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Very severe ards

Zhiheng Xu, Xi Li, Yongbo Huang, Pu Mao, Sulong Wu, Baoxin Yang, Yuanyuan Yang, Kangxie Chen, Xiaoqing Liu, Yimin Li
BACKGROUND: Galectin-3 is a β-galactoside-binding lectin implicated as a mediator in a variety of inflammatory and fibrotic diseases. However, information about galectin-3 release in patients with acute respiratory distress syndrome (ARDS) is very limited. We sought to determine whether plasma galectin-3 levels were increased in ARDS patients and were associated with disease severity. METHODS: Patients admitted to intensive care unit (ICU) within 48 h and diagnosed with ARDS were identified...
September 19, 2016: Shock
Benjamin Kasenda, Willi Sauerbrei, Patrick Royston, Alain Mercat, Arthur S Slutsky, Deborah Cook, Gordon H Guyatt, Laurent Brochard, Jean-Christophe M Richard, Thomas E Stewart, Maureen Meade, Matthias Briel
OBJECTIVES: A recent individual patient data (IPD) meta-analysis suggested that patients with moderate or severe acute respiratory distress syndrome (ARDS) benefit from higher positive end-expiratory pressure (PEEP) ventilation strategies. However, thresholds for continuous variables (eg, hypoxaemia) are often arbitrary and linearity assumptions in regression approaches may not hold; the multivariable fractional polynomial interaction (MFPI) approach can address both problems. The objective of this study was to apply the MFPI approach to investigate interactions between four continuous patient baseline variables and higher versus lower PEEP on clinical outcomes...
September 8, 2016: BMJ Open
Mathieu Gerfaud-Valentin, Vincent Cottin, Yvan Jamilloux, Arnaud Hot, Agathe Gaillard-Coadon, Isabelle Durieu, Christiane Broussolle, Jean Iwaz, Pascal Sève
Parenchymal lung involvement (PLI) in adult-onset Still's disease (AOSD) has seldom, if ever, been studied. We examine here retrospective cohort AOSD cases and present a review of the literature (1971-2014) on AOSD-related PLI cases.Patients with PLI were identified in 57 AOSD cases. For inclusion, the patients had to fulfill Yamaguchi or Fautrel classification criteria, show respiratory symptoms, and have imaging evidence of pulmonary involvement, and data allowing exclusion of infectious, cardiogenic, toxic, or iatrogenic cause of PLI should be available...
July 2016: Medicine (Baltimore)
Gurveen Malhotra, Nitya Ramreddy, Serafin Chua, Mira Iliescu, Tanjeev Kaur
Antisynthetase (AS) syndrome is a major subgroup of inflammatory myopathies seen in a minority of patients with dermatomyositis and polymyositis. Although it is usually associated with elevated creatine phosphokinase level, some patients may have amyopathic dermatomyositis (ADM) like presentation with predominant skin involvement. Interstitial lung disease (ILD) is the main pulmonary manifestation and may be severe thereby determining the prognosis. It may rarely present with a very aggressive course resulting in acute respiratory distress syndrome (ARDS)...
2016: Case Reports in Critical Care
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Montserrat Rojo de la Vega, Matthew Dodson, Christine Gross, Heidi Manzour, R Clark Lantz, Eli Chapman, Ting Wang, Stephen M Black, Joe G N Garcia, Donna D Zhang
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are the clinical manifestations of severe lung damage and respiratory failure. Characterized by severe inflammation and compromised lung function, ALI/ARDS result in very high mortality of affected individuals. Currently, there are no effective treatments for ALI/ARDS, and ironically, therapies intended to aid patients (specifically mechanical ventilation, MV) may aggravate the symptoms. Key events contributing to the development of ALI/ARDS are: increased oxidative and proteotoxic stresses, unresolved inflammation, and compromised alveolar-capillary barrier function...
April 2016: Current Pharmacology Reports
Michael Kalina
Very elderly trauma patients (VETs) were routinely admitted to nonsurgical services at our institution; therefore, a trauma service activation and admission policy was implemented. Our goal was to determine policy success and impact on efficiency and outcomes. VETs, defined as trauma patients aged >89 years, admitted before and after policy implementation were reviewed. Demographics included age, gender, Injury Severity Score, Glasgow Coma Score, admission diagnosis, mechanism of injury, admission service, and comorbidities...
