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Ventilator induced lung injury

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https://www.readbyqxmd.com/read/28937238/effects-of-roflumilast-a-phosphodiesterase-4-inhibitor-on-the-lung-functions-in-a-saline-lavage-induced-model-of-acute-lung-injury
#1
P Kosutova, P Mikolka, M Kolomaznik, S Rezakova, A Calkovska, D Mokra
Acute lung injury (ALI) is associated with deterioration of alveolar-capillary lining and transmigration and activation of inflammatory cells. Whereas a selective phosphodiesterase-4 (PDE4) inhibitor roflumilast has exerted potent anti-inflammatory properties, this study evaluated if its intravenous delivery can influence inflammation, edema formation, and respiratory parameters in rabbits with a lavage-induced model of ALI. ALI was induced by repetitive saline lung lavage (30 ml/kg). Animals were divided into 3 groups: ALI without therapy (ALI), ALI treated with roflumilast i...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28937237/selective-inhibition-of-nf-kappab-and-surfactant-therapy-in-experimental-meconium-induced-lung-injury
#2
J Kopincova, P Mikolka, M Kolomaznik, P Kosutova, A Calkovska, D Mokra
Meconium aspiration syndrome (MAS) in newborns is characterized mainly by respiratory failure due to surfactant dysfunction and inflammation. Previous meta-analyses did not prove any effect of exogenous surfactant treatment nor glucocorticoid administration on final outcome of children with MAS despite oxygenation improvement. As we supposed there is the need to intervene in both these fields simultaneously, we evaluated therapeutic effect of combination of exogenous surfactant and selective inhibitor of NF-kappaB (IKK-NBD peptide)...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28932519/preventing-ventilator-induced-lung-injury-what-does-the-evidence-say
#3
EDITORIAL
Sandra Hoegl, Bernhard Zwissler
No abstract text is available yet for this article.
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931657/neutrophil-transfer-of-mir-223-to-lung-epithelial-cells-dampens-acute-lung-injury-in-mice
#4
Viola Neudecker, Kelley S Brodsky, Eric T Clambey, Eric P Schmidt, Thomas A Packard, Bennett Davenport, Theodore J Standiford, Tingting Weng, Ashley A Fletcher, Lea Barthel, Joanne C Masterson, Glenn T Furuta, Chunyan Cai, Michael R Blackburn, Adit A Ginde, Michael W Graner, William J Janssen, Rachel L Zemans, Christopher M Evans, Ellen L Burnham, Dirk Homann, Marc Moss, Simone Kreth, Kai Zacharowski, Peter M Henson, Holger K Eltzschig
Intercellular transfer of microRNAs can mediate communication between critical effector cells. We hypothesized that transfer of neutrophil-derived microRNAs to pulmonary epithelial cells could alter mucosal gene expression during acute lung injury. Pulmonary-epithelial microRNA profiling during coculture of alveolar epithelial cells with polymorphonuclear neutrophils (PMNs) revealed a selective increase in lung epithelial cell expression of microRNA-223 (miR-223). Analysis of PMN-derived supernatants showed activation-dependent release of miR-223 and subsequent transfer to alveolar epithelial cells during coculture in vitro or after ventilator-induced acute lung injury in mice...
September 20, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28930639/50-years-of-research-in-ards-tidal-volume-selection-in-the-acute-respiratory-distress-syndrome
#5
Sarina K Sahetya, Jordi Mancebo, Roy G Brower
Mechanical ventilation (MV) is critical in the management of many patients with the acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate tidal volume is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower tidal volumes, the use of tidal volumes of 6 mL/kg predicted body weight (PBW, based on sex and height) has been recommended in clinical practice guidelines...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28911957/a-double-blind-randomized-experimental-study-on-the-use-of-igm-enriched-polyclonal-immunoglobulins-in-an-animal-model-of-pneumonia-developing-shock
#6
Rosanna Vaschetto, Nausicaa Clemente, Aline Pagni, Teresa Esposito, Federico Longhini, Francesca Mercalli, Elena Boggio, Renzo Boldorini, Annalisa Chiocchetti, Umberto Dianzani, Paolo Navalesi
BACKGROUND: Patients with severe pneumonia often develop septic shock. IgM-enriched immunoglobulins have been proposed as a potential adjuvant therapy for septic shock. While in vitro data are available on the possible mechanisms of action of IgM-enriched immunoglobulins, the results of the in vivo experimental studies are non-univocal and, overall, unconvincing. We designed this double blinded randomized controlled study to test whether IgM-enriched immunoglobulins administered as rescue treatment in a pneumonia model developing shock, could either limit lung damage and/or contain systemic inflammatory response...
