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https://www.readbyqxmd.com/read/28817980/pathways-to-pulmonary-hypertension-in-sickle-cell-disease-the-search-for-prevention-and-early-intervention
#1
Natalie R Shilo, Claudia R Morris
Pulmonary hypertension (PH) develops in a significant number of patients with sickle cell disease (SCD), resulting in increased morbidity and mortality. This review focuses on PH pathophysiology, risk stratification, and new recommendations for screening and treatment for patients with SCD. Areas covered: An extensive PubMed literature search was performed. While the pathophysiology of PH in SCD is yet to be fully deciphered, it is known that the etiology is multifactorial; hemolysis, hypercoagulability, hypoxemia, ischemic-reperfusion injury, oxidative stress, and genetic susceptibility all contribute in varying degrees to endothelial dysfunction...
August 18, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28816096/management-of-severe-pulmonary-hemorrhage-in-a-neonate-on-veno-arterial-ecmo-by-the-temporary-clamping-of-the-endotracheal-tube-a-case-report
#2
Vaclav Vobruba, Tomas Grus, Frantisek Mlejnsky, Jan Belohlavek, Jan Hridel, Lukas Lambert
Severe pulmonary hemorrhage in the newborn is an infrequent, but life-threatening, event. A newborn with persistent pulmonary hypertension and a large persistent ductus arteriosus and open foramen ovale presented with hypoxemia and progressive right heart failure shortly after birth, requiring veno-arterial extracorporeal membrane oxygenation (ECMO) support. Twenty minutes after the initiation of ECMO, the patient developed severe pulmonary hemorrhage refractory to conventional treatment. As a last resort, the endotracheal tube was clamped...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28808186/oxygenation-inflammatory-response-and-lung-injury-during-one-lung-ventilation-in-rabbits-using-inspired-oxygen-fraction-of-0-6-vs-1-0
#3
Zeping Xu, Lianbing Gu, Qingming Bian, Pengyi Li, Lijun Wang, Jingyuan Zhang, Yanning Qian
Maintaining adequate oxygenation during one-lung ventilation (OLV) requires high inspired oxygen fraction (FiO2). However, high FiO2 also causes inflammatory response and lung injury. Therefore, it remains a great interest to clinicians and scientists to optimize the care of patients undergoing OLV. The aim of this study was to determine and compare oxygenation, inflammatory response and lung injury during OLV in rabbits using FiO2 of 0.6 vs. 1.0. After 30 minutes of two-lung ventilation (TLV) as baseline, 30 rabbits were randomly assigned to three groups receiving mechanical ventilation for 3 hours: the sham group, receiving TLV with 0...
October 17, 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28806218/hypoxemic-patients-with-bilateral-infiltrates-treated-with-high-flow-nasal-cannula-present-a-similar-pattern-of-biomarkers-of-inflammation-and-injury-to-acute-respiratory-distress-syndrome-patients
#4
Marina García-de-Acilu, Judith Marin-Corral, Antonia Vázquez, Laura Ruano, Mònica Magret, Ricard Ferrer, Joan R Masclans, Oriol Roca
OBJECTIVE: To examine whether patients with acute hypoxemia and bilateral opacities treated with high-flow nasal cannula and acute respiratory distress syndrome patients who were directly mechanically ventilated are similar in terms of lung epithelial, endothelial, and inflammatory biomarkers. DESIGN: Prospective, multicenter study. SETTING: ICUs at three university tertiary hospitals. PATIENTS: Intubated and nonintubated patients admitted to the ICU with acute hypoxemia (PaO2/FIO2 ≤ 300) and bilateral opacities...
August 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28800865/contemporary-reviews-in-critical-care-medicine-anaphylaxis
#5
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or non-allergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28797271/successful-long-term-extracorporeal-membrane-oxygenation-for-invasive-pulmonary-aspergillosis-a-case-report
#6
Hiroyuki Tanaka, Kei Nishiyama, Nobuaki Shime
BACKGROUND: Extracorporeal membrane oxygenation is an established life-saving procedure for severe acute respiratory failure due to various causes. In general, the duration of extracorporeal membrane oxygenation ranges from 1 to 2 weeks, with withdrawal recommended if no improvement is noted. We report a successful case of long-term extracorporeal membrane oxygenation management for respiratory failure due to invasive pulmonary Aspergillus infection. CASE PRESENTATION: A 64-year-old Asian man with no previous underlying medical conditions was transferred to our hospital for fever and dyspnea...
