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recruitment and ards

Jeffrey Earl Gotts, Lauren F Chun, Jason Abbott, Xiaohui Fang, Naoki Takasaki, Stephen L Nishimura, Matthew L Springer, Suzaynn F Schick, Carolyn S Calfee, Michael A Matthay
Evidence is accumulating that exposure to cigarette smoke (CS) increases the risk of developing Acute Respiratory Distress Syndrome (ARDS). S. pneumoniae is the most common cause of bacterial pneumonia, which in turn is the leading cause of ARDS. Chronic smokers have increased rates of pneumococcal colonization and develop more severe pneumococcal pneumonia than nonsmokers, yet mechanistic connections between CS exposure, bacterial pneumonia, and ARDS pathogenesis remain relatively unexplored. We exposed mice to 3 weeks of moderate whole-body CS or air, followed by intranasal inoculation with an invasive serotype of S...
March 15, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
Andrew C McKown, Matthew W Semler, Todd W Rice
No abstract text is available yet for this article.
March 6, 2018: JAMA: the Journal of the American Medical Association
Idunn S Morris, Andrew S Lane, Ian Seppelt
No abstract text is available yet for this article.
March 6, 2018: JAMA: the Journal of the American Medical Association
Carmen Silvia Valente Barbas, Sérgio Nogueira Nemer
No abstract text is available yet for this article.
March 6, 2018: JAMA: the Journal of the American Medical Association
Mehrdad Pourfathi, Maurizio Cereda, Shampa Chatterjee, Yi Xin, Stephen Kadlecek, Ian Duncan, Hooman Hamedani, Sarmad Siddiqui, Harrilla Profka, Jason Ehrich, Kai Ruppert, Rahim R Rizi
Acute respiratory distress syndrome (ARDS) is a major cause of mortality in critically ill patients. Patients are currently managed by protective ventilation and alveolar recruitment using positive-end expiratory pressure (PEEP). However, the PEEP's effect on both pulmonary metabolism and regional inflammation is poorly understood. Here, we demonstrate the effect of PEEP on pulmonary anaerobic metabolism in mechanically ventilated injured rats, using hyperpolarized carbon-13 imaging. Pulmonary lactate-to-pyruvate ratio was measured in 21 rats; 14 rats received intratracheal instillation of hydrochloric-acid, while 7 rats received sham saline...
February 23, 2018: Scientific Reports
Eddy Fan, Daniel Brodie, Arthur S Slutsky
Importance: Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that affects approximately 200 000 patients each year in the United States, resulting in nearly 75 000 deaths annually. Globally, ARDS accounts for 10% of intensive care unit admissions, representing more than 3 million patients with ARDS annually. Objective: To review advances in diagnosis and treatment of ARDS over the last 5 years. Evidence Review: We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 2012 to 2017 focusing on randomized clinical trials, meta-analyses, systematic reviews, and clinical practice guidelines...
February 20, 2018: JAMA: the Journal of the American Medical Association
Hernan Aguirre-Bermeo, Marta Turella, Maddalena Bitondo, Juan Grandjean, Stefano Italiano, Olimpia Festa, Indalecio Morán, Jordi Mancebo
BACKGROUND: The use of positive end-expiratory pressure (PEEP) and prone position (PP) is common in the management of severe acute respiratory distress syndrome patients (ARDS). We conducted this study to analyze the variation in lung volumes and PEEP-induced lung volume recruitment with the change from supine position (SP) to PP in ARDS patients. METHODS: The investigation was conducted in a multidisciplinary intensive care unit. Patients who met the clinical criteria of the Berlin definition for ARDS were included...
February 14, 2018: Annals of Intensive Care
Sitang Maknitikul, Natthanej Luplertlop, Urai Chaisri, Yaowapa Maneerat, Sumate Ampawong
Plasmodium falciparum, the most virulent malaria parasite species, causes severe symptoms especially acute lung injury (ALI), of which characterized by alveolar epithelium and endothelium destruction and accelerated to blood-gas-barrier breakdown. Parasitized erythrocytes, endothelial cells, monocytes, and cytokines are all involved in this mechanism, but hemozoin (HZ), the parasitic waste from heme detoxification, also mainly contributes. In addition, it is not clear why type II pneumocyte proliferation, alveolar restorative stage, is rare in malaria-associated ALI...
