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https://www.readbyqxmd.com/read/28638160/low-flow-extracorporeal-carbon-dioxide-removal-using-the-hemolung-respiratory-dialysis-system-%C3%A2-to-facilitate-lung-protective-mechanical-ventilation-in-acute-respiratory-distress-syndrome
#1
Bindu Akkanti, Keshava Rajagopal, Kirti P Patel, Sangeeta Aravind, Emmanuel Nunez-Centanu, Rahat Hussain, Farshad Raissi Shabari, Wayne L Hofstetter, Ara A Vaporciyan, Igor S Banjac, Biswajit Kar, Igor D Gregoric, Pranav Loyalka
Extracorporeal carbon dioxide removal (ECCO2R) permits reductions in alveolar ventilation requirements that the lungs would otherwise have to provide. This concept was applied to a case of hypercapnia refractory to high-level invasive mechanical ventilator support. We present a case of an 18-year-old man who developed post-pneumonectomy acute respiratory distress syndrome (ARDS) after resection of a mediastinal germ cell tumor involving the left lung hilum. Hypercapnia and hypoxemia persisted despite ventilator support even at traumatic levels...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28620066/mitochondrial-complex-iv-subunit-4-isoform-2-is-essential-for-acute-pulmonary-oxygen-sensing
#2
Natascha Sommer, Maik Huttemann, Oleg Pak, Susan Scheibe, Fenja Knöpp, Christopher Sinkler, Monika Malczyk, Mareike Gierhardt, Azadeh Esfandiary, Simone Kraut, Felix T Jonas, Christine Veith, Siddhesh Aras, Akylbek Sydykov, Nasim Alebrahimdehkordi, Klaudia Giehl, Matthias Hecker, Ralf P Brandes, Werner Seeger, Friedrich Grimminger, Hossein A Ghofrani, Ralph T Schermuly, Lawrence I Grossman, Norbert Weissmann
Rationale: Acute pulmonary oxygen sensing is essential to avoid life-threatening hypoxemia via hypoxic pulmonary vasoconstriction (HPV) which matches perfusion to ventilation. Hypoxia-induced mitochondrial superoxide release has been suggested as critical step in the signaling pathway underlying HPV. However, the identity of the primary oxygen sensor and mechanism of superoxide release in acute hypoxia, as well as its relevance for chronic pulmonary oxygen sensing remains unresolved. Objective: To investigate the role of the pulmonary specific isoform 2 of subunit 4 of mitochondrial complex IV (Cox4i2) and the subsequent mediators superoxide and hydrogen peroxide for pulmonary oxygen sensing and signaling...
June 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28613912/molecular-and-immune-biomarkers-in-acute-respiratory-distress-syndrome-a-perspective-from-members-of-the-pulmonary-pathology-society
#3
Vera Luiza Capelozzi, Timothy Craig Allen, Mary Beth Beasley, Philip T Cagle, Don Guinee, Lida P Hariri, Aliya N Husain, Deepali Jain, Sylvie Lantuejoul, Brandon T Larsen, Ross Miller, Mari Mino-Kenudson, Mehrad Mitra, Kirtee Raparia, Anja Roden, Frank Schneider, Lynette M Sholl, Maxwell Lawrence Smith
Acute respiratory distress syndrome (ARDS) is a multifactorial syndrome with high morbidity and mortality rates, characterized by deficiency in gas exchange and lung mechanics that lead to hypoxemia, dyspnea, and respiratory failure. Histologically, ARDS is characterized by an acute, exudative phase, combining diffuse alveolar damage and noncardiogenic edema, followed by a later fibroproliferative phase. Despite an enhanced understanding of ARDS pathogenesis, the capacity to predict the development of ARDS and to risk-stratify patients with the disease remains limited...