September 8, 2017: Immunobiology
https://www.readbyqxmd.com/read/28904482/mathematics-of-ventilator-induced-lung-injury
#7
REVIEW
Ubaidur Rahaman
Ventilator-induced lung injury (VILI) results from mechanical disruption of blood-gas barrier and consequent edema and releases of inflammatory mediators. A transpulmonary pressure (PL) of 17 cmH2O increases baby lung volume to its anatomical limit, predisposing to VILI. Viscoelastic property of lung makes pulmonary mechanics time dependent so that stress (PL) increases with respiratory rate. Alveolar inhomogeneity in acute respiratory distress syndrome acts as a stress riser, multiplying global stress at regional level experienced by baby lung...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28899408/respiratory-support-in-patients-with-acute-respiratory-distress-syndrome-an-expert-opinion
#8
REVIEW
Davide Chiumello, Laurent Brochard, John J Marini, Arthur S Slutsky, Jordi Mancebo, V Marco Ranieri, B Taylor Thompson, Laurent Papazian, Marcus J Schultz, Marcelo Amato, Luciano Gattinoni, Alain Mercat, Antonio Pesenti, Daniel Talmor, Jean-Louis Vincent
Acute respiratory distress syndrome (ARDS) is a common condition in intensive care unit patients and remains a major concern, with mortality rates of around 30-45% and considerable long-term morbidity. Respiratory support in these patients must be optimized to ensure adequate gas exchange while minimizing the risks of ventilator-induced lung injury. The aim of this expert opinion document is to review the available clinical evidence related to ventilator support and adjuvant therapies in order to provide evidence-based and experience-based clinical recommendations for the management of patients with ARDS...
September 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28895380/how-to-optimize-the-lung-donor
#9
Gabriele Sales, Andrea Costamagna, Vito Fanelli, Massimo Boffini, Francesco Pugliese, Luciana Mascia, Luca Brazzi
In the last two decades, lung transplantation emerged as the standard of care for patients with advanced and terminal lung disease. Despite the increment in lung transplantation rates, in 2016 the overall mortality while on waiting list in Italy reached the 10%, whereas only the 39% of the wait-list patients were successfully transplanted. A number of approaches, including protective ventilatory strategy, accurate management of fluid balance, administration of a hormonal resuscitation therapy have been reported to improve lung donor performance before organ retrieval...
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28887062/diaphragm-dysfunction-in-critical-illness
#10
REVIEW
Gerald S Supinski, Peter E Morris, Sanjay Dhar, Leigh Ann Callahan
The diaphragm is the major muscle of inspiration and its function is critical for optimal respiration. Diaphragmatic failure has long been recognized as a major contributor to death in a variety of systemic neuromuscular disorders. More recently, it is increasingly apparent that diaphragm dysfunction is present in a high percentage of critically ill patients, and is associated with increased morbidity and mortality. In these patients, diaphragm weakness is thought to develop from disuse secondary to ventilator-induced diaphragm inactivity, and as a consequence of the effects of systemic inflammation, including sepsis...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28886582/protective-effects-of-ghrelin-in-ventilator-induced-lung-injury-in-rats
#11
Guang Li, Jiao Liu, Wen-Fang Xia, Chen-Liang Zhou, Li-Qiong Lv
Ghrelin has exhibited potent anti-inflammatory effects on various inflammatory diseases. The aim of this study was to investigate the potential effects of ghrelin on a model of ventilator-induced lung injury (VILI) established in rats. Male Sprague-Dawley rats were randomly divided into three groups: low volume ventilation (LV, Vt=8ml/kg) group, a VILI group (Vt=30ml/kg), and a VILI group pretreated with ghrelin (GH+VILI). For the LV group, for the VILI and GH+VILI groups, the same parameters were applied except the tidal volume was increased to 40ml/kg...
September 5, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28882955/differential-expression-of-aquaporins-in-experimental-models-of-acute-lung-injury
#12
Alice G Vassiliou, Nikolaos Manitsopoulos, Matina Kardara, Nikolaos A Maniatis, Stylianos E Orfanos, Anastasia Kotanidou
AIM: The mammalian lung expresses at least three aquaporin (AQP) water channels whose precise role in lung injury or inflammation is still controversial. MATERIALS AND METHODS: Three murine models of lung inflammation and corresponding controls were used to evaluate the expression of Aqp1, Aqp4, Aqp5 and Aqp9: lipopolysaccharide (LPS)-induced lung injury; HCl-induced lung injury; and ventilation-induced lung injury (VILI). RESULTS: All models yielded increased lung vascular permeability, and inflammatory cell infiltration in the broncho-alveolar lavage fluid; VILI additionally produced altered lung mechanics...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28872540/effects-on-pulmonary-vascular-mechanics-of-two-different-lung-protective-ventilation-strategies-in-an-experimental-model-of-acute-respiratory-distress-syndrome
#13
Arnoldo Santos, Eva Gomez-Peñalver, M Ignacio Monge-Garcia, Jaime Retamal, João Batista Borges, Gerardo Tusman, Goran Hedenstierna, Anders Larsson, Fernando Suarez-Sipmann
OBJECTIVES: To compare the effects of two lung-protective ventilation strategies on pulmonary vascular mechanics in early acute respiratory distress syndrome. DESIGN: Experimental study. SETTING: University animal research laboratory. SUBJECTS: Twelve pigs (30.8 ± 2.5 kg). INTERVENTIONS: Acute respiratory distress syndrome was induced by repeated lung lavages and injurious mechanical ventilation...