January 1, 2018: Experimental Biology and Medicine
J García-Fernández, A Romero, A Blanco, P Gonzalez, A Abad-Gurumeta, S D Bergese
Pulmonary recruitment manoeuvres (RM) are intended to reopen collapsed lung areas. RMs are present in nature as a physiological mechanism to get a newborn to open their lungs for the first time at birth, and we also use them, in our usual anaesthesiological clinical practice, after induction or during general anaesthesia when a patient is desaturated. However, there is much confusion in clinical practice regarding their safety, the best way to perform them, when to do them, in which patients they are indicated, and in those where they are totally contraindicated...
January 26, 2018: Revista Española de Anestesiología y Reanimación
Savino Spadaro, Tommaso Mauri, Stephan H Böhm, Gaetano Scaramuzzo, Cecilia Turrini, Andreas D Waldmann, Riccardo Ragazzi, Antonio Pesenti, Carlo Alberto Volta
BACKGROUND: Assessing alveolar recruitment at different positive end-expiratory pressure (PEEP) levels is a major clinical and research interest because protective ventilation implies opening the lung without inducing overdistention. The pressure-volume (P-V) curve is a validated method of assessing recruitment but reflects global characteristics, and changes at the regional level may remain undetected. The aim of the present study was to compare, in intubated patients with acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS), lung recruitment measured by P-V curve analysis, with dynamic changes in poorly ventilated units of the dorsal lung (dependent silent spaces [DSSs]) assessed by electrical impedance tomography (EIT)...
January 31, 2018: Critical Care: the Official Journal of the Critical Care Forum
Bethany M Biron, Chun-Shiang Chung, Yaping Chen, Zachary Wilson, Eleanor A Fallon, Jonathan S Reichner, Alfred Ayala
Indirect acute respiratory distress syndrome (iARDS) is caused by a nonpulmonary inflammatory process resulting from insults such as nonpulmonary sepsis. Neutrophils are thought to play a significant role in mediating ARDS, with the development of iARDS being characterized by dysregulation and recruitment of activated neutrophils into the lung. Recently, a novel mechanism of microbial killing by neutrophils was identified through the formation of neutrophil extracellular traps (NETs). NETs are composed of large webs of decondensed chromatin released from activated neutrophils into the extracellular space; they are regulated by the enzyme peptidylarginine deiminase 4 (PAD4) through mediation of chromatin decondensation via citrullination of target histones...
January 26, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Yu-Jung Chen, Sheng-Fan Wang, I-Chun Weng, Ming-Hsiang Hong, Tzu-Han Lo, Jia-Tsrong Jan, Li-Chung Hsu, Huan-Yuan Chen, Fu-Tong Liu
Highly pathogenic avian influenza A H5N1 virus causes pneumonia and acute respiratory distress syndrome in humans. Virus-induced excessive inflammatory response contributes to severe disease and high mortality rates. Galectin-3, a β-galactoside-binding protein widely distributed in immune and epithelial cells, regulates various immune functions and modulates microbial infections. Here we describe galectin-3 up-regulation in mouse lung tissue following challenges with the H5N1 influenza virus. We investigated the effects of endogenous galectin-3 on H5N1 infection and found that survival of galectin-3 knockout (Gal-3KO) mice was comparable to wild-type (WT) mice following infections...
January 20, 2018: American Journal of Pathology
Takahiro Hiruma, Hitoshi Tsuyuzaki, Kanji Uchida, Bruce C Trapnell, Yoshiro Yamamura, Yoshiomi Kusakabe, Tokie Totsu, Takuji Suzuki, Shigeki Morita, Kent Doi, Eisei Noiri, Kensuke Nakamura, Susumu Nakajima, Naoki Yahagi, Naoto Morimura, Kyungho Chang, Yoshitsugu Yamada
Interferon-β (IFNβ) is reported to improve survival in patients with acute respiratory distress syndrome (ARDS), possibly by preventing sepsis-induced immunosuppression, but its therapeutic nature in ARDS pathogenesis is poorly understood. We investigated the therapeutic effects of IFNβ for post-septic ARDS to better understand its pathogenesis in mice. Post-septic ARDS was reproduced in mice by cecal ligation and puncture to induce sepsis followed 4 days later by intratracheal instillation of Pseudomonas aeruginosa to cause pneumonia with or without subcutaneous administration of IFNβ 1 day earlier...
