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Acute Distress Syndrome

Stije J Leopold, Aniruddha Ghose, Katherine A Plewes, Subash Mazumder, Luigi Pisani, Hugh W F Kingston, Sujat Paul, Anupam Barua, M Abdus Sattar, Michaëla A M Huson, Andrew P Walden, Patricia C Henwood, Elisabeth D Riviello, Marcus J Schultz, Nicholas P J Day, Asok Kumar Dutta, Nicholas J White, Arjen M Dondorp
INTRODUCTION: Patients with severe malaria or sepsis are at risk of developing life-threatening acute respiratory distress syndrome (ARDS). The objective of this study was to evaluate point-of-care lung ultrasound as a novel tool to determine the prevalence and early signs of ARDS in a resource-limited setting among patients with severe malaria or sepsis. MATERIALS AND METHODS: Serial point-of-care lung ultrasound studies were performed on four consecutive days in a planned sub study of an observational cohort of patients with malaria or sepsis in Bangladesh...
2018: PloS One
Youlin Koh, Hashrul Rashid, Stephanie Khaw, Arthur Nasis
Patients often experience emotional distress after acute coronary syndrome (ACS). These may lead to symptoms of depression or anxiety and greater morbidity/mortality. We sought to determine whether flowering plants in the coronary care ward reduced depressive and anxiety symptoms in these patients. Patients with ACS were randomly allocated to flowering plants (intervention) or no plants (control) in their room during index hospitalisation. Baseline data were collected. The primary outcome was the Hospital Anxiety and Depression Scale (HADS) depressive and anxiety symptom scores at discharge...
December 11, 2018: Heart and Vessels
Weifeng Huang, Yongmei Cao, Yujing Liu, Feng Ping, Jiawei Shang, Zhongwei Zhang, Yingchuan Li
The balance between Ang II/AT1R and Ang-(1-7)/Mas plays a pivotal role in the development of lipopolysaccharides (LPS)-induced acute respiratory distress syndrome. However, the mechanisms underlying the balancing process still remain unclear. Here we investigated the roles of nuclear factor (NF)-κB and p53 in regulating AT1R and Mas expression. The results demonstrated that Ang II pretreatment resulted in downregulation of Mas and upregulation of AT1R, phosphorylated p65, and apoptosis in LPS-treated Human pulmonary microvascular endothelial cells (HPMVECs), but had no effect on p53 expression...
December 7, 2018: Journal of Cellular Physiology
Martin Ruste, Laurent Bitker, Hodane Yonis, Zakaria Riad, Aurore Louf-Durier, Floriane Lissonde, Sophie Perinel-Ragey, Claude Guerin, Jean-Christophe Richard
BACKGROUND: Hemodynamic response to prone position (PP) has never been studied in a large series of patients with acute respiratory distress syndrome (ARDS). The primary aim of this study was to estimate the rate of PP sessions associated with cardiac index improvement. Secondary objective was to describe hemodynamic response to PP and during the shift from PP to supine position. METHODS: The study was a single-center retrospective observational study, performed on ARDS patients, undergoing at least one PP session under monitoring by transpulmonary thermodilution...
December 7, 2018: Annals of Intensive Care
Carlos Toufen Junior, Roberta R De Santis Santiago, Adriana S Hirota, Alysson Roncally S Carvalho, Susimeire Gomes, Marcelo Brito Passos Amato, Carlos Roberto Ribeiro Carvalho
BACKGROUND: Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide type III procollagen (NT-PCP-III) and driving pressure during protective mechanical ventilation. It was a secondary analysis of data from randomized controlled trial that included patients with moderate/severe ARDS with at least one follow-up visit performed...
December 7, 2018: Annals of Intensive Care
Thomas Blakeman, Dario Rodriquez, Jay Johannigman, Richard Branson
Introduction: Adequate oxygenation is one of the primary goals of mechanical ventilation. Maintenance of adequate oxygenation and prevention of hypoxemia are the primary goals for the battlefield casualty, but military operations have unique concerns. In military operations, oxygen is a limited resource. A portable oxygen concentrator has the advantage of operating solely from electrical power and theoretically is a never-exhausting supply of oxygen. Our previous bench work demonstrated that the pulsed dose setting of the concentrator can be used in concert with the ventilator to maximize oxygen delivery...