September 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28870157/ten-important-articles-on-noninvasive-ventilation-in-critically-ill-patients-and-insights-for-the-future-a-report-of-expert-opinions
#14
A Cortegiani, V Russotto, M Antonelli, E Azoulay, A Carlucci, G Conti, A Demoule, M Ferrer, N S Hill, S Jaber, P Navalesi, P Pelosi, R Scala, C Gregoretti
BACKGROUND: Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury)...
September 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28862509/partially-assisted-ventilation-induced-lung-injury-in-early-acute-respiratory-distress-syndrome-when-real-life-is-different-from-classical-physiology
#15
Salvatore Grasso
No abstract text is available yet for this article.
September 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28839101/hyperoxia-treatment-of-trek-1-trek-2-traak-deficient-mice-is-associated-with-a-reduction-in-surfactant-proteins
#16
Andreas Schwingshackl, Benjamin Lopez, Bin Teng, Charlean L Luellen, Florian Lesage, John Belperio, Riccardo Olcese, Christopher M Waters
We previously proposed a role for the 2-pore domain potassium (K2P) channel TREK-1 in hyperoxia (HO)-induced lung injury. To determine whether redundancy between the 3 TREK isoforms (TREK-1, TREK-2, TRAAK) could protect from HO-induced injury, we now examined the effect of deletion of all 3 TREK isoforms in a clinically relevant scenario of prolonged HO exposure and mechanical ventilation (MV). We exposed WT and TREK-1/TREK-2/TRAAK-deficient (triple ko) mice to either room air, 72 hours HO, MV (high and low tidal volume), or a combination of HO+MV, and measured quasi-static lung compliance, BAL protein concentration, histologic lung injury scores (LIS), cellular apoptosis, and cytokine levels...
August 24, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28828372/high-flow-nasal-oxygen-therapy-and-noninvasive-ventilation-in-the-management-of-acute-hypoxemic-respiratory-failure
#17
REVIEW
Jean-Pierre Frat, Rémi Coudroy, Nicolas Marjanovic, Arnaud W Thille
High-flow nasal cannula (HFNC) oxygen therapy is a recent technique delivering a high flow of heated and humidified gas. HFNC is simpler to use and apply than noninvasive ventilation (NIV) and appears to be a good alternative treatment for hypoxemic acute respiratory failure (ARF). HFNC is better tolerated than NIV, delivers high fraction of inspired oxygen (FiO2), generates a low level of positive pressure and provides washout of dead space in the upper airways, thereby improving mechanical pulmonary properties and unloading inspiratory muscles during ARF...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828367/spontaneous-breathing-a-double-edged-sword-to-handle-with-care
#18
REVIEW
Tommaso Mauri, Barbara Cambiaghi, Elena Spinelli, Thomas Langer, Giacomo Grasselli
In acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) patients, spontaneous breathing is associated with multiple physiologic benefits: it prevents muscles atrophy, avoids paralysis, decreases sedation needs and is associated with improved hemodynamics. On the other hand, in the presence of uncontrolled inspiratory effort, severe lung injury and asynchronies, spontaneous ventilation might also worsen lung edema, induce diaphragm dysfunction and lead to muscles exhaustion and prolonged weaning...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828366/sedation-and-neuromuscular-blocking-agents-in-acute-respiratory-distress-syndrome
#19
REVIEW
Jeremy Bourenne, Sami Hraiech, Antoine Roch, Marc Gainnier, Laurent Papazian, Jean-Marie Forel
Mechanical ventilation (MV) is the cornerstone of acute respiratory distress syndrome (ARDS) management. The use of protective ventilation is a priority in this acute phase of lung inflammation. Neuromuscular blocking agents (NMBAs) induce reversible muscle paralysis. Their use in patients with ARDS remains controversial but occurs frequently. NMBAs are used in 25-45% of ARDS patients for a mean period of 1±2 days. The main indications of NMBAs are hypoxemia and facilitation of MV. For ethical reasons, NMBA use is inseparable from sedation in the management of early ARDS...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828365/recruitment-maneuvers-in-acute-respiratory-distress-syndrome
#20
REVIEW
Jean-Michel Constantin, Thomas Godet, Matthieu Jabaudon, Jean-Etienne Bazin, Emmanuel Futier
The rationale for the use of recruitment maneuvers (RMs) in acute respiratory distress syndrome (ARDS) is to promote alveolar recruitment, leading to an increased end-expiratory lung volume and thus decreased ventilator-induced lung injury (VILI). RMs consists of a transient increase in transpulmonary pressure that can re-open previously collapsed alveoli. RMs represents a physiological response to lung aggression in different conditions by re-opening the collapsed part of the lung and decreasing lung oedema...
July 2017: Annals of Translational Medicine
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