August 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#7
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28774332/baicalin-attenuates-chronic-hypoxia-induced-pulmonary-hypertension-via-adenosine-a2a-receptor-induced-sdf-1-cxcr4-pi3k-akt-signaling
#8
Xiaoying Huang, Peiliang Wu, Feifei Huang, Min Xu, Mayun Chen, Kate Huang, Guo-Ping Li, Manhuan Xu, Dan Yao, Liangxing Wang
BACKGROUND: Baicalin, an important flavonoid in Scutellaria baicalensis Georgi extracts, exerts a variety of pharmacological effects. In this study, we explored the effects of baicalin on chronic hypoxia-induced pulmonary arterial hypertension (PAH) and investigated the mechanism underlying these effects. Moreover, we examined whether the inflammatory response was mediated by the A2A receptor (A2AR) and stromal cell-derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4)-induced phosphatidyl inositol-3-kinase (PI3K) signaling in vivo...
August 3, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#9
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28754002/pediatric-respiratory-support-technology-and-practices-a-global-survey
#10
Amélie O von Saint André-von Arnim, Shelina M Jamal, Grace C John-Stewart, Ndidiamaka L Musa, Joan Roberts, Larissa I Stanberry, Christopher R A Howard
OBJECTIVE: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. METHODS: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. RESULTS: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC)...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28751366/recent-advances-in-oxygen-sensing-and-signal-transduction-in-hypoxic-pulmonary-vasoconstriction
#11
Ievgen Strielkov, Oleg Pak, Natascha Sommer, Norbert Weissmann
Hypoxic pulmonary vasoconstriction (HPV) is a physiological reaction, which adapts lung perfusion to regional ventilation and optimizes gas exchange. Impaired HPV may cause systemic hypoxemia, while generalized HPV contributes to the development of pulmonary hypertension. The triggering mechanisms underlying HPV are still not fully elucidated. Several hypotheses are currently under debate, including a possible decrease as well as an increase in reactive oxygen species as a triggering event. Recent findings suggest an increase in the production of reactive oxygen species in pulmonary artery smooth muscle cells by complex III of the mitochondrial electron transport chain and occurrence of oxygen sensing at complex IV...
July 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28721821/current-perspectives-for-the-use-of-gonane-progesteronergic-drugs-in-the-treatment-of-central-hypoventilation-syndromes
#12
Camille Loiseau, Florence Cayetanot, Fanny Joubert, Anne-Sophie Perrin-Terrin, Philippe Cardot, Marie-Noëlle Fiamma, Alain Frugiere, Christian Straus, Laurence Bodineau
BACKGROUND: Central alveolar hypoventilation syndromes (CHS) encompass neurorespiratory diseases resulting from congenital or acquired neurological disorders. Hypercapnia, acidosis, and hypoxemia resulting from CHS negatively affect physiological functions and can be life-threatening. To date, the absence of pharmacological treatment implies that the patients must receive assisted ventilation throughout their lives. OBJECTIVE: To highlight the relevance of determining conditions in which using gonane synthetic progestins could be of potential clinical interest for the treatment of CHS...
