. The burden of diabetes is not uniformly borne by American society; rather, this disease disproportionately affects certain populations, including African Americans, Latinos, and low-income individuals. The purpose of this study was to review the evidence linking unequal exposures to EDCs with racial, ethnic, and socioeconomic diabetes disparities in the U...
November 15, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29140963/when-the-momentum-has-gone-what-will-be-the-role-of-extracorporeal-lung-support-in-the-future
#7
Darryl Abrams, Matthew Bacchetta, Daniel Brodie
PURPOSE OF REVIEW: There has been expanding interest in and use of extracorporeal support in respiratory failure concurrent with technological advances and predominantly observational data demonstrating improved outcomes. However, until there is more available data from rigorous, high-quality randomized studies, the future of extracorporeal support remains uncertain. RECENT FINDINGS: Outcomes for patients supported with extracorporeal devices continue to show favorable trends...
November 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29140951/platelet-aggregation-after-blunt-trauma-is-associated-with-the-acute-respiratory-distress-syndrome-and-altered-by-cigarette-smoke-exposure
#8
Farzad Moazed, Carolyn Hendrickson, Mary Nelson, Amanda Conroy, Mitchell J Cohen, Carolyn S Calfee
BACKGROUND: The risk of the acute respiratory distress syndrome (ARDS) is increased in passive and active smokers after blunt trauma. However, the mechanisms responsible, including the role of platelet aggregation, for this association are unknown. METHODS: We analyzed 215 patients with severe blunt trauma from a prospective observational cohort at a Level 1 trauma center between 2010 - 2015. Subjects underwent impedance-based platelet aggregometry in response to platelet agonists arachidonic acid (ASPI), adenosine diphosphate (ADP), collagen (COL) and thrombin receptor activating peptide-6 (TRAP)...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29138874/using-il-6-concentrations-in-the-first-24%C3%A2-h-following-trauma-to-predict-immunological-complications-and-mortality-in-trauma-patients-a-meta-analysis
#9
REVIEW
Zhi Qiao, Weikang Wang, Luxu Yin, Peng Luo, Johannes Greven, Klemens Horst, Frank Hildebrand
PURPOSE: In previous studies, interleukin-6 (IL-6) has been shown to have a high predictive value for the development of complications and mortality after trauma; however, there is some uncertainty around these results. The aim of this meta-analysis was to assess the value of early IL-6 levels (within the first 24 h after trauma) for predicting post-traumatic complications [acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, multiple organ failure (MOF), and multiple organ dysfunction syndrome (MODS)] and mortality...
November 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29138069/traumatic-fractures-of-the-cervical-spine-analysis-of-changes-in-incidence-etiology-concurrent-injuries-and-complications-among-488-262-patients-from-2005-2013
#10
Peter G Passias, Gregory W Poorman, Frank A Segreto, Cyrus M Jalai, Samantha R Horn, Cole A Bortz, Dennis Vasquez-Montes, Bassel G Diebo, Shaleen Vira, Olivia J Bono, Rafael De La Garza-Ramos, John Y Moon, Charles Wang, Brandon P Hirsch, Peter L Zhou, Michael Gerling, Heiko Koller, Virginie Lafage
OBJECTIVE: The etiologies and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, etiology, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. METHODS: Retrospective review of the Nationwide Inpatient Sample. ICD-9 E-Codes identified trauma cases from 2005-2013. Patients with cervical fracture were isolated...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137274/effective-protection-against-acute-respiratory-distress-syndrome-sepsis-injury-by-combined-adipose-derived-mesenchymal-stem-cells-and-preactivated-disaggregated-platelets
#11
Chih-Hung Chen, Yung-Lung Chen, Pei-Hsun Sung, Cheuk-Kwan Sun, Kuan-Hung Chen, Yi-Ling Chen, Tien-Hung Huang, Hung-I Lu, Fan-Yen Lee, Jiunn-Jye Sheu, Sheng-Ying Chung, Mel S Lee, Hon-Kan Yip
This study assessed whether combining adipose-derived mesenchymal stem cells (ADMSC) with preactivated, disaggregated shape-changed platelets (PreD-SCP) was superior to either therapy alone for protecting rat lung from acute respiratory distress syndrome (ARDS) complicated by sepsis. ARDS and sepsis were induced through 100% oxygen inhalation and peritoneal administration of 1.5 mg/kg lipopolysaccharide (LPS), respectively. Adult-male Sprague-Dawley rats (n=40) were randomized into sham-control (SC), ARDS-LPS, ARDS-LPS-ADMSC (1...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29136129/comparison-of-respirable-mass-concentrations-measured-by-a-personal-dust-monitor-and-a-personal-dataram-to-gravimetric-measurements
#12
Andrew Halterman, Sinan Sousan, Thomas M Peters
In 2016, the Mine Safety and Health Administration required the use of continuous monitors to measure respirable dust in mines and better protect miner health. The Personal Dust Monitor, PDM3700, has met stringent performance criteria for this purpose. In a laboratory study, respirable mass concentrations measured with the PDM3700 and a photometer (personal DataRam, pDR-1500) were compared to those measured gravimetrically for five aerosols of varying refractive index and density (diesel exhaust fume, welding fume, coal dust, Arizona road dust (ARD), and salt [NaCl] aerosol) at target concentrations of 0...
