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ventilator associated lung injury

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https://www.readbyqxmd.com/read/28910913/-effect-of-transcutaneous-oximetry-on-prognosis-of-patients-with-severe-acute-respiratory-failure-receiving-extracorporeal-membrane-oxygenation
#1
L Dong, X H Zhang, F M Liang, T Yang, J Yan, Z Yan, L Li
Objective: To investigate the prognostic value of transcutaneous oximetry in patients with severe acute respiratory failure receiving extracorporeal membrane oxygenation(ECMO). Methods: Forty-nine patients diagnosed as severe acute respiratory failure receiving Venous-Venous(V-V)ECMO were enrolled from January 2013 to December 2015 in intensive care unit(ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University.The 10-min oxygen challenge test was performed using transcutaneous oximetry 6 h after the initiation of ECMO, and the 10-min oxygen challenge test value(OCT(10)) and oxygen challenge index(OCI) were calculated...
September 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28887292/protocol-for-usability-testing-and-validation-of-the-iso-draft-international-standard-19223-for-lung-ventilators
#2
Dev Minotra, Steven L Dain, Catherine M Burns
BACKGROUND: Clinicians, such as respiratory therapists and physicians, are often required to set up pieces of medical equipment that use inconsistent terminology. Current lung ventilator terminology that is used by different manufacturers contributes to the risk of usage errors, and in turn the risk of ventilator-associated lung injuries and other conditions. Human factors and communication issues are often associated with ventilator-related sentinel events, and inconsistent ventilator terminology compounds these issues...
September 8, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28887062/diaphragm-dysfunction-in-critical-illness
#3
REVIEW
Gerald S Supinski, Peter E Morris, Sanjay Dhar, Leigh Ann Callahan
The diaphragm is the major muscle of inspiration and its function is critical for optimal respiration. Diaphragmatic failure has long been recognized as a major contributor to death in a variety of systemic neuromuscular disorders. More recently, it is increasingly apparent that diaphragm dysfunction is present in a high percentage of critically ill patients, and is associated with increased morbidity and mortality. In these patients, diaphragm weakness is thought to develop from disuse secondary to ventilator-induced diaphragm inactivity, and as a consequence of the effects of systemic inflammation, including sepsis...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28873275/retrospective-evaluation-of-the-prevalence-risk-factors-management-outcome-and-necropsy-findings-of-acute-lung-injury-and-acute-respiratory-distress-syndrome-in-dogs-and-cats-29-cases-2011-2013
#4
Anusha Balakrishnan, Kenneth J Drobatz, Deborah C Silverstein
OBJECTIVE: To determine the prevalence and risk factors for veterinary acute lung injury (VetALI) and veterinary acute respiratory distress syndrome (VetARDS), assess mechanical ventilation settings and patient outcomes, and to evaluate the relationship of clinical diagnoses with necropsy findings. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: Twenty-four dogs and 5 cats with a clinical diagnosis of VetALI or VetARDS...
September 5, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28872540/effects-on-pulmonary-vascular-mechanics-of-two-different-lung-protective-ventilation-strategies-in-an-experimental-model-of-acute-respiratory-distress-syndrome
#5
Arnoldo Santos, Eva Gomez-Peñalver, M Ignacio Monge-Garcia, Jaime Retamal, João Batista Borges, Gerardo Tusman, Goran Hedenstierna, Anders Larsson, Fernando Suarez-Sipmann
OBJECTIVES: To compare the effects of two lung-protective ventilation strategies on pulmonary vascular mechanics in early acute respiratory distress syndrome. DESIGN: Experimental study. SETTING: University animal research laboratory. SUBJECTS: Twelve pigs (30.8 ± 2.5 kg). INTERVENTIONS: Acute respiratory distress syndrome was induced by repeated lung lavages and injurious mechanical ventilation...
September 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28839101/hyperoxia-treatment-of-trek-1-trek-2-traak-deficient-mice-is-associated-with-a-reduction-in-surfactant-proteins
#6
Andreas Schwingshackl, Benjamin Lopez, Bin Teng, Charlean L Luellen, Florian Lesage, John Belperio, Riccardo Olcese, Christopher M Waters
We previously proposed a role for the 2-pore domain potassium (K2P) channel TREK-1 in hyperoxia (HO)-induced lung injury. To determine whether redundancy between the 3 TREK isoforms (TREK-1, TREK-2, TRAAK) could protect from HO-induced injury, we now examined the effect of deletion of all 3 TREK isoforms in a clinically relevant scenario of prolonged HO exposure and mechanical ventilation (MV). We exposed WT and TREK-1/TREK-2/TRAAK-deficient (triple ko) mice to either room air, 72 hours HO, MV (high and low tidal volume), or a combination of HO+MV, and measured quasi-static lung compliance, BAL protein concentration, histologic lung injury scores (LIS), cellular apoptosis, and cytokine levels...