January 24, 2018: American Journal of Respiratory Cell and Molecular Biology
Adriana E Kajon, Daryl M Lamson, Camden R Bair, Xiaoyan Lu, Marie L Landry, Marilyn Menegus, Dean D Erdman, Kirsten St George
Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011-2015. Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities. HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases...
February 2018: Emerging Infectious Diseases
Giorgia Maiolo, Francesca Collino, Francesco Vasques, Francesca Rapetti, Tommaso Tonetti, Federica Romitti, Massimo Cressoni, Davide Chiumello, Onnen Moerer, Peter Herrmann, Tim Friede, Michael Quintel, Luciano Gattinoni
RATIONALE: The ratio of PaO2 to FiO2 (P/F) defines ARDS severity and suggests appropriate therapies. OBJECTIVES: We investigated 1) whether a 150 mmHg P/F threshold within the range of moderate ARDS (100-200 mmHg) would define two, more homogeneous subgroups, 2) which criteria led the clinicians to apply ECMO in severe ARDS. Methods & Measurements: At 150 mmHg P/F threshold, moderate patients were split in mild-moderate (n=50) and moderate-severe (n=55). Severe ARDS patients (FiO2 not available in 3 patients ) were split in higher (n=63) and lower-FiO2 (n=18) at 80% FiO2 threshold...
January 18, 2018: American Journal of Respiratory and Critical Care Medicine
Thomas Godet, Matthieu Jabaudon, Raïko Blondonnet, Aymeric Tremblay, Jules Audard, Benjamin Rieu, Bruno Pereira, Jean-Marc Garcier, Emmanuel Futier, Jean-Michel Constantin
BACKGROUND: High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). METHODS: Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory...
January 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
Caio C A Morais, Yukiko Koyama, Takeshi Yoshida, Glauco M Plens, Susimeire Gomes, Cristhiano L A S Lima, Ozyres P Ramos, Sérgio M Pereira, Naomasa Kawaguchi, Hirofumi Yamamoto, Akinori Uchiyama, João B Borges, Marcos F Vidal Melo, Mauro R Tucci, Marcelo B P Amato, Brian P Kavanagh, Eduardo L V Costa, Yuji Fujino
RATIONALE: In ARDS, atelectatic 'solid-like' lung tissue impairs transmission of negative 'swings' in pleural pressure (Ppl) resulting from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions, e.g., non-dependent lung (Pendelluft) or from the ventilator. Lowering of the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort non-injurious...
January 11, 2018: American Journal of Respiratory and Critical Care Medicine
Valentina Della Torre, Rafael Badenes, Francesco Corradi, Fabrizio Racca, Andrea Lavinio, Basil Matta, Federico Bilotta, Chiara Robba
Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice...
December 2017: Journal of Thoracic Disease
Federica De Giacomi, Robert Vassallo, Eunhee S Yi, Jay H Ryu
Acute eosinophilic pneumonia (AEP) is an uncommon acute respiratory illness of varying severity that includes presentation as acute respiratory distress syndrome with fatal outcome. AEP may be idiopathic, but identifiable causes include smoking and other inhalational exposures, medications, and infections. The pathogenesis of AEP is poorly understood but likely varies depending on the underlying cause. Airway epithelial injury, endothelial injury, and release of IL-33 are early events that subsequently promote eosinophil recruitment to the lung; eosinophilic infiltration and degranulation appear to mediate subsequent lung inflammation and associated clinical manifestations...
March 15, 2018: American Journal of Respiratory and Critical Care Medicine
Zhaoqiang Jiang, Shibo Ying, Wei Shen, Xianglei He, Junqiang Chen, Hailing Xia, Min Yu, Yun Xiao, Lingfang Feng, Lijin Zhu, Li Ju, Xinnian Guo, Yixiao Zhang, Jia-Wei Shen, Yan Tong, Xing Zhang, Jianlin Lou
Fibulin-3 has been reported as a potential biomarker for mesothelioma. However, little is known about the diagnostic efficacies of fibulin-3 for asbestos-related diseases (ARDs) in China. This study was to investigate the utility of fibulin-3 for asbestos exposure and ARDs. A total of 430 subjects were recruited from Southeast China, including healthy individuals, asbestos-exposed (AE) individuals, and patients with pleural plaques (PP), asbestosis, and malignant pleural mesothelioma (MPM). Plasma fibulin-3 was measured using the enzyme-linked immunosorbent assay...
2017: Disease Markers
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