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Acute Distress Syndrome

Chin-Mao Hung, Chung-Kan Peng, Chin-Pyng Wu, Kun-Lun Huang
Bumetanide is a potent loop diuretic that acts as an inhibitor of sodium-potassium-chloride cotransporter 2 (NKCC2) and its isoform NKCC1. Although the expression of NKCC2 is limited to the kidney, NKCC1 is widely expressed in various cells, where it participates in a variety of physiological functions including ion transport, alveolar fluid secretion, and cell volume regulation. We investigated the role of NKCC1 in modulation of host immunity. Lipopolysaccharide (LPS) stimulated the expression and phosphorylation of NKCC1 in RAW264...
August 10, 2018: Biochemical Pharmacology
Serra Sürmeli-Döven, Ali Delibaş, İclal Gürses, Uğur Raşit Kayacan, Banu Coşkun-Yılmaz, Kaan Esen, Emine Korkmaz, Fatih Özaltın
Sürmeli-Döven S, Delibaş A, Gürses İ, Kayacan UR, Coşkun-Yılmaz B, Esen K, Korkmaz E, Özaltın F. Hemolytic uremic syndrome and IgA nephropathy in a child: Coincidence or not? Turk J Pediatr 2018; 60: 81-85. A previously healthy 18-month old boy, presenting with diarrhea, anemia, thrombocytopenia and acute renal failure was admitted to our hospital. Hemolytic uremic syndrome (HUS) was diagnosed with his clinical and laboratory findings. His stool was negative for Shiga toxin producing E. coli (STEC)...
2018: Turkish Journal of Pediatrics
Ying Zhou, Qianqian Fan, Omer Cavus, Xuezheng Zhang
Purpose: The purpose of the study was to review and summarize current literature concerning the validation and application of lung ultrasound (LUS) in critically ill patients with acute respiratory distress syndrome (ARDS). Materials and Methods: An extensive literature search was conducted using PubMed, Cochrane Review, Google Scholar, and Ohio State University Link based on the question if LUS should be considered a reliable investigational technique for ARDS diagnosis, treatment, and prognosis in pediatric and adult population...
July 2018: Saudi Journal of Anaesthesia
Gabriella F Pogorzelski, Taline Aal Silva, Thamara Piazza, Tomás M Lacerda, Fernando Ac Spencer Netto, Amaury Cesar Jorge, Péricles Ad Duarte
Background: Trauma is a major cause of hospital admissions and is associated with manifold complications and high mortality rates. However, data on intensive care unit (ICU) admissions are scarce in developing and low-income countries, where its incidence has been increasing. Objectives: To analyze epidemiological and clinical factors and outcomes in adult trauma patients admitted to the ICU of a public teaching hospital in a developing country as well as to identify risk factors for complications in the ICU...
2018: Open Access Emergency Medicine: OAEM
Rachel L Bussard, Laurence W Busse
Angiotensin II (Ang II), part of the renin-angiotensin-aldosterone system (RAS), is a potent vasoconstrictor and has been recently approved for use by the US Food and Drug Administration in high-output shock. Though not a new drug, the recently published Angiotensin II for the Treatment of High Output Shock (ATHOS-3) trial, as well as a number of retrospective analyses have sparked renewed interest in the use of Ang II, which may have a role in treating refractory shock. We describe refractory shock, the unique mechanism of action of Ang II, RAS dysregulation in shock, and the evidence supporting the use of Ang II to restore blood pressure...
2018: Therapeutics and Clinical Risk Management
Soon Leong Yong, Safilah Dahian, Aznim Hani Ramlan, Marcus Kang
Normal-sized ovarian carcinoma syndrome (NOCS) is a rare condition characterised by malignancy identified in ovaries of normal size with abdominal metastasis. We report two cases of advanced ovarian carcinoma with ovaries of normal size. The first case was a 13-year-old adolescent with malignant ascites and bilateral normal sized multicystic ovaries detected on ultrasound. Serum cancer antigen 125 (CA 125) and lactate dehydrogenase were markedly raised. A computed tomography (CT) scan showed the presence of thick omental cake but no ovarian tumour...
August 11, 2018: Hormone Molecular Biology and Clinical Investigation
Athanasios Chalkias, Theodoros Xanthos, Effie Papageorgiou, Artemis Anania, Apostolos Beloukas, Fotios Pavlopoulos
PURPOSE: To assess the intraoperative initiation and feasibility of a modified NIH-NHLBI ARDS Network Mechanical Ventilation Protocol (mARDSNet protocol) in septic patients with severe ARDS. MATERIALS AND METHODS: This prospective observational study included consecutive adult septic patients with severe ARDS who underwent emergency abdominal surgery prior to intensive care unit (ICU) admission. The primary outcome was survival to hospital discharge and at 90 days...
