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recruitment and ards

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https://www.readbyqxmd.com/read/27923015/project-shikamana-baseline-findings-from-a-community-empowerment-based-combination-hiv-prevention-trial-among-female-sex-workers-in-iringa-tanzania
#1
Deanna Kerrigan, Jessie Mbwambo, Samuel Likindikoki, Sarah Beckham, Ard Mwampashi, Catherine Shembilu, Andrea Mantsios, Anna Leddy, Wendy Davis, Noya Galai
BACKGROUND: Community empowerment approaches have been found to be effective in responding to HIV among female sex workers (FSWs) in South Asia and Latin America. To date, limited rigorous evaluations of these approaches have been conducted in sub-Saharan Africa. METHODS: A phase II community randomized controlled trial is being conducted in Iringa, Tanzania, to evaluate the effectiveness of a community empowerment-based combination HIV prevention model (Project Shikamana) among a stratified sample of HIV-infected and HIV-uninfected FSWs...
January 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27903788/treatment-of-adenoviral-acute-respiratory-distress-syndrome-using-cidofovir-with-extracorporeal-membrane-oxygenation-case-series-and-literature-review
#2
Minhyeok Lee, Seulgi Kim, Oh Jung Kwon, Ji Hye Kim, Inbeom Jeong, Ji Woong Son, Moon Jun Na, Yoo Sang Yoon, Hyun Woong Park, Sun Jung Kwon
Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir...
November 30, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#3
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27855477/recruitment-manoeuvres-for-adults-with-acute-respiratory-distress-syndrome-receiving-mechanical-ventilation
#4
REVIEW
Carol Hodgson, Ewan C Goligher, Meredith E Young, Jennifer L Keating, Anne E Holland, Lorena Romero, Scott J Bradley, David Tuxen
BACKGROUND: Recruitment manoeuvres involve transient elevations in airway pressure applied during mechanical ventilation to open ('recruit') collapsed lung units and increase the number of alveoli participating in tidal ventilation. Recruitment manoeuvres are often used to treat patients in intensive care who have acute respiratory distress syndrome (ARDS), but the effect of this treatment on clinical outcomes has not been well established. This systematic review is an update of a Cochrane review originally published in 2009...
November 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27842745/managing-acute-lung-injury
#5
REVIEW
Gregory A Schmidt
The foundation of mechanical ventilation for acute respiratory distress syndrome involves limiting lung overdistention by using small tidal volumes or transpulmonary pressures. Potential for additional lung recruitment with higher positive end-expiratory pressure (PEEP) should be assessed. When stress index indicates tidal recruitment-derecruitment, PEEP is increased to higher values. Alternatively, a high PEEP table is used in all patients. When these conventional approaches are insufficient to sustain acceptable gas exchange, rescue is attempted using extracorporeal therapies, airway pressure-release ventilation, inhaled vasodilators, or high-frequency oscillatory ventilation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27831560/manipulating-the-air-filled-zebrafish-swim-bladder-as-a-neutrophilic-inflammation-model-for-acute-lung-injury
#6
Yuefei Zhang, Hongcui Liu, Junlin Yao, Yanfeng Huang, Shenlu Qin, Zheng Sun, Yingchun Xu, Shu Wan, Hongqiang Cheng, Chunqi Li, Xue Zhang, Yuehai Ke
Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS), are life-threatening diseases that are associated with high mortality rates due to treatment limitations. Neutrophils play key roles in the pathogenesis of ALI/ARDS by promoting the inflammation and injury of the alveolar microenvironment. To date, in vivo functional approaches have been limited by the inaccessibility to the alveolar sacs, which are located at the anatomical terminal of the respiratory duct in mammals...
November 10, 2016: Cell Death & Disease
https://www.readbyqxmd.com/read/27822747/venovenous-extracorporeal-membrane-oxygenation-for-ards-outcome-analysis-of-a-croatian-referral-center-for-respiratory-ecmo
#7
Marko Kutleša, Anđa Novokmet, Renata Josipović Mraović, Bruno Baršić
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy in severe acute respiratory distress syndrome (ARDS) has become well established; however, the affirmation of evidence on VV-ECMO application and the analysis of patient outcomes after VV-ECMO treatment for ARDS continues. The aim of the study is to identify variables that affected the outcome of patients treated with VV-ECMO for severe ARDS outside a major ECMO center. METHODS: The study included adult patients with severe ARDS treated with ECMO at a tertiary care hospital in Zagreb, Croatia between October 2009 and July 2014...
