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Acute Respiratory Distress Syndrome

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https://www.readbyqxmd.com/read/27914908/association-between-ventilatory-settings-and-development-of-acute-respiratory-distress-syndrome-in-mechanically-ventilated-patients-due-to-brain-injury
#1
Eva Tejerina, Paolo Pelosi, Alfonso Muriel, Oscar Peñuelas, Yuda Sutherasan, Fernando Frutos-Vivar, Nicolás Nin, Andrew R Davies, Fernando Rios, Damian A Violi, Konstantinos Raymondos, Javier Hurtado, Marco González, Bin Du, Pravin Amin, Salvatore M Maggiore, Arnaud W Thille, Marco Antonio Soares, Manuel Jibaja, Asisclo J Villagomez, Michael A Kuiper, Younsuck Koh, Rui P Moreno, Amine Ali Zeggwagh, Dimitrios Matamis, Antonio Anzueto, Niall D Ferguson, Andrés Esteban
PURPOSE: In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. MATERIALS AND METHODS: We performed a secondary analysis of a prospective, observational study on mechanical ventilation...
November 18, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27913426/depletion-of-circulating-monocytes-suppresses-il-17-and-hmgb1-expression-in-mice-with-lps-induced-acute-lung-injury
#2
Zhilong Jiang, Qianlin Zhou, Chenlin Gu, Dandan Li, Lei Zhu
Acute lung injury/Acute Respiratory distress syndrome (ALI/ARDS) is an important cause of mortality in critically ill patients. Macrophages play an important role in the pathogenesis of ALI/ARDS. To investigate the role and underlying mechanisms of circulating monocytes and resident alveolar macrophages (AMs) in ALI/ARDS, we depleted circulating monocytes and AMs by clodronate-loaded liposome (CL) in lipopolysaccharide (LPS)-induced ALI/ARDS mouse model. Our results indicated that depletion of circulating monocytes by intravenous (i...
December 2, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27906709/looking-closer-at-acute-respiratory-distress-syndrome-the-role-of-advanced-imaging-techniques
#3
Giacomo Bellani, Jean-Jaques Rouby, Jean-Michel Constantin, Antonio Pesenti
PURPOSE OF REVIEW: Advanced imaging techniques have provided invaluable insights in understanding of acute respiratory distress syndrome (ARDS) and the effect of therapeutic strategies, thanks to the possibility of gaining regional information and moving from simple 'anatomical' information to in-vivo functional imaging. RECENT FINDINGS: Computed tomography (CT) led to the understanding of several ARDS mechanisms and interaction with mechanical ventilation. It is nowadays frequently part of routine diagnostic workup, often leading to treatment changes...
November 30, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27906708/acute-respiratory-distress-syndrome-mimics-the-role-of-lung-biopsy
#4
Mylène Aublanc, Sophie Perinel, Claude Guérin
PURPOSE OF REVIEW: Acute respiratory distress syndrome (ARDS) mimics is a condition looking like ARDS but that does not fulfill every criterion according to the recent Berlin definition. The purpose of this review is to better delineate ARDS mimics, to discuss why the complete diagnosis of ARDS is important, and to make a brief overview on the role of open lung biopsy in this setting. RECENT FINDINGS: Recent autopsy and lung biopsy data from ARDS patients compared lung histologic findings with the new Berlin definition of ARDS...
November 30, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27904836/pulmonary-complications-of-transcatheter-arterial-chemoembolization-for-hepatocellular-carcinoma
#5
Quan M Nhu, Harry Knowles, Paul J Pockros, Catherine T Frenette
Transarterial chemoembolization (TACE) is an effective palliative intervention that is widely accepted for the management of hepatocellular carcinoma (HCC). Post-TACE pulmonary complications resulting in acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) are rare events. Pulmonary complications after TACE are thought to be related to chemical injury subsequent to the migration of the infused ethiodized oil or chemotherapeutic agent to the lung vasculature, facilitated by arteriovenous (AV) shunts within the hyper-vascular HCC...
2016: World Journal of Respirology
https://www.readbyqxmd.com/read/27904536/a-review-on-human-respiratory-modeling
#6
REVIEW
Pardis Ghafarian, Hamidreza Jamaati, Seyed Mohammadreza Hashemian
Input impedance of the respiratory system is measured by forced oscillation technique (FOT). Multiple prior studies have attempted to match the electromechanical models of the respiratory system to impedance data. Since the mechanical behavior of airways and the respiratory system as a whole are similar to an electrical circuit in a combination of series and parallel formats some theories were introduced according to this issue. It should be noted that, the number of elements used in these models might be less than those required due to the complexity of the pulmonary-chest wall anatomy...
2016: Tanaffos
https://www.readbyqxmd.com/read/27903788/treatment-of-adenoviral-acute-respiratory-distress-syndrome-using-cidofovir-with-extracorporeal-membrane-oxygenation-case-series-and-literature-review
#7
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/27903300/inhaled-nitric-oxide-and-the-risk-of-renal-dysfunction-in-patients-with-acute-respiratory-distress-syndrome-a-propensity-matched-cohort-study
#8
Sheng-Yuan Ruan, Hon-Yen Wu, Hsien-Ho Lin, Huey-Dong Wu, Chong-Jen Yu, Mei-Shu Lai
BACKGROUND: Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary data to evaluate the risk of iNO-associated renal dysfunction in patients with ARDS. METHODS: We conducted a cohort study using data from a tertiary teaching hospital to evaluate the risk of incident renal replacement therapy (RRT) in iNO users compared with that of non-users...