July 19, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28720675/the-effect-of-nebulizer-position-on-aerosolized-epoprostenol-delivery-in-an-adult-lung-model
#13
Allison C Anderson, Meagan N Dubosky, Kelly A Fiorino, Vanessa Quintana, Carl A Kaplan, David L Vines
BACKGROUND: Aerosolized epoprostenol is an alternative for inhaled nitric oxide in the management of pulmonary arterial hypertension and possibly acute hypoxemia. Our objective was to determine differences in drug deposition based on different nebulizer positions in the ventilator circuit, using a vibrating mesh nebulizer. METHODS: An 8.0-mm inner diameter endotracheal tube (ETT) was connected to a training test lung, compliance of 30 mL/cm H2O, with a collecting filter placed at the ETT-test lung junction...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28717522/effect-of-hypoxic-injury-in-mood-disorder
#14
REVIEW
Fenglian Zhao, Junling Yang, Ranji Cui
Hypoxemia is a common complication of the diseases associated with the central nervous system, and neurons are highly sensitive to the availability of oxygen. Neuroplasticity is an important property of the neural system controlling breathing, memory, and cognitive ability. However, the underlying mechanism has not yet been clearly elucidated. In recent years, several pieces of evidence have highlighted the effect of hypoxic injury on neuronal plasticity in the pathogenesis and treatment of mood disorder. Therefore, the present study reviewed the relevant articles regarding hypoxic injury and neuronal plasticity and discussed the pathological changes and physiological functions of neurons in hypoxemia in order to provide a translational perspective to the relevance of hypoxic injury and mood disorder...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/28688997/maternal-body-mass-index-impacts-fetal-placental-size-at-birth-and-umbilical-cord-oxygen-values-with-implications-for-regulatory-mechanisms
#15
Bryan S Richardson, Stephanie Ruttinger, Hilary K Brown, Timothy R H Regnault, Barbra de Vrijer
BACKGROUND: Maternal under- and over-nutrition are known to effect fetal growth with altered placental development and nutrient transport, but whether fetal oxygenation is also altered remains unknown. AIMS: To examine linkages between maternal BMI and birth weights, placental weights, and umbilical vein and artery PO2, with implications for signaling mechanisms. STUDY DESIGN: Population-based cohort study. SUBJECTS: Analysis of hospital database information on all patients with pre-pregnant BMI values delivering viable, singleton infants between Jan 1, 1999 and Dec 31, 2010 (N=29,212)...
July 6, 2017: Early Human Development
https://www.readbyqxmd.com/read/28685420/oxygen-sensing-by-the-carotid-body-past-and-present
#16
Nanduri R Prabhakar, Ying-Jie Peng
It is now well established that carotid bodies are sensory organs for monitoring arterial blood oxygen levels and trigger reflexes that are critical for maintaining homeostasis during hypoxemia. This review article provides a brief account of the early studies leading to the discovery of the carotid body as a sensory receptor and addresses current views of O2 sensing mechanism(s) in the carotid body and their physiological importance.
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28685297/hemodynamic-effects-of-lipid-based-oxygen-microbubbles-via-rapid-intravenous-injection-in-rodents
#17
Katherine J Black, Andrew T Lock, Lindsay M Thomson, Alexis R Cole, Xiaoqi Tang, Brian D Polizzotti, John N Kheir
PURPOSE: Low oxygen levels, or hypoxemia, is a common cause of morbidity and mortality in critically ill patients. Hypoxemia is typically addressed by increasing the fraction of inspired oxygen, the use of mechanical ventilation, or more invasive measures. Recently, the injection of oxygen gas directly into the bloodstream by packaging it within lipid-based oxygen microbubbles (LOMs) has been explored. The purpose of this work is to examine the acute hemodynamic effects of intravenous injections of LOMs...
July 6, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28684287/high-frequency-oscillatory-ventilation-in-adults-with-ards-past-present-and-future
#18
REVIEW
Michael C Sklar, Eddy Fan, Ewan C Goligher
High-frequency oscillatory ventilation (HFOV) is a unique mode of mechanical ventilation that uses nonconventional gas exchange mechanisms to deliver ventilation at very low tidal volumes and high frequencies. The properties of HFOV make it a potentially ideal mode to prevent ventilator-induced lung injury in patients with ARDS. Despite a compelling physiological basis and promising experimental data, large randomized controlled trials have not detected an improvement in survival with the use of HFOV, and its use as an early lung-protective strategy in patients with ARDS may be harmful...
July 3, 2017: Chest
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#19
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28672919/brain-injury-with-systemic-inflammation-in-newborns-with-congenital-heart-disease-undergoing-heart-surgery
#20
Rossitza P Pironkova, Joseph Giamelli, Howard Seiden, Vincent A Parnell, Dorota Gruber, Cristina P Sison, Czeslawa Kowal, Kaie Ojamaa
The potential role of systemic inflammation on brain injury in newborns with congenital heart disease (CHD) was assessed by measuring levels of central nervous system (CNS)-derived proteins in serum prior to and following cardiac surgery. A total of 23 newborns (gestational age, 39±1 weeks) with a diagnosis of CHD that required cardiac surgery with cardiopulmonary bypass (CPB) were enrolled in the current study. Serum samples were collected immediately prior to surgery and 2, 24 and 48 h following CPB, and serum levels of phosphorylated neurofilament-heavy subunit (pNF-H), neuron-specific enolase (NSE) and S100B were analyzed...
July 2017: Experimental and Therapeutic Medicine
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