June 2016: American Surgeon
Ahmet Çağkan İnkaya, Filiz Kaya, İrem Yıldız, Ömrüm Uzun, Sibel Ergüven
Among Plasmodium species the causative agent of malaria in Turkey is P.vivax, however the incidence of imported falciparum malaria cases is steadily increasing. P.falciparum may cause severe malaria with the involvement of central nervous system, acute renal failure, severe anemia or acute respiratory distress syndrome. Furhermore most of the casualties due to malaria are related with P.falciparum. There is recently, a considerable increase in malaria infections especially in tropical areas. In this report, three cases, who have admitted to our hospital with three different clinical presentations of falciparum malaria, and all shared common history of travelling to Africa were presented...
April 2016: Mikrobiyoloji Bülteni
S David, O Wiesner
Hypoxic lung failure is among the major indications for patients' referral to intensive care units either for surveillance or if necessary therapy. There are a vast number of pathophysiological causes of lung failure and the optimal treatment highly depends on the underlying pathology; therefore, no standard algorithm exists. So-called acute respiratory distress syndrome (ARDS) represents a very severe manifestation of hypoxemic lung failure that is of particular relevance for intensivists and is therefore the focus of this review...
April 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Ebru Atike Ongun, Reha Artan, Aysen Bingol, Oguz Dursun
Crohn's disease (CD), known as the disease of gastrointestinal system, is a granulamatous systemic disorder with extraintestinal manifestations including the respiratory system. The resemblance in the embriological origins and the immunities of both organ systems' mucosae, also the circulating immune complexes and the autoantibodies are accepted as contributing factors. The shift of inflammation may become prominent when the colon is removed after colectomy and independent of the bowel disease activity; pulmonary involvement may be exarbecated...
February 2016: Indian Journal of Critical Care Medicine
Xavier Repessé, Cyril Charron, Antoine Vieillard-Baron
PURPOSE OF REVIEW: The right ventricle (RV) plays a pivotal role during respiratory failure because of its high sensitivity to small loading changes during inspiration. Both RVs, preload and afterload, are altered during inspiration, either in spontaneous breathing or during mechanical ventilation. Some clinical situations especially affect RV load during inspiration, for example acute asthma and acute respiratory distress syndrome. The aim of this review is to explain and to summarize the different mechanisms leading to RV failure in these situations...
June 2016: Current Opinion in Critical Care
Sachin Sud, Maneesh Sud, Jan O Friedrich, Hannah Wunsch, Maureen O Meade, Niall D Ferguson, Neill K J Adhikari
BACKGROUND: High-frequency oscillation (HFO) is an alternative to conventional mechanical ventilation that is sometimes used to treat people with acute respiratory distress syndrome, but effects on oxygenation, mortality and adverse clinical outcomes are uncertain. This review was originally published in 2004 and was updated in 2013 and again in 2015. OBJECTIVES: To determine the effects of HFO compared to conventional mechanical ventilation on physiological outcomes, clinical outcomes, and mortality when used for the treatment of acute respiratory distress syndrome (ARDS)...
April 4, 2016: Cochrane Database of Systematic Reviews
John S Schreck, Flavio Romano, Matthew H Zimmer, Ard A Louis, Jonathan P K Doye
We use oxDNA, a coarse-grained model of DNA at the nucleotide level, to simulate large nanoprisms that are composed of multi-arm star tiles, in which the size of bulge loops that have been incorporated into the tile design is used to control the flexibility of the tiles. The oxDNA model predicts equilibrium structures for several different nanoprism designs that are in excellent agreement with the experimental structures as measured by cryoTEM. In particular we reproduce the chiral twisting of the top and bottom faces of the nanoprisms, as the bulge sizes in these structures are varied due to the greater flexibility of larger bulges...
April 26, 2016: ACS Nano
Sabrina Arondi, Alberto Valsecchi, Andrea Borghesi, Stefano Monti
Sarcoidosis is a common disease that involve almost constantly the lung. Usually the onset is insidious, and symptoms are slowly ingravescent. Very rarely, as in the case here reported, sarcoidosis can cause an acute respiratory failure with acute respiratory distress syndrome (ARDS). A 20-year-old girl from Pakistan presented for acute fatigue, fever, and cough with a chest X-ray displayed the micronodular interstitial disease. Despite of anti-tuberculosis therapy, ARDS developed in a few days requiring continuous positive airway pressure treatment...