November 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#9
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#10
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27899151/lung-ultrasound-can-be-used-to-predict-the-potential-of-prone-positioning-and-assess-prognosis-in-patients-with-acute-respiratory-distress-syndrome
#11
Xiao-Ting Wang, Xin Ding, Hong-Min Zhang, Huan Chen, Long-Xiang Su, Da-Wei Liu
BACKGROUND: It is very important to assess the effectiveness of prone positioning (PP) in patients with severe acute respiratory distress syndrome (ARDS). However, it is difficult to identify patients who may benefit from PP. The purpose of this study was to investigate whether prone positioning potential (PPP) can be predicted by lung ultrasound in patients with ARDS. METHODS: In this prospective study, 45 patients with ARDS were included for the assessment of PPP...
November 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#12
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#13
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/27898437/how-best-to-set-the-ventilator-on-extracorporeal-membrane-lung-oxygenation
#14
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Extracorporeal respiratory support in patients with acute respiratory distress syndrome is applied either as rescue maneuver for life-threatening hypoxemia or as a tool to reduce the harm of mechanical ventilation. Depending on the blood and gas flow, extracorporeal support may completely substitute the natural lung as a gas exchanger (high-flow venovenous bypass) or reduce the need for mechanical ventilation, enabling the removal of a fraction of the metabolically produced CO2...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898436/golden-anniversary-of-the-acute-respiratory-distress-syndrome-still-much-work-to-do
#15
Jesús Villar, Arthur S Slutsky
PURPOSE OF REVIEW: Over the past 50 years, we have developed a conceptual model of the acute respiratory distress syndrome (ARDS), and have witnessed significant advances in the care of patients with ARDS. In this commentary, we will discuss recent published articles reporting or suggesting new conceptual models for diagnosis, classification, stratification, prevention, ventilatory management, pharmacologic treatment, and outcome prediction of ARDS. RECENT FINDINGS: This review is a tribute to all clinicians and investigators that have contributed to a better understanding of ARDS...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#16
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27895451/non-cardiogenic-pulmonary-edema-rhabdomyolysis-and-myocardial-injury-following-heroin-inhalation-a-case-report
#17
G Bazoukis, A Spiliopoulou, K Mourouzis, P Grigoropoulou, A Yalouris
BACKGROUND: Heroin use by non-injecting routes of administration (snorting, swallowing, "chasing the dragon") is considered to be safer but is not risk-free for fatal overdose or serious side effects. We report the case of an adolescent who was transferred unconscious to the emergency department after heroin inhalation. Description of the case: A 17-year-old male was transferred to the emergency department unconscious (Glasgow coma scale: 6/15) after heroin inhalation. He was treated with non-rebreather mask and intravenous infusion of naloxone with gradual improvement of consciousness and arterial blood gasses...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27894382/-study-of-tumor-necrosis-factor-%C3%AE-induced-protein-8-like-2-expression-in-peripheral-blood-mononuclear-cells-of-patients-with-acute-respiratory-distress-syndrome-correlate-with-disease-severity
#18
He Huang, Cong Feng, Zhaotao Tian, Yongming Yao, Tanshi Li
OBJECTIVE: To demonstrate the effect of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) expression in patients with acute respiratory distress syndrome (ARDS) and its mechanism. METHODS: A prospective observation was conducted. Thirty-nine patients with ARDS admitted to department of emergency of PLA General Hospital from July 2013 to July 2015 were enrolled, and 35 healthy persons served as control group. The acute physiology and chronic health evaluation II (APACHE II) score within 24 hours after admission, blood gas analysis, procalcitonin (PCT), and C-reactive protein (CRP) were recorded...
June 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/27894328/effect-of-driving-pressure-on-mortality-in-ards-patients-during-lung-protective-mechanical-ventilation%C3%A2-in-two-randomized-controlled-trials
#19
Claude Guérin, Laurent Papazian, Jean Reignier, Louis Ayzac, Anderson Loundou, Jean-Marie Forel
BACKGROUND: Driving pressure (ΔPrs) across the respiratory system is suggested as the strongest predictor of hospital mortality in patients with acute respiratory distress syndrome (ARDS). We wonder whether this result is related to the range of tidal volume (VT). Therefore, we investigated ΔPrs in two trials in which strict lung-protective mechanical ventilation was applied in ARDS. Our working hypothesis was that ΔPrs is a risk factor for mortality just like compliance (Crs) or plateau pressure (Pplat,rs) of the respiratory system...
November 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27892925/a-mouse-model-for-mers-coronavirus-induced-acute-respiratory-distress-syndrome
#20
Adam S Cockrell, Boyd L Yount, Trevor Scobey, Kara Jensen, Madeline Douglas, Anne Beall, Xian-Chun Tang, Wayne A Marasco, Mark T Heise, Ralph S Baric
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel virus that emerged in 2012, causing acute respiratory distress syndrome (ARDS), severe pneumonia-like symptoms and multi-organ failure, with a case fatality rate of ∼36%. Limited clinical studies indicate that humans infected with MERS-CoV exhibit pathology consistent with the late stages of ARDS, which is reminiscent of the disease observed in patients infected with severe acute respiratory syndrome coronavirus. Models of MERS-CoV-induced severe respiratory disease have been difficult to achieve, and small-animal models traditionally used to investigate viral pathogenesis (mouse, hamster, guinea-pig and ferret) are naturally resistant to MERS-CoV...
November 28, 2016: Nature Microbiology
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