June 14, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28584437/severe-pediatric-acute-respiratory-distress-syndrome-due-to-scrub-typhus-successful-ventilation-with-airway-pressure-release-ventilation-mode-after-becoming-refractory-to-protective-ventilation
#4
Sudha Chandelia, Sarika Jain
Scrub typhus can affect lungs from mild illness like pneumonitis to a severe illness like acute respiratory distress syndrome (ARDS). Such patients may be very challenging to treat when their hypoxemia becomes severe and refractory to treatment. Main treatment is supportive in terms of mechanical ventilation. In adult ARDS, low tidal volume (TV) ventilation has been recommended, but there is no consensus on most effective ventilation mode in children. We present a case of a 12-year-old girl who developed severe ARDS (PO2/FiO2 ratio - 58), refractory to low TV ventilation...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28578633/early-pulmonary-compliance-increase-during-cardiac-surgery-predicted-post-operative-lung-dysfunction
#5
Yann Sacuto, Thierry Sacuto
INTRODUCTION: Lung dysfunction following cardiac surgery is currently viewed as the consequence of atelectasis and lung injury. While the mechanism of atelectasis has been largely detailed, the pathogenesis of lung injury after cardiopulmonary bypass is still unclear. Based upon clinical and experimental studies, we hypothesized that lungs could be injured through a mechanical phenomenon. METHODS: We recorded pulmonary compliance at six key moments of a heart operation in 62 adult patients undergoing elective cardiac surgery...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28561960/acute-respiratory-distress-syndrome-and-septic-shock-in-a-cat-with-disseminated-toxoplasmosis
#6
Natashia A Evans, Julie M Walker, Alison C Manchester, Jonathan F Bach
OBJECTIVE: To describe acute respiratory distress syndrome (ARDS) and septic shock in a cat with disseminated toxoplasmosis. CASE SUMMARY: A 2-year-old neutered male domestic shorthair cat was presented for acute respiratory distress. At the time of presentation it had been receiving cyclosporine for treatment of eosinophilic dermatitis. Thoracic radiographs revealed severe mixed nodular interstitial and alveolar patterns. An endotracheal wash was performed, which confirmed a diagnosis of pulmonary toxoplasmosis...
May 31, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28538439/nonlinear-imputation-of-pao2-fio2-from-spo2-fio2-among-mechanically-ventilated-patients-in-the-icu-a-prospective-observational-study
#7
Samuel M Brown, Abhijit Duggal, Peter C Hou, Mark Tidswell, Akram Khan, Matthew Exline, Pauline K Park, David A Schoenfeld, Ming Liu, Colin K Grissom, Marc Moss, Todd W Rice, Catherine L Hough, Emanuel Rivers, B Taylor Thompson, Roy G Brower
OBJECTIVES: In the contemporary ICU, mechanically ventilated patients may not have arterial blood gas measurements available at relevant timepoints. Severity criteria often depend on arterial blood gas results. Retrospective studies suggest that nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 is accurate, but this has not been established prospectively among mechanically ventilated ICU patients. The objective was to validate the superiority of nonlinear imputation of PaO2/FIO2 among mechanically ventilated patients and understand what factors influence the accuracy of imputation...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28533903/using-paco2-values-to-grade-obesity-hypoventilation-syndrome-severity-a-retrospective-study
#8
Mario Francesco Damiani, Vito Antonio Falcone, Pierluigi Carratù, Cristina Scoditti, Elioda Bega, Silvano Dragonieri, Alfredo Scoditti, Onofrio Resta
BACKGROUND: To date, an important aspect that has still not been clarified is the assessment of OHS severity. The purpose of this retrospective study was to evaluate whether grading OHS severity according to PaCO2 values may be useful in order to provide a more definite characterization and targeted management of patients. In this regard, baseline anthropometric and sleep polygraphic characteristics, treatment options, and follow up outcomes, were compared between OHS patients with different degree of severity (as assessed according to PaCO2 values)...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28526710/gbt1118-a-potent-allosteric-modifier-of-hemoglobin-oxygen-affinity-increases-tolerance-to-severe-hypoxia-in-mice
#9
Kobina Dufu, Ozlem Yalcin, Eilleen Sy Ao-Ieong, Athiwat Hutchaleelala, Qing Xu, Zhe Li, Nicholas Vlahakis, Donna Oksenberg, Josh Lehrer-Graiwer, Pedro Cabrales
Adaptation to hypoxia requires compensatory mechanisms that affect oxygen (O2) transport and utilization. Decreased hemoglobin (Hb)-O2 affinity is considered part of the physiological adaptive process to chronic hypoxia. This manuscript explores the hypothesis that increased Hb-O2 affinity can complement acute physiological responses to hypoxia by increasing O2 uptake and delivery when compared to normal Hb-O2 affinity during acute severe hypoxia. To test this hypothesis, mice Hb-O2 affinity was increased via oral administration of 70 or 140 mg/kg GBT1118...