August 24, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28828367/spontaneous-breathing-a-double-edged-sword-to-handle-with-care
#7
REVIEW
Tommaso Mauri, Barbara Cambiaghi, Elena Spinelli, Thomas Langer, Giacomo Grasselli
In acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) patients, spontaneous breathing is associated with multiple physiologic benefits: it prevents muscles atrophy, avoids paralysis, decreases sedation needs and is associated with improved hemodynamics. On the other hand, in the presence of uncontrolled inspiratory effort, severe lung injury and asynchronies, spontaneous ventilation might also worsen lung edema, induce diaphragm dysfunction and lead to muscles exhaustion and prolonged weaning...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828364/prone-positioning-acute-respiratory-distress-syndrome-patients
#8
REVIEW
Claude Guérin
Prone position has been used in acute respiratory distress syndrome (ARDS) patients for more than 40 years in ICU. After having demonstrated its capability to significantly improve oxygenation in a large number of patients, sometimes dramatically, this procedure has been found to prevent ventilator-induced lung injury, the primary concern for the intensivists managing ARDS patients. Over the time, several trials have been done, which regularly improved and refined from each other. At the end, significant improvement in survival has been demonstrated in the most severe ARDS patients, at a threshold of 100-150 mmHg PaO2/FiO2 ratio...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828362/tidal-volume-in-acute-respiratory-distress-syndrome-how-best-to-select-it
#9
REVIEW
Michele Umbrello, Antonella Marino, Davide Chiumello
Mechanical ventilation is the type of organ support most widely provided in the intensive care unit. However, this form of support does not constitute a cure for acute respiratory distress syndrome (ARDS), as it mainly works by buying time for the lungs to heal while contributing to the maintenance of vital gas exchange. Moreover, it can further damage the lung, leading to the development of a particular form of lung injury named ventilator-induced lung injury (VILI). Experimental evidence accumulated over the last 30 years highlighted the factors associated with an injurious form of mechanical ventilation...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828361/driving-pressure-and-mechanical-power-new-targets-for-vili-prevention
#10
REVIEW
Tommaso Tonetti, Francesco Vasques, Francesca Rapetti, Giorgia Maiolo, Francesca Collino, Federica Romitti, Luigi Camporota, Massimo Cressoni, Paolo Cadringher, Michael Quintel, Luciano Gattinoni
Several factors have been recognized as possible triggers of ventilator-induced lung injury (VILI). The first is pressure (thus the 'barotrauma'), then the volume (hence the 'volutrauma'), finally the cyclic opening-closing of the lung units ('atelectrauma'). Less attention has been paid to the respiratory rate and the flow, although both theoretical considerations and experimental evidence attribute them a significant role in the generation of VILI. The initial injury to the lung parenchyma is necessarily mechanical and it could manifest as an unphysiological distortion of the extracellular matrix and/or as micro-fractures in the hyaluronan, likely the most fragile polymer embedded in the matrix...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828357/definition-and-epidemiology-of-acute-respiratory-distress-syndrome
#11
REVIEW
Emanuele Rezoagli, Roberto Fumagalli, Giacomo Bellani
Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28810549/dexmedetomidine-preconditioning-protects-against-lung-injury-induced-by-ischemia-reperfusion-through-inhibition-of-autophagy
#12
Wei Zhang, Jiaqiang Zhang
The present study aimed to evaluate the role of autophagy in the protective effect of dexmedetomidine in lung injury caused by ischemia-reperfusion (IR) in rats. In total 48 adult male Sprague-Dawley rats were randomly divided into 6 groups (n=8) as follows: i) Sham group; ii) the IR group; iii) IR + 1 µg/kg dexmedetomidine preconditioning group (pre-LD); iv) IR + 10 µg/kg dexmedetomidine preconditioning group (pre-HD); v) IR + 1 µg/kg dexmedetomidine postconditioning group (post-LD); and vi) IR + 10 µg/kg dexmedetomidine postconditioning group (post-HD)...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28808222/perioperative-remote-acute-lung-injury-recent-update
#13
Zhaosheng Jin, Ka Chun Suen, Daqing Ma
Perioperative acute lung injury (ALI) is a syndrome characterised by hypoxia and chest radiograph changes. It is a serious post-operative complication, associated with considerable mortality and morbidity. In addition to mechanical ventilation, remote organ insult could also trigger systemic responses which induce ALI. Currently, there are limited treatment options available beyond conservative respiratory support. However, increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28808186/oxygenation-inflammatory-response-and-lung-injury-during-one-lung-ventilation-in-rabbits-using-inspired-oxygen-fraction-of-0-6-vs-1-0
#14
Zeping Xu, Lianbing Gu, Qingming Bian, Pengyi Li, Lijun Wang, Jingyuan Zhang, Yanning Qian
Maintaining adequate oxygenation during one-lung ventilation (OLV) requires high inspired oxygen fraction (FiO2). However, high FiO2 also causes inflammatory response and lung injury. Therefore, it remains a great interest to clinicians and scientists to optimize the care of patients undergoing OLV. The aim of this study was to determine and compare oxygenation, inflammatory response and lung injury during OLV in rabbits using FiO2 of 0.6 vs. 1.0. After 30 minutes of two-lung ventilation (TLV) as baseline, 30 rabbits were randomly assigned to three groups receiving mechanical ventilation for 3 hours: the sham group, receiving TLV with 0...