December 7, 2018: Military Medicine
Maxwell Osei-Ampofo, Alfred Aidoo, Akwasi Antwi-Kusi, Obiageli Joan Ofungwu, Solomon Nii-Kotey Kotey, Moses Siaw-Frimpong, Osuoji Chiedozie, Matthew J Tafoya, Torben K Becker
Introduction: Respiratory failure is commonly seen in African emergency centres and intensive care units, but little is known about the need for intubation and mechanical ventilation. Methods: From April to October 2017, we recorded the number of patients intubated and ventilated in the emergency centre and intensive care unit at Komfo Anokye Teaching Hospital in Kumasi, Ghana on a daily basis. We assessed patients for presence of acute respiratory distress syndrome (ARDS) using the Kigali Modification of the Berlin ARDS criteria...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Jeremy R Beitler
PURPOSE OF REVIEW: The most effective strategies for treating the patient with acute respiratory distress syndrome center on minimizing ventilation-induced lung injury (VILI). Yet, current standard-of-care does little to modify mechanical ventilation to patient-specific risk. This review focuses on evaluation of bedside respiratory mechanics, which when interpreted in patient-specific context, affords opportunity to individualize lung-protective ventilation in patients with acute respiratory distress syndrome...
December 5, 2018: Current Opinion in Critical Care
Aude Gibelin, Antoine Parrot, Muriel Fartoukh, Nicolas de Prost
PURPOSE OF REVIEW: A prompt identification of the cause of acute respiratory failure (ARF)/acute respiratory distress syndrome (ARDS) is required in order to initiate a targeted treatment. Yet, almost 10% of ARDS patients have no identified ARDS risk factor at ARDS diagnosis. Numerous rare causes of ARF have been reported in this setting. The purpose of this review is to delineate the main rare causes of ARF/ARDS and to provide clinicians with a pragmatic diagnostic work-up. RECENT FINDINGS: Recent epidemiological data have proposed the identification of a subgroup of ARDS patients lacking exposure to common risk factors...
December 5, 2018: Current Opinion in Critical Care
Pratik Sinha, Carolyn S Calfee
PURPOSE OF REVIEW: To provide an overview of the current research in identifying homogeneous subgroups and phenotypes in ARDS. RECENT FINDINGS: In recent years, investigations have used either physiology, clinical data, biomarkers or a combination of these to stratify patients with ARDS into distinct subgroups with divergent clinical outcomes. In some studies, there has also been evidence of differential treatment response within subgroups. Physiologic approaches include stratification based on P/F ratio and ventilatory parameters; stratification based on P/F ratio is already being employed in clinical trials...
December 10, 2018: Current Opinion in Critical Care
P Thakore, A E Dunbar, E B Lindsay
A 710 g male infant was born at a referring hospital at a gestational age of 23 weeks and 2 days via vaginal delivery and was transferred to our facility at 14 days of age. His delivery was complicated by the breech presentation with difficult head extraction. The infant's initial course was significant for respiratory distress syndrome, grade III-IV intraventricular hemorrhage (IVH), acute kidney injury, and large PDA. On the day of life 29, a gradual increase in serum sodium level refractory to increasing total fluid volume was noted...
December 1, 2018: Journal of Neonatal-perinatal Medicine
Li Xiaoli, Zou Wujun, Liu Jing
Acute lung injury (ALI) and its more serious form, respiratory distress syndrome (ARDS), are considered as an acute and severe inflammatory process existing in lungs, and still remain high mortality rates. Tripartite motif 8 (TRIM8) contains an N-terminal RING finger, which is followed by two B-boxes and a coiled-coil domain, belonging to the TRIM/RBCC family and playing significant role in meditating inflammation, oxidative stress and apoptosis. In the study, we investigated the role of TRIM8 in ALI induced by lipopolysaccharide (LPS) and the underlying molecular mechanisms...
December 4, 2018: Biochemical and Biophysical Research Communications
Kaitlin M Best, Lisa A Asaro, Martha A Q Curley
OBJECTIVE: To compare current analgesia and sedation management practices between critically ill children with pre-existing cognitive impairment and critically ill neurotypical children, including possible indicators of therapeutic efficacy. STUDY DESIGN: This study used secondary analysis of prospective data from the RESTORE clinical trial, with 2449 children admitted to the pediatric intensive care unit and receiving mechanical ventilation for acute respiratory failure...
December 5, 2018: Journal of Pediatrics
Weiyi Wang, Xiaofeng Yu, Fengli Zuo, Shuixiu Yu, Zhenghui Luo, Jie Liu, Yuan Wang, Guoqin Zhu, Hui Lin, Ning Xu, Hui Ren, Jiaping Zhang
BACKGROUND: Increased extravascular lung water (EVLW) correlates with pulmonary morbidity and mortality in critical illness. The extravascular lung water index (EVLWI), which reflects the degree of EVLW in an individual, increases in the fluid reabsorption stage rather than the initial resuscitation stage in severe burn cases. While many factors contribute to EVLWI variation, the risk factors contributing to its abnormal elevation in severe burns remain unclear. The aim of this study was to identify the risk factors and associated limit values for abnormal elevation of EVLWI during the fluid reabsorption stage in a cohort of severely burned adults...