November 9, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/29136027/expression-of-toll-like-receptors-tlrs-in-the-lungs-of-an-experimental-sepsis-mouse-model
#13
Anargyros Bakopoulos, Alkistis Kapelouzou, Diamantis I Tsilimigras, Michalis Katsimpoulas, Dimitrios Schizas, Chrysostomos Aravanis, Evaggelos Balafas, Manolis Mavroidis, Kitty Pavlakis, Anastasios Machairas, Theodore Liakakos
BACKGROUND: Sepsis is a condition characterized by high mortality rates and often accompanied by multiple-organ dysfunction. During sepsis, respiratory system may be affected and possibly result in acute respiratory distress syndrome (ARDS). Toll-like receptors (TLRs), as a first line defense against invading pathogens, seem to be highly expressed in septic states. Therefore, expression of TLRs in the lungs of a sepsis animal model could indicate the involvement of the respiratory system and appear as a severity index of the clinical course...
2017: PloS One
https://www.readbyqxmd.com/read/29135617/lessons-to-learn-from-epidemiologic-studies-in-ards
#14
Bairbre A McNicholas, Grainne M Rooney, John G Laffey
PURPOSE OF REVIEW: Recent advances in our understanding of the epidemiology of ARDS has generated key insights into the incidence, risk factors, demographics, management and outcomes from this devastating clinical syndrome. RECENT FINDINGS: ARDS occurs in 10% of all ICU patients, in 23% of all mechanically ventilated patients, with 5.5 cases per ICU bed each year. Although some regional variation exists regarding ARDS incidence, this may be less than previously thought...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29135583/effect-of-immediate-initiation-of-antiretroviral-treatment-on-the-risk-of-acquired-hiv-drug-resistance
#15
Sara Lodi, Huldrych F Günthard, David Dunn, Federico Garcia, Roger Logan, Sophie Jose, Heiner C Bucher, Alexandra U Scherrer, Marie-Paule Schneider, Matthias Egger, Tracy R Glass, Peter Reiss, Ard van Sighem, T Sonia Boender, Andrew N Phillips, Kholoud Porter, David Hawkins, Santiago Moreno, Susana Monge, Dimitrios Paraskevis, Metallidis Simeon, Georgia Vourli, Caroline Sabin, Miguel A Hernán
OBJECTIVE: We estimated and compared the risk of clinically identified acquired drug resistance under i) immediate initiation (the currently recommended ART initiation strategy), ii) initiation with CD4 < 500, and iii) initiation with CD4 < 350 cells/mm. DESIGN: Cohort study based on routinely collected data from the HIV-CAUSAL Collaboration. METHODS: For each individual, baseline was the earliest time when all eligibility criteria (ART-naïve, AIDS-free, and others) were met after 1999...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29134246/does-high-peep-prevent-alveolar-cycling
#16
REVIEW
M Cressoni, C Chiurazzi, D Chiumello, L Gattinoni
Acute respiratory distress syndrome (ARDS) patients need mechanical ventilation to sustain gas exchange. Animal experiments showed that mechanical ventilation with high volume/plateau pressure and no positive end-expiratory pressure (PEEP) damages healthy lungs, while low tidal volumes and the application of higher PEEP levels are protective. PEEP makes the lung homogeneous, reducing the pressure multiplication at the interface between lung units with different inflation statuses and keeps the lung open through the whole respiratory cycle, avoiding intratidal opening and closing...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29134245/esophageal-pressure-research-or-clinical-tool
#17
REVIEW
E Baedorf Kassis, S H Loring, D Talmor
Esophageal manometry has traditionally been utilized for respiratory physiology research, but clinicians have recently found numerous applications within the intensive care unit. Esophageal pressure (PEs) is a surrogate for pleural pressures (PPl), and the difference between airway pressure (PAO) and PEs provides a good estimate for the pressure across the lung also known as the transpulmonary pressure (PL). Differentiating the effects of mechanical ventilation and spontaneous breathing on the respiratory system, chest wall, and across the lung allows for improved personalization in clinical decision making...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#18
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29132514/ventilator-strategies-for-chronic-obstructive-pulmonary-disease-and-acute-respiratory-distress-syndrome
#19
REVIEW
Nathan T Mowery
The management of the ventilator in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS) has a dramatic effect on the overall outcome. The incidence of COPD is increasing as the US population grows older. The most effective means to deal with pulmonary complications is to avoid them, but both COPD and ARDS have evidence-based interventions that have been shown to improve outcomes. Pulmonary complications affect up to 40% of patients, and their occurrence is associated with an increased duration of hospital stay, and an increased mortality...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132404/comparison-of-the-efficacy-and-safety-of-fp-1201-lyo-intravenously-administered-recombinant-human-interferon-beta-1a-and-placebo-in-the-treatment-of-patients-with-moderate-or-severe-acute-respiratory-distress-syndrome-study-protocol-for-a-randomized-controlled
#20
Geoff Bellingan, David Brealey, Jordi Mancebo, Alain Mercat, Nicolò Patroniti, Ville Pettilä, Michael Quintel, Jean-Louis Vincent, Mikael Maksimow, Markku Jalkanen, Ilse Piippo, V Marco Ranieri
BACKGROUND: Acute respiratory distress syndrome (ARDS) results in vascular leakage, inflammation and respiratory failure. There are currently no approved pharmacological treatments for ARDS and standard of care involves treatment of the underlying cause, and supportive care. The vascular leakage may be related to reduced concentrations of local adenosine, which is involved in maintaining endothelial barrier function. Interferon (IFN) beta-1a up-regulates the cell surface ecto-5'-nucleotidase cluster of differentiation 73 (CD73), which increases adenosine levels, and IFN beta-1 may, therefore, be a potential treatment for ARDS...
November 13, 2017: Trials
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