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Ventilator induced lung injury

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https://www.readbyqxmd.com/read/28283699/opening-pressures-and-atelectrauma-in-acute-respiratory-distress-syndrome
#1
Massimo Cressoni, Davide Chiumello, Ilaria Algieri, Matteo Brioni, Chiara Chiurazzi, Andrea Colombo, Angelo Colombo, Francesco Crimella, Mariateresa Guanziroli, Ivan Tomic, Tommaso Tonetti, Giordano Luca Vergani, Eleonora Carlesso, Vladimir Gasparovic, Luciano Gattinoni
PURPOSE: Open lung strategy during ARDS aims to decrease the ventilator-induced lung injury by minimizing the atelectrauma and stress/strain maldistribution. We aim to assess how much of the lung is opened and kept open within the limits of mechanical ventilation considered safe (i.e., plateau pressure 30 cmH2O, PEEP 15 cmH2O). METHODS: Prospective study from two university hospitals. Thirty-three ARDS patients (5 mild, 10 moderate, 9 severe without extracorporeal support, ECMO, and 9 severe with it) underwent two low-dose end-expiratory CT scans at PEEP 5 and 15 cmH2O and four end-inspiratory CT scans (from 19 to 40 cmH2O)...
March 10, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28277372/one-hit-models-of-ventilator-induced-lung-injury-benign-inflammation-versus-inflammation-as-a-by-product
#2
Dennis Lex, Stefan Uhlig
BACKGROUND: One important explanation for the detrimental effects of conventional mechanical ventilation is the biotrauma hypothesis that ventilation may trigger proinflammatory responses that subsequently cause lung injury. This hypothesis has frequently been studied in so-called one-hit models (overventilation of healthy lungs) that so far have failed to establish an unequivocal link between inflammation and hypoxemic lung failure. This study was designed to develop a one-hit biotrauma model...
March 9, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28268882/noninvasive-estimation-of-alveolar-pressure
#3
Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat
This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267435/-the-right-ventricle-in-acute-respiratory-distress-syndrome
#4
REVIEW
Vasileios Zochios, Ken Parhar, William Tunnicliffe, Andrew Roscoe, Fang Gao
Acute respiratory distress syndrome is associated with poor clinical outcomes with a pooled mortality rate of approximately 40% despite best standards of care. Current therapeutic strategies are based upon improving oxygenation and pulmonary compliance while minimizing ventilator induced lung injury. It has been demonstrated that relative hypoxemia can be well tolerated and improvements in oxygenation do not necessarily translate into survival benefit. Cardiac failure, in particular right ventricular dysfunction, is commonly encountered in moderate to severe acute respiratory distress syndrome and is reported to be one of the major determinants of mortality...
March 3, 2017: Chest
https://www.readbyqxmd.com/read/28261612/increased-circulating-endothelial-microparticles-associated-with-pak4-play-a-key-role-in-ventilation-induced-lung-injury-process
#5
Shuming Pan, Aihua Fei, Lihong Jing, Xiangyu Zhang, Chengjin Gao
Inappropriate mechanical ventilation (MV) can result in ventilator-induced lung injury (VILI). Probing mechanisms of VILI and searching for effective methods are current areas of research focus on VILI. The present study aimed to probe into mechanisms of endothelial microparticles (EMPs) in VILI and the protective effects of Tetramethylpyrazine (TMP) against VILI. In this study, C57BL/6 and TLR4KO mouse MV models were used to explore the function of EMPs associated with p21 activated kinases-4 (PAK-4) in VILI...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28251431/48%C3%A2-h-cessation-of-mechanical-ventilation-during-venovenous-extracorporeal-membrane-oxygenation-in-severe-trauma-a-case-report
#6
Justyna Swol, Yann Fülling, Christopher Ull, Matthias Bechtel, Thomas A Schildhauer
A 32-year-old motorcyclist who was hit by a tram subsequently presented with blunt force thoracic trauma, a pelvic fracture and a penetrating injury to the left lower extremity. Coagulopathy persisted following surgery of the leg and pelvic vascular intervention. Bedside thoracotomy was performed to treat pneumothorax and pneumopericardium. Severe hypoxemia secondary to lung failure ensued, which required venovenous extracorporeal membrane oxygenation (VV ECMO) support. On the third day after the trauma, ultra-protective mechanical ventilation was not possible due to non-existent lung compliance; thus, the ventilator was disconnected, and the T-piece was connected to the blocked tracheal tube left in the airway...