October 17, 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28802561/recombinant-human-elafin-promotes-alveologenesis-in-newborn-mice-exposed-to-chronic-hyperoxia
#15
Wenli Han, Xiaomei Li, Han Zhang, Benli Yu, Chunbao Guo, Chun Deng
BACKGROUND/AIMS: Elastase inhibitors reverse elastin degradation and abnormal alveologenesis and attenuate the lung structural abnormalities induced by mechanical ventilation with O2-rich gas. The potential of these molecules to improve endothelial function and to ameliorate severe bronchopulmonary dysplasia (BPD) during lung development is not yet understood. We sought to determine whether the intratracheal treatment of newborn mice with the elastase inhibitor elafin would prevent hyperoxia-induced lung elastin degradation and the cascade of events that cause abnormal alveologenesis...
August 9, 2017: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/28790180/pseudomonas-aeruginosa-lasb-protease-impairs-innate-immunity-in-mice-and-humans-by-targeting-a-lung-epithelial-cystic-fibrosis-transmembrane-regulator-il-6-antimicrobial-repair-pathway
#16
Vinciane Saint-Criq, Bérengère Villeret, Fabien Bastaert, Saadé Kheir, Aurélie Hatton, Aurélie Cazes, Zhou Xing, Isabelle Sermet-Gaudelus, Ignacio Garcia-Verdugo, Aleksander Edelman, Jean-Michel Sallenave
BACKGROUND: Pseudomonas aeruginosa lung infections are a huge problem in ventilator-associated pneumonia, cystic fibrosis (CF) and in chronic obstructive pulmonary disease (COPD) exacerbations. This bacterium secretes virulence factors that may subvert host innate immunity. OBJECTIVE: We evaluated the effect of P. aeruginosa elastase LasB, an important virulence factor secreted by the type II secretion system, on ion transport, innate immune responses and epithelial repair, both in vitro and in vivo...
August 8, 2017: Thorax
https://www.readbyqxmd.com/read/28768578/the-use-of-inhaled-corticosteroids-in-chronically-ventilated-preterm-infants
#17
REVIEW
Leif D Nelin, J Wells Logan
Bronchopulmonary dysplasia (BPD) is the most usual reason for preterm infants to require chronic mechanical ventilation. Inflammation is a key factor underlying the lung injury leading to the development of BPD, and the rationale for use of corticosteroids in the management of ventilator-dependent preterm infants is based on their anti-inflammatory effects. Because systemic corticosteroids are associated with significant adverse effects in preterm infants, attention has turned to the use of inhaled corticosteroids (ICS) as a potentially safer therapy for BPD...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28765901/mir-127-contributes-to-ventilator-induced-lung-injury
#18
Qian Li, Ya-Li Ge, Min Li, Xiang-Zhi Fang, Yan-Ping Yuan, Lei Liang, Shao-Qiang Huang
Although it is essential in critical care medicine, mechanical ventilation often results in ventilator‑induced lung injury (VILI). Treating mice with lipopolysaccharide has been reported to upregulate the expression of miR‑127, which has been implicated in the modulation of immune responses. However, the putative roles of miR‑127 during the development of VILI have yet to be elucidated. The present study demonstrated that challenging mice with mechanical ventilation for 6 h significantly upregulated the expression of miR‑127 in bronchoalveolar lavage fluid, serum and lung tissue samples...
October 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28759484/impact-of-different-ventilation-strategies-on-driving-pressure-mechanical-power-and-biological-markers-during-open-abdominal-surgery-in-rats
#19
Lígia de A Maia, Cynthia S Samary, Milena V Oliveira, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Marcelo M Morales, Marcus J Schultz, Marcelo G Abreu, Paolo Pelosi, Pedro L Silva, Patricia Rieken Macedo Rocco
BACKGROUND: Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28758151/the-effect-of-diet-induced-serum-hypercholesterolemia-on-the-surfactant-system-and-the-development-of-lung-injury
#20
Scott Milos, Joshua Qua Hiansen, Brandon Banaschewski, Yi Y Zuo, Li-Juan Yao, Lynda A McCaig, James Lewis, Cory M Yamashita, Ruud A W Veldhuizen
Acute respiratory distress syndrome (ARDS) is a pulmonary disorder associated with alterations to the pulmonary surfactant system. Recent studies showed that supra-physiological levels of cholesterol in surfactant contribute to impaired function. Since cholesterol is incorporated into surfactant within the alveolar type II cells which derives its cholesterol from serum, it was hypothesized that serum hypercholesterolemia would predispose the host to the development of lung injury due to alterations of cholesterol content in the surfactant system...
September 2016: Biochemistry and Biophysics Reports
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