August 7, 2018: Heart & Lung: the Journal of Critical Care
Wan-Ling Chen, Wei-Ting Lin, Shu-Chen Kung, Chih-Cheng Lai, Chien-Ming Chao
This study aims to investigate the association between oxygenation saturation index (OSI) and the outcome of acute respiratory distress syndrome (ARDS) patients, and assess the predictive performance of OSI for ARDS patients' mortality. This study was conducted at one regional hospital with 66 adult intensive care unit (ICU) beds. All patients with ARDS were identified between November 1 2016 and May 31 2018, and their clinical information was retrospectively collected. The lowest PaO₂/FiO₂ ratio and SpO₂/FiO₂ ratio and highest mean airway pressure (MAP) were recorded on the first day of ARDS; and oxygen index (OI) and OSI were calculated as (FiO₂ × MAP × 100)/PaO₂, and (FiO₂ × MAP × 100) /SpO₂ accordingly...
August 8, 2018: Journal of Clinical Medicine
Mary K Dahmer, Michael W Quasney, Anil Sapru, Ginny Gildengorin, Martha A Q Curley, Michael A Matthay, Heidi Flori
OBJECTIVES: To test whether plasma interleukin-1 receptor antagonist or variants within the gene encoding for interleukin-1ra (IL1RN), or proteins involved in regulating interleukin-1β levels or interleukin-1β response, are associated with pediatric acute respiratory distress syndrome or outcomes in mechanically ventilated children with parenchymal lung disease. DESIGN: Prospective cohort study. SETTING: Twenty-two PICUs participating in the multisite clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (U01 HL086622)...
August 7, 2018: Pediatric Critical Care Medicine
Adam S Himebauch, Nadir Yehya, Yan Wang, Thomas Conlon, Todd J Kilbaugh, Francis X McGowan, Laura Mercer-Rosa
OBJECTIVES: The prevalence and importance of early right ventricular dysfunction and pulmonary hypertension in pediatric acute respiratory distress syndrome are unknown. We aimed to describe the prevalence of right ventricular dysfunction and pulmonary hypertension within 24 hours of pediatric acute respiratory distress syndrome diagnosis and their associations with outcomes. DESIGN: Retrospective, single-center cohort study. SETTING: Tertiary care, university-affiliated PICU...
August 7, 2018: Critical Care Medicine
Chitaru Kurihara, James M Walter, Benjamin D Singer, Hector Cajigas, Shahriar Shayan, Abbas Al-Qamari, Malcolm M DeCamp, Rich Wunderink, G R Scott Budinger, Ankit Bharat
OBJECTIVES: Extracorporeal membrane oxygenation is increasingly used in the management of severe acute respiratory distress syndrome. With extracorporeal membrane oxygenation, select patients with acute respiratory distress syndrome can be managed without mechanical ventilation, sedation, or neuromuscular blockade. Published experience with this approach, specifically with attention to a patient's respiratory drive following cannulation, is limited. DESIGN: We describe our experience with three consecutive patients with severe acute respiratory distress syndrome supported with right jugular-femoral configuration of venovenous extracorporeal membrane oxygenation without therapeutic anticoagulation as an alternative to lung-protective mechanical ventilation...
August 7, 2018: Critical Care Medicine
Jasmine C Dowell, Kaushik Parvathaneni, Neal J Thomas, Robinder G Khemani, Nadir Yehya
OBJECTIVES: Investigations of acute respiratory distress syndrome in adults suggest hypoxemia is an uncommon cause of death. However, the epidemiology of death in pediatric acute respiratory distress syndrome is not well characterized. We aimed to describe the cause, mode, and timing of death in pediatric acute respiratory distress syndrome nonsurvivors. We hypothesized that most deaths would be due to nonpulmonary factors, rather than hypoxemia. DESIGN: Retrospective, decedent-only analysis...
August 7, 2018: Critical Care Medicine
Christopher John Joyce, Kiran Shekar, David Andrew Cook
BACKGROUND: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an effective treatment for severe respiratory failure. The interaction between the cardiorespiratory system and the oxygenator can be explored with mathematical models. Understanding the physiology will help the clinician optimise therapy. As others have examined O2 exchange, the main focus of this study was on CO2 exchange. METHODS: A model of the cardiorespiratory system during vv-ECMO was developed, incorporating O2 , CO2 and N2 exchange in both the lung and the oxygenator...