March 1, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28250891/hydrogen-sulfide-prevents-formation-of-reactive-oxygen-species-through-pi3k-akt-signaling-and-limits-ventilator-induced-lung-injury
#7
Sashko Georgiev Spassov, Rosa Donus, Paul Mikael Ihle, Helen Engelstaedter, Alexander Hoetzel, Simone Faller
The development of ventilator-induced lung injury (VILI) is still a major problem in mechanically ventilated patients. Low dose inhalation of hydrogen sulfide (H2S) during mechanical ventilation has been proven to prevent lung damage by limiting inflammatory responses in rodent models. However, the capacity of H2S to affect oxidative processes in VILI and its underlying molecular signaling pathways remains elusive. In the present study we show that ventilation with moderate tidal volumes of 12 ml/kg for 6 h led to an excessive formation of reactive oxygen species (ROS) in mice lungs which was prevented by supplemental inhalation of 80 parts per million of H2S...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28243236/inhibition-of-tnf-receptor-p55-by-a-domain-antibody-attenuates-the-initial-phase-of-acid-induced-lung-injury-in-mice
#8
Michael R Wilson, Kenji Wakabayashi, Szabolcs Bertok, Charlotte M Oakley, Brijesh V Patel, Kieran P O'Dea, Joanna C Cordy, Peter J Morley, Andrew I Bayliffe, Masao Takata
BACKGROUND: Tumor necrosis factor-α (TNF) is strongly implicated in the development of acute respiratory distress syndrome (ARDS), but its potential as a therapeutic target has been hampered by its complex biology. TNF signals through two receptors, p55 and p75, which play differential roles in pulmonary edema formation during ARDS. We have recently shown that inhibition of p55 by a novel domain antibody (dAb™) attenuated ventilator-induced lung injury. In the current study, we explored the efficacy of this antibody in mouse models of acid-induced lung injury to investigate the longer consequences of treatment...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28230150/an-experimental-study-on-the-impacts-of-inspiratory-and-expiratory-muscles-activities-during-mechanical-ventilation-in-ards-animal-model
#9
Xianming Zhang, Juan Du, Weiliang Wu, Yongcheng Zhu, Ying Jiang, Rongchang Chen
In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs' ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically...
February 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28227081/noninvasive-estimation-of-alveolar-pressure
#10
Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat, Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat, Francesco Vicario, Roberto Buizza, Nicolas W Chbat, William A Truschel
This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224112/intravenous-vitamin-c-as-adjunctive-therapy-for-enterovirus-rhinovirus-induced-acute-respiratory-distress-syndrome
#11
Alpha A Fowler Iii, Christin Kim, Lawrence Lepler, Rajiv Malhotra, Orlando Debesa, Ramesh Natarajan, Bernard J Fisher, Aamer Syed, Christine DeWilde, Anna Priday, Vigneshwar Kasirajan
We report a case of virus-induced acute respiratory distress syndrome (ARDS) treated with parenteral vitamin C in a patient testing positive for enterovirus/rhinovirus on viral screening. This report outlines the first use of high dose intravenous vitamin C as an interventional therapy for ARDS, resulting from enterovirus/rhinovirus respiratory infection. From very significant preclinical research performed at Virginia Commonwealth University with vitamin C and with the very positive results of a previously performed phase I safety trial infusing high dose vitamin C intravenously into patients with severe sepsis, we reasoned that infusing identical dosing to a patient with ARDS from viral infection would be therapeutic...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224077/electrical-impedance-tomography-and-trans-pulmonary-pressure-measurements-in-a-patient-with-extreme-respiratory-drive
#12
Atsuko Shono, Peter Somhorst, Diederik Gommers
Preserving spontaneous breathing during mechanical ventilation prevents muscle atrophy of the diaphragm, but may lead to ventilator induced lung injury (VILI). We present a case in which monitoring of trans-pulmonary pressure and ventilation distribution using Electrical Impedance Tomography (EIT) provided essential information for preventing VILI.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28204830/monoclonal-antibody-against-toll-like-receptor%C3%A2-4-attenuates-ventilator-induced-lung-injury-in-rats-by-inhibiting-myd88-and-nf-%C3%AE%C2%BAb-dependent-signaling
#13
Cuiyuan Huang, Linghui Pan, Fei Lin, Huijun Dai, Ruili Fu
The mechanisms through which mechanical ventilation causes non-infectious inflammatory diseases and lung injury are poorly understood. Animals models of this type of injury suggest that it involves signaling mediated by Toll‑like receptor (TLR)4 and 9. In this study, in order to gain further insight into the involvement of TLR4 in this type of injury, we performed in vivo and in vitro experiments to determine the mechanisms through which TLR4 triggers inflammation. We also examined whether the use of TLR4 monoclonal antibody (mAb) can alleviate this type of injury...
March 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28196122/detrimental-elavl-1-hur-dependent-gsk3%C3%AE-mrna-stabilization-impairs-resolution-in-acute-respiratory-distress-syndrome
#14
Olivia Hoffman, Nana Burns, István Vadász, Holger K Eltzschig, Michael G Edwards, Christine U Vohwinkel
A hallmark of acute respiratory distress syndrome (ARDS) is accumulation of protein-rich edema in the distal airspaces and its removal is critical for patient survival. Previous studies have shown a detrimental role of Glycogen Synthase Kinase (GSK) 3β during ARDS via inhibition of alveolar epithelial protein transport. We hypothesized that post-transcriptional regulation of GSK3β could play a functional role in ARDS resolution. To address this hypothesis, we performed an in silico analysis to identify regulatory genes whose expression correlation to GSK3β messenger RNA utilizing two lung cancer cell line array datasets...