January 2016: Annals of Thoracic Medicine
Anvar Shukurov, Graeme Sarson, Mykhailo Videiko, Kate Henderson, Robert Shiel, Pavel Dolukhanov, Galina Pashkevich
We present paleoeconomy reconstructions for premodern agriculture, selecting, wherever required, features and parameter values specific for the Cucuteni-Trypillia cultural unity (CTU; 5,400-2,700 BC, mostly the territory of modern Ukraine, Moldova, and Romania). We verify the self-consistency and viability of the archaeological evidence related to all major elements of the agricultural production cycle within the constraints provided by environmental and technological considerations. The starting point of our analysis is the paleodiet structure suggested by archaeological data, stable isotope analyses of human remains, and palynology studies in the CTU area...
July 2015: Human Biology
Djillali Annane
Neuromuscular blocking agents and corticosteroids are widely used in medicine and in particular in the intensive care unit (ICU). Neuromuscular blockade is commonly used to ease tracheal intubation, to optimize mechanical ventilation and oxygenation in acute respiratory disorders such as status asthmaticus and acute respiratory distress syndrome (ARDS), to prevent shivering during therapeutic hypothermia, and also in patients with elevated intracranial pressure. In the ICU, patients with sepsis, ARDS, community-acquired pneumonia, exacerbation of chronic obstructive pulmonary disease, severe asthma, or trauma may receive corticosteroids...
February 2016: Seminars in Respiratory and Critical Care Medicine
Robert H Notter, Zhengdong Wang, Frans J Walther
Background/objectives. This study examines the surface activity, resistance to biophysical inhibition, and pulmonary efficacy of a synthetic lung surfactant containing glycerophospholipids combined with Super Mini-B (S-MB) DATK, a novel and stable molecular mimic of lung surfactant protein (SP)-B. The objective of the work is to test whether S-MB DATK synthetic surfactant has favorable biophysical and physiological activity for future use in treating surfactant deficiency or dysfunction in lung disease or injury...
2016: PeerJ
Subbiah Rajasekaran, Dhamotharan Pattarayan, P Rajaguru, P S Sudhakar Gandhi, Rajesh K Thimmulappa
The acute respiratory distress syndrome (ARDS), a severe form of acute lung injury (ALI), is a very common condition associated with critically ill patients, which causes substantial morbidity and mortality worldwide. Despite decades of research, effective therapeutic strategies for clinical ALI/ARDS are not available. In recent years, microRNAs (miRNAs), small non-coding molecules have emerged as a major area of biomedical research as they post-transcriptionally regulate gene expression in diverse biological and pathological processes, including ALI/ARDS...
October 2016: Journal of Cellular Physiology
Stelios Parissopoulos, Meropi DA Mpouzika, Fiona Timmins
BACKGROUND: Adult respiratory distress syndrome (ARDS) is a type of acute diffuse lung injury characterized by severe inflammation, increased pulmonary vascular permeability and a loss of aerated lung tissue. The effects of high fraction of inspired oxygen (FiO2 ) include oxygen toxicity manifested by damage to the lung parenchyma in the acute phase of lung injury. There is still a high mortality rate among this group of patients, so clinically sensitive evidence-based interventions are paramount to maximize survival chances during critical care...
October 23, 2015: Nursing in Critical Care
Didier Dreyfuss, Jean-Damien Ricard, Stéphane Gaudry
High frequency oscillatory ventilation (HFOV) has been the subject of extensive physiological research for 30 years and even more so of an intense debate on its potential usefulness in the treatment of acute respiratory distress syndrome (ARDS). This technique has been enthusiastically promoted by some teams until two high-quality randomized clinical trials in adults with ARDS showed that HFOV did not decrease and might have even increased mortality. As a consequence of these results, physiological concepts such as atelectrauma and biotrauma on which ARDS management with HFOV were based should be reexamined...
December 2015: Intensive Care Medicine
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