May 19, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28522758/regulation-of-erythropoiesis-after-normoxic-return-from-chronic-sustained-and-intermittent-hypoxia
#10
Jihyun Song, Krishna Sundar, Radhika Gangaraju, Josef T Prchal
Hypoxia increases erythropoiesis mediated by hypoxia-inducible transcription factors (HIF) which regulate erythropoietin (EPO) transcription. Neocytolysis is a physiological mechanism that corrects polycythemia from chronic sustained hypoxemia (CSH) by transient, preferential destruction of young RBCs after normoxia is restored. We showed that neocytolysis is caused by excessive mitochondrial-derived reactive oxygen species (ROS) in reticulocytes mediated by down-regulation of HIF-controlled BNIP3L regulated mitophagy and a decrease in RBC antioxidant catalase (CAT) in hypoxia-produced erythrocytes...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28509776/hyperleukocytosis-complicated-by-intracerebral-hemorrhage-and-spurious-hypoxemia-a-case-report-and-literature-review
#11
Yumi Katakura, Yoshikazu Yamaguchi, Tetsuya Miyashita, Masafumi Idei, Tasuku Yoshida, Yuko Matsuda, Shunsuke Takaki, Aki Kamijo, Osamu Yamaguchi, Takahisa Goto
We present the management of a 15-year-old girl with acute myeloid leukemia who presented with massive hyperleukocytosis and neurological deficit due to intracerebral hemorrhage. Surgical intervention was considered but ultimately not undertaken because of the presence of massive hyperleukocytosis, thrombocytopenia, hypokalemia, and considerable discrepancy between the oxygen saturation values determined mechanically and by peripheral oximetry. Aggressive treatment of the hyperleukocytosis was immediately started, which improved the patient's overall condition and rendered surgical intervention unnecessary...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28466866/posttreatment-with-protectin-dx-ameliorates-bleomycin-induced-pulmonary-fibrosis-and-lung-dysfunction-in-mice
#12
Hui Li, Yu Hao, Huawei Zhang, Weiyang Ying, Dan Li, Yahe Ge, Binyu Ying, Bihuan Cheng, Qingquan Lian, Shengwei Jin
Protectin DX (10S,17S-dihydroxydocosa-4Z,7Z,11E,13Z,15E,19Z-hexaenoic acid) (PDX), generated from Ω-3 fatty docosahexaenoic acids, is believed to exert anti-inflammatory and proresolution bioactions. To date, few studies have been performed regarding its effect on pulmonary fibrosis. Herein we show that PDX exerts a potential therapeutic effect which is distinct from its anti-inflammation and pro-resolution activity on mice with pulmonary fibrosis. In the present study, we showed that bleomycin (BLM) increased inflammatory infiltration, collagen deposition, and lung dysfunction on day7 after challenged in mice...