August 9, 2018: Intensive Care Medicine Experimental
S J Klein, F Husain-Syed, C Karagiannidis, G F Lehner, K Singbartl, M Joannidis
Interactions between lung and kidney can significantly affect the course of acute diseases, a phenomenon that was first observed in the 1950s by describing pulmonary dysfunction in uremic patients. From animal experiments there is ample evidence for remote lung injury following acute kidney injury (AKI), with an increased risk for the development of pulmonary edema and acute respiratory distress syndrome (ARDS). Coincident ARDS and AKI are associated with higher rates of intubation and mechanical ventilation, significantly prolonged weaning from mechanical ventilation and increased mortality...
August 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Sanja Cicko, Thomas Christian Köhler, Cemil Korcan Ayata, Tobias Müller, Nicolas Ehrat, Anja Meyer, Madelon Hossfeld, Andreas Zech, Francesco Di Virgilio, Marco Idzko
Acute respiratory distress syndrome (ARDS) is a life-threating lung condition resulting from a direct and indirect injury to the lungs [1, 2]. Pathophysiologically it is characterized by an acute alveolar damage, an increased permeability of the microvascular-barrier, leading to protein-rich pulmonary edema and subsequent impairment of arterial oxygenation and respiratory failure [1]. This study examined the role of extracellular ATP in recruiting inflammatory cells to the lung after induction of acute lung injury with lipopolysaccharide (LPS)...
July 17, 2018: Oncotarget
Lindsay A Gil, Anai N Kothari, Sarah A Brownlee, Hieu Ton-That, Purvi P Patel, Richard P Gonzalez, Fred A Luchette, Michael J Anstadt
BACKGROUND: Health care spending is driven by a very small percentage of Americans, many of whom are patients with prolonged durations of stay. The objective of this study was to characterize superusers in the trauma population. METHODS: The National Trauma Data Bank for 2008-2012 was queried. Superusers were defined as those with a duration of stay in the top 0.06% of the population and were compared with the remainder of the population to determine differences in demographic characteristics, comorbidities, prehospital factors, and outcomes...
August 7, 2018: Surgery
Jens Kamuf, Andreas Garcia-Bardon, Alexander Ziebart, Rainer Thomas, Konstantin Folkert, Katrin Frauenknecht, Serge C Thal, Erik K Hartmann
INTRODUCTION: The acute respiratory distress syndrome is not only associated with a high mortality, but also goes along with cognitive impairment in survivors. The cause for this cognitive impairment is still not clear. One possible mechanism could be cerebral inflammation as result of a "lung-brain-crosstalk". Even mechanical ventilation itself can induce cerebral inflammation. We hypothesized, that an acute lung injury aggravates the cerebral inflammation induced by mechanical ventilation itself and leads to neuronal damage...
2018: PloS One
Nirmal S Sharma, Charitharth Vivek Lal, Jin-Dong Li, Xiang-Yang Lou, Liliana Viera, Tarek Abdallah, Robert King, Jaskaran Sethi, Prashanth Kanagarajah, Ricardo Restrepo-Jaramillo, Amanda Sales-Conniff, Shi Wei, Patricia L Jackson, J Edwin Blalock, Amit Gaggar, Xin Xu
ARDS is characterized by unrelenting PMN inflammation and vascular permeability. The matrikine proline-glycine-proline (PGP) and acetylated PGP (Ac-PGP) have been shown to induce PMN inflammation and endothelial permeability in vitro and in vivo. In this study, we investigated the presence and role of airway PGP peptides in acute lung injury (ALI)/ARDS. P. aeruginosa-derived LPS was instilled intratracheally (i.t) in mice to induce ALI and increased Ac-PGP with neutrophil inflammation was noted. The PGP inhibitory peptide, RTR (arginine-threonine-arginine), was administered (i...
August 9, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
Junyan Liu, Xuejun Lv, Weijie Dong, Mingdong Hu, Jiancheng Xu, Guisheng Qian, Yuying Li
Silent mating type information regulation 2 homolog-1 (SIRT1) is involved in a wide range of cellular processes because of its role as a deacetylated histone and its association with a variety of transcription factors. SIRT1 has essential roles in autophagy, including in the formation of autophagic vacuoles and the assembly of autophagy-related gene (ATG) protein complexes. The present study focused on the role of SIRT1 in autophagy in lipopolysaccharide (LPS)-induced mouse type II alveolar epithelial cells (AECII)...
August 8, 2018: Inflammation
Thomas D Greensmith, Stefano Cortellini
OBJECTIVE: To describe the successful management of a dog with acute respiratory distress syndrome secondary to inhalant toxin exposure. CASE SUMMARY: An 8-year-old male neutered Greyhound was referred with severe respiratory distress 56 hours after exposure to an aerosol toxicant. The patient developed respiratory difficulties requiring veterinary attention within 12 hours of initial exposure. Treatment at the referral hospital included mechanical ventilation and supportive care...
August 8, 2018: Journal of Veterinary Emergency and Critical Care
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