November 7, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27790273/clinical-practice-guideline-of-acute-respiratory-distress-syndrome
#8
REVIEW
Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27768389/a-missense-genetic-variant-in-lrrc16a-carmil1-improves-ards-survival-by-attenuating-platelet-count-decline
#9
Yongyue Wei, Paula Tejera, Zhaoxi Wang, Ruyang Zhang, Feng Chen, Li Su, Xihong Lin, Ednan K Bajwa, B Taylor Thompson, David C Christiani
RATIONALE: Platelets are believed to contribute to the acute respiratory distress syndrome (ARDS) pathogenesis through inflammatory coagulation pathways. We recently reported that LRRC16A modulates baseline platelet counts to mediate ARDS risk. OBJECTIVES: To examine the role of LRRC16A in ARDS survival and its mediating effect through platelets. METHODS: 414 ARDS cases from intensive care unit (ICU) were recruited which had exome-wide genotyping data, detailed platelet counts and follow-up data during ICU hospitalizaiton...
October 21, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27763913/the-open-lung-approach-improves-pulmonary-vascular-mechanics-in-an-experimental-model-of-acute-respiratory-distress-syndrome
#10
Arnoldo Santos, Luca Lucchetta, M Ignacio Monge-Garcia, Joao Batista Borges, Gerardo Tusman, Goran Hedenstierna, Anders Larsson, Fernando Suarez-Sipmann
OBJECTIVE: To test whether positive end-expiratory pressure consistent with an open lung approach improves pulmonary vascular mechanics compared with higher or lower positive end-expiratory pressures in experimental acute respiratory distress syndrome. DESIGN: Experimental study. SETTING: Animal research laboratory. SUBJECTS: Ten pigs, 35 ± 5.2 kg. INTERVENTIONS: Acute respiratory distress syndrome was induced combining saline lung lavages with injurious mechanical ventilation...
October 19, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27741949/hydrocortisone-treatment-in-early-sepsis-associated-acute-respiratory-distress-syndrome-results-of-a-randomized-controlled-trial
#11
Surat Tongyoo, Chairat Permpikul, Wasineenart Mongkolpun, Veerapong Vattanavanit, Suthipol Udompanturak, Mehmet Kocak, G Umberto Meduri
BACKGROUND: Authors of recent meta-analyses have reported that prolonged glucocorticoid treatment is associated with significant improvements in patients with severe pneumonia or acute respiratory distress syndrome (ARDS) of multifactorial etiology. A prospective randomized trial limited to patients with sepsis-associated ARDS is lacking. The objective of our study was to evaluate the efficacy of hydrocortisone treatment in sepsis-associated ARDS. METHODS: In this double-blind, single-center (Siriraj Hospital, Bangkok), randomized, placebo-controlled trial, we recruited adult patients with severe sepsis within 12 h of their meeting ARDS criteria...
October 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27729414/acute-lung-injury-is-reduced-by-the-%C3%AE-7nachr-agonist-pnu-282987-through-changes-in-the-macrophage-profile
#12
Nathalia M Pinheiro, Fernanda P R Santana, Rafael Ribeiro Almeida, Marina Guerreiro, Milton A Martins, Luciana C Caperuto, Niels O S Câmara, Lislaine A Wensing, Vânia F Prado, Iolanda F L C Tibério, Marco Antônio M Prado, Carla M Prado
Nicotinic α-7 acetylcholine receptor (nAChRα7) is a critical regulator of cholinergic anti-inflammatory actions in several diseases, including acute respiratory distress syndrome (ARDS). Given the potential importance of α7nAChR as a therapeutic target, we evaluated whether PNU-282987, an α7nAChR agonist, is effective in protecting the lung against inflammation. We performed intratracheal instillation of LPS to generate acute lung injury (ALI) in C57BL/6 mice. PNU-282987 treatment, either before or after ALI induction, reduced neutrophil recruitment and IL-1β, TNF-α, IL-6, keratinocyte chemoattractant (KC), and IL-10 cytokine levels in the bronchoalveolar lavage fluid (P < 0...
October 11, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27707929/constitutively-expressed-ifitm3-protein-in-human-endothelial-cells-poses-an-early-infection-block-to-human-influenza-viruses
#13
Xiangjie Sun, Hui Zeng, Amrita Kumar, Jessica A Belser, Taronna R Maines, Terrence M Tumpey
: A role for pulmonary endothelial cells in the orchestration of cytokine production and leukocyte recruitment during influenza virus infection, leading to severe lung damage, has been recently identified. As the mechanistic pathway for this ability is not fully known, we extended previous studies on influenza virus tropism in cultured human pulmonary endothelial cells. We found that a subset of avian influenza viruses, including potentially pandemic H5N1, H7N9, and H9N2 viruses, could infect human pulmonary endothelial cells (HULEC) with high efficiency compared to human H1N1 or H3N2 viruses...