May 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28459409/-correlation-factor-analysis-on-constipation-in-long-term-ventilated-patients-in-intensive-care-unit-a-prospective-observational-cohort-study
#13
Mingying Dai, Huimin Wang, Kun Li, Bangxu Yu, Xinting Pan
OBJECTIVE: To explore the factors associated with delayed defecation in long-term ventilated patients in intensive care unit (ICU) and their potential effect on prognosis. METHODS: A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days)...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459322/fifty-years-of-research-in-ards-is-extracorporeal-circulation-the-future-of-acute-respiratory-distress-syndrome-management
#14
Alain Combes, Antonio Pesenti, V Marco Ranieri
Mechanical ventilation (MV) remains the cornerstone of acute respiratory distress syndrome (ARDS) management. It guarantees sufficient alveolar ventilation, high FiO2 concentration, and high positive end-expiratory pressure levels. However, experimental and clinical studies have accumulated, demonstrating that MV also contributes to the high mortality observed in patients with ARDS by creating ventilator-induced lung injury. Under these circumstances, extracorporeal lung support (ECLS) may be beneficial in two distinct clinical settings: to rescue patients from the high risk for death associated with severe hypoxemia, hypercapnia, or both not responding to maximized conventional MV, and to replace MV and minimize/abolish the harmful effects of ventilator-induced lung injury...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28444079/use-of-noninvasive-ventilation-in-severe-acute-respiratory-distress-syndrome-due-to-accidental-chlorine-inhalation-a-case-report
#15
Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443953/flexible-bronchoscopy-and-mechanical-ventilation-in-managing-mounier-kuhn-syndrome-a-case-report
#16
Aslihan Gürün Kaya, Aydin Çiledağ, Çetin Atasoy, Demet Karnak
CONTEXT: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support. CASE REPORT: The patient was a 60-year-old male with recurrent hospital admission. He was admitted in this case due to dyspnea, cough and sputum production. An arterial blood sample revealed decompensated respiratory acidosis with moderate hypoxemia. A chest computed tomography (CT) scan showed dilatation of the trachea and bronchi, tracheal diverticula and bronchiectasis...
April 20, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28435094/diammonium-glycyrrhizinate-alleviates-hepatopulmonary-syndrome-via-restoring-superoxide-dismutase-3-activity-in-rats
#17
Xin Zhao, Jinyu Liu, Shijun Yang, Chen Chen, He Yin, Ting Li, Qiuting Wang, Xiaoya Li, Yulin Lin, Dayong Cai
Hepatopulmonary syndrome (HPS) has a fatal hypoxemia from pulmonary shunts. Superoxide dismutase 3 (SOD3) deficiency involves in this pathogenesis. The purpose of this study was to investigate the underlying mechanisms of diammonium glycyrrhizinate (DG) on HPS via SOD3. Carbon tetrachloride induced HPS rats were treated with captopril or DG for 56 days. Blood gas, pulmonary artery pressures, and histological changes were measured. Molecule dynamics of inducible (iNOS), endothelial (eNOS), neuronal nitric oxide synthase (nNOS) and SOD3 were assessed by immunohistochemistry, quantitative RT-PCR and western blot...
July 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28430880/cerebral-abscess-associated-with-odontogenic-bacteremias-hypoxemia-and-iron-loading-in-immunocompetent-patients-with-right-to-left-shunting-through-pulmonary-arteriovenous-malformations
#18
E J Boother, S Brownlow, H C Tighe, K B Bamford, J E Jackson, C L Shovlin
Background: Cerebral abscess is a recognised complication of pulmonary arteriovenous malformations (PAVMs) that allow systemic venous blood to bypass the pulmonary capillary bed through anatomic right-to-left shunts. Broader implications and mechanisms remain poorly explored. Methods: Between June 2005 and December 2016, at a single institution, 445 consecutive adult patients with CT-scan confirmed PAVMs (including 403 (90.5%) with hereditary haemorrhagic telangiectasia) were recruited to a prospective series...
April 19, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#19
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28424613/the-relationship-between-cerebral-small-vessel-disease-hippocampal-volume-and-cognitive-functioning-in-patients-with-copd-an-mri-study
#20
Fiona A H M Cleutjens, Rudolf W H M Ponds, Martijn A Spruit, Saartje Burgmans, Heidi I L Jacobs, Ed H B M Gronenschild, Julie Staals, Frits M E Franssen, Jeanette B Dijkstra, Lowie E G W Vanfleteren, Paul A Hofman, Emiel F M Wouters, Daisy J A Janssen
The neural correlates of cognitive impairment in chronic obstructive pulmonary disease (COPD) are not yet understood. Structural brain abnormalities could possibly be associated with the presence of cognitive impairment through cigarette smoke, inflammation, vascular disease, or hypoxemia in these patients. This study aimed to investigate whether macrostructural brain magnetic resonance imaging (MRI) features of cerebral small vessel disease (SVD) and hippocampal volume (HCV) are related to cognitive performance in patients with COPD...
2017: Frontiers in Aging Neuroscience
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