December 6, 2018: Burns: Journal of the International Society for Burn Injuries
Biniam Kidane, Daniel Cornejo Palma, Neal H Badner, Melissa Hamilton, Larissa Leydier, Dalilah Fortin, Richard I Inculet, Richard A Malthaner
BACKGROUND: Existing evidence regarding lung-protective ventilation (LPV) during one-lung ventilation (OLV) focuses on surrogate outcomes. Our objective was to assess whether an LPV protocol during OLV surgery is associated with reduced respiratory complications. MATERIALS AND METHODS: This was a matched control retrospective cohort study of patients undergoing pulmonary resection at a tertiary Canadian hospital. The experimental group (n = 50) was derived from primary data of two crossover RCTs, which utilized protocolized LPV strategies with varying levels of positive end-expiratory pressure and recruitment maneuvers...
February 2019: Journal of Surgical Research
Vinícius Rosa Oliveira, Juan José Uriarte, Bryan Falcones, Walter Araujo Zin, Daniel Navajas, Ramon Farré, Isaac Almendros
INTRODUCTION: Application of lipopolysaccharide (LPS) is a widely employed model to mimic acute respiratory distress syndrome (ARDS). Available data regarding LPS-induced biomechanical changes on pulmonary epithelial cells are limited only to P. aeruginosa LPS. Considering that LPS from different bacteria could promote a specific mechanical response in epithelial cells, we aim to assess the effect of E. coli LPS, widely employed as a model of ARDS, in the biomechanics of alveolar epithelial cells...
November 29, 2018: Journal of Biomechanics
Lan Chen, Wen Li, Daoxin Wang
To explore the effects of honokiol (HKL) on pulmonary microvascular endothelial cells in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) and the underlying mechanisms.
 Methods: In animal experiment, a total of 40 C57BL/6J mice were randomly divided into a control group (Con group), a LPS intervention group (LPS group), a LPS+honokiol (HKL) intervention group (HKL group) and a LPS+HKL+nicotinamide (NAM) intervention group (NAM group) (n=10 in each group). In the cell experiment, the experiment cells were divided into a control group (Con group), a LPS intervention group (LPS group), a LPS+HKL intervention group (HKL group), a LPS+HKL+NAM intervention group (NAM group), and a LPS+HKL+compound C (CMC) intervention group (CMC group)...
October 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Dannette A Mitchell, Maureen A Seckel
Acute respiratory distress syndrome continues to have high morbidity and mortality despite more than 50 years of research. The Berlin definition in 2012 established risk stratification based on degree of hypoxemia and the use of positive end-expiratory pressure. The use of prone positioning as a treatment modality has been studied for more than 40 years, with recent studies showing an improvement in oxygenation and decreased mortality. The studies also provide evidence to support the methodology and length of treatment time...
2018: AACN Advanced Critical Care
Max T Wayne, Thomas S Valley, Colin R Cooke, Michael W Sjoding
BACKGROUND: The acute respiratory distress syndrome (ARDS) results in substantial mortality but remains underdiagnosed in clinical practice. Automated ARDS "sniffer" systems, tools that can automatically analyze electronic medical record data, have been developed to improve recognition of ARDS in clinical practice. OBJECTIVE: To perform a systematic review examining the evidence underlying automated sniffer systems for ARDS detection. DATA SOURCES: MEDLINE and Scopus databases through October 2018 to identify studies of tools using routinely available clinical data to detect patients with ARDS...
December 6, 2018: Annals of the American Thoracic Society
Diana Islam, Yongbo Huang, Vito Fanelli, Luisa Delsedime, Sulong Wu, Julie Khang, Bing Han, Alice Grassi, Manshu Li, Yonghao Xu, Alice Luo, Jianfeng Wu, Xiaoqing Liu, Montey McKillop, Jeffery Medin, Haibo Qiu, Nanshan Zhong, Mingyao Liu, John Laffey, Yimin Li, Haibo Zhang
RATIONALE: There are controversial reports on applications of mesenchymal stromal cells (MSCs) in patients with acute respiratory distress syndrome (ARDS). OBJECTIVE: We hypothesized that lung microenvironment was the main determinant of beneficial versus detrimental effects of MSCs during ARDS. METHODS: Lung proteome was profiled in three models of injury induced by acid instillation and/or mechanical ventilation in mice. Human gene of glutathione peroxidase-1 (GPx-1) was delivered prior to MSC administration; or MSCs carrying human gene of interleukin-10 (MSCIL-10) or hepatocyte growth factor (MSCHGF) were administered after lung injury...
December 6, 2018: American Journal of Respiratory and Critical Care Medicine
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