2017: PloS One
https://www.readbyqxmd.com/read/28195073/effects-of-budesonide-on-the-lung-functions-inflammation-and-apoptosis-in-a-saline-lavage-model-of-acute-lung-injury
#15
D Mokra, P Kosutova, S Balentova, M Adamkov, P Mikolka, J Mokry, M Antosova, A Calkovska
Diffuse alveolar injury, edema, and inflammation are fundamental signs of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Whereas the systemic administration of corticosteroids previously led to controversial results, this study evaluated if corticosteroids given intratracheally may improve lung functions and reduce edema formation, migration of cells into the lung and their activation in experimentally-induced ALI. In oxygen-ventilated rabbits, ALI was induced by repetitive saline lung lavage, until PaO2 decreased to < 26...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28195072/complement-activation-contributes-to-ventilator-induced-lung-injury-in-rats
#16
B Petersen, T Busch, J Gaertner, J J Haitsma, S Krabbendam, M Ebsen, B Lachmann, U X Kaisers
The complement system contributes to ventilator induced lung injury (VILI). We hypothesized that pretreatment with the C1 esterase inhibitor (C1INH) Berinert® constrains complement activation consecutively inducing improvements in arterial oxygenation and histological pulmonary damage. At baseline, male Sprague-Dawley rats underwent mechanical ventilation in a conventional mode (PIP 13 cm H2O, PEEP 3 cm H2O). In the Control group, the ventilator setting was maintained (Control, n = 15). The other animals randomly received intravenous pretreatment with either 100 units/kg of the C1-INH Berinert® (VILI-C1INH group, n = 15) or 1 ml saline solution (VILI-C group, n = 15)...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28189055/the-protective-effect-of-dopamine-on-ventilator-induced-lung-injury-via-the-inhibition-of-nlrp3-inflammasome
#17
Xiaomei Yang, Xiaotong Sun, Hongli Chen, Guangmin Xi, Yonghao Hou, Jianbo Wu, Dejie Liu, Huanliang Wang, Yuedong Hou, Jingui Yu
Dopamine (DA), a neurotransmitter, was previously shown to have anti-inflammatory effects. However, its role in ventilator-induced lung injury (VILI) has not been explicitly demonstrated. This study aimed to investigate the therapeutic efficacy and molecular mechanisms of dopamine in VILI. Rats were treated with dopamine during mechanical ventilation. Afterwards, the influence of dopamine on histological changes, pulmonary edema, the lung wet/dry (W/D) ratio, myeloperoxidase (MPO) activity, polymorphonuclear(PMN)counts, inflammatory cytokine levels, and NLRP3 inflammasome protein expression were examined...
February 7, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28188062/mechanical-ventilation-in-patients-subjected-to-extracorporeal-membrane-oxygenation-ecmo
#18
M L Sánchez
Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28159772/%C3%AE-tocopherol-transfer-protein-mediates-protective-hypercapnia-in-murine-ventilator-induced-lung-injury
#19
Gail Otulakowski, Doreen Engelberts, Hajime Arima, Hiroyuki Hirate, Hülya Bayir, Martin Post, Brian P Kavanagh
RATIONALE: Hypercapnia is common in mechanically ventilated patients. Experimentally, 'therapeutic hypercapnia' can protect, but it can also cause harm, depending on the mechanism of injury. Hypercapnia suppresses multiple signalling pathways. Previous investigations have examined mechanisms that were known a priori, but only a limited number of pathways, each suppressed by CO2, have been reported. OBJECTIVE: Because of the complexity and interdependence of processes in acute lung injury, this study sought to fill in knowledge gaps using an unbiased screen, aiming to identify a specifically upregulated pathway...
February 3, 2017: Thorax
https://www.readbyqxmd.com/read/28159013/the-effects-of-low-tidal-ventilation-on-lung-strain-correlate-with-respiratory-system-compliance
#20
Jianfeng Xie, Fang Jin, Chun Pan, Songqiao Liu, Ling Liu, Jingyuan Xu, Yi Yang, Haibo Qiu
BACKGROUND: The effect of alterations in tidal volume on mortality of acute respiratory distress syndrome (ARDS) is determined by respiratory system compliance. We aimed to investigate the effects of different tidal volumes on lung strain in ARDS patients who had various levels of respiratory system compliance. METHODS: Nineteen patients were divided into high (Chigh group) and low (Clow group) respiratory system compliance groups based on their respiratory system compliance values...
February 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
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