December 15, 2016: Journal of Virology
https://www.readbyqxmd.com/read/27684585/lavage-induced-surfactant-depletion-in-pigs-as-a-model-of-the-acute-respiratory-distress-syndrome-ards
#14
Martin Russ, Sebastian Kronfeldt, Willehad Boemke, Thilo Busch, Roland C E Francis, Philipp A Pickerodt
Various animal models of lung injury exist to study the complex pathomechanisms of human acute respiratory distress syndrome (ARDS) and evaluate future therapies. Severe lung injury with a reproducible deterioration of pulmonary gas exchange and hemodynamics can be induced in anesthetized pigs using repeated lung lavages with warmed 0.9% saline (50 ml/kg body weight). Including standard respiratory and hemodynamic monitoring with clinically applied devices in this model allows the evaluation of novel therapeutic strategies (drugs, modern ventilators, extracorporeal membrane oxygenators, ECMO), and bridges the gap between bench and bedside...
September 7, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27638902/protein-phosphatase-2a-activation-attenuates-inflammation-in-murine-models-of-acute-lung-injury
#15
Walker M McHugh, William W Russell, Andrew J Fleszar, Paul E Rodenhouse, Skyler P Rietberg, Lei Sun, Thomas P Shanley, Timothy T Cornell
Acute respiratory distress syndrome (ARDS) remains a leading cause of morbidity and mortality in both adult and pediatric intensive care units. A key event in the development of ARDS is neutrophil recruitment into the lungs leading to tissue damage and destruction. Interleukin-8 (IL-8) is the major human chemokine responsible for neutrophil recruitment into the lungs. Protein phosphatase 2A (PP2A) has been shown to be a key regulator of the mitogen-activated protein kinase (MAPK) cascades, which control the production of IL-8...
November 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27638132/external-validation-of-the-apps-a-new-and-simple-outcome-prediction-score-in-patients-with-the-acute-respiratory-distress-syndrome
#16
Lieuwe D Bos, Laura R Schouten, Olaf L Cremer, David S Y Ong, Marcus J Schultz
BACKGROUND: A recently developed prediction score based on age, arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO2/FiO2) and plateau pressure (abbreviated as 'APPS') was shown to accurately predict mortality in patients diagnosed with the acute respiratory distress syndrome (ARDS). After thorough temporal external validation of the APPS, we tested the spatial external validity in a cohort of ARDS patients recruited during 3 years in two hospitals in the Netherlands...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27634821/il-17a-attracts-inflammatory-cells-in-murine-lung-infection-with-p-aeruginosa
#17
Bodo Wonnenberg, Christopher Jungnickel, Anja Honecker, Lisa Wolf, Meike Voss, Markus Bischoff, Thomas Tschernig, Christian Herr, Robert Bals, Christoph Beisswenger
IL-17A-dependent immunity is of importance in the protection against extracellular bacterial pathogens. However, IL-17A is also suggested to mediate the pathogenesis of lung diseases, such as acute respiratory distress syndrome. Here, we studied the role of IL-17A in a mouse model of acute pneumonia. IL-17A mediated the expression of keratinocyte-derived chemokine (KC) and the recruitment of inflammatory cells in mice infected with a sub-lethal dose of Pseudomonas aeruginosa IL-17A deficiency protected mice from lethal P...
September 15, 2016: Innate Immunity
https://www.readbyqxmd.com/read/27624632/respiratory-management-of-perioperative-obese-patients
#18
REVIEW
David Ae Imber, Massimiliano Pirrone, Changsheng Zhang, Daniel F Fisher, Robert M Kacmarek, Lorenzo Berra
With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27608686/clinical-profile-of-patients-requiring-prolonged-mechanical-ventilation-and-their-outcome-in-a-tertiary-care-medical-icu
#19
Chakor S Vora, Niteen D Karnik, Vishal Gupta, Milind Y Nadkar, Jaimala V Shetye
INTODUCTION: An increasing number of patients require mechanical ventilation and there has been a proportional increase in patients needing prolonged mechanical ventilation (ventilated for ≥ 21 days, for atleast 6 hours per day). It accounts for about 10% of all mechanically ventilated patients. Although these patients represent a smaller proportion of intensive care unit (ICU) patients, they consume substantial ICU resources. We studied etiology, metabolic and clinical profile, complications and outcome of these patients...
October 2015: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27588065/effect-of-setting-high-aprv-guided-by-expiratory-inflection-point-of-pressure-volume-curve-on-oxygen-delivery-in-canine-models-of-severe-acute-respiratory-distress-syndrome
#20
Jia-Qiong Li, Hong-Yang Xu, Mao-Qin Li, Jing-Yu Chen
In the present study, the effect of setting high airway pressure release ventilation (APRV) pressure guided by an expiratory inflection point of pressure-volume (PV) curve following lung recruitment maneuver (RM) on oxygen delivery (DO2) in canine models of severe acute respiratory distress syndrome (ARDS) was examined. Canine models of severe ARDS were established by intravenous injection of oleic acid. After injection of sedative muscle relaxants, a PV curve plotted using the super-syringe technique, and the pressure at lower inflection point (LIP) at the inhale branch and the pressure at the point of maximum curvature (PMC) at the exhale branch were measured...
September 2016: Experimental and Therapeutic Medicine
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