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Sepsis ,ARDS,

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https://www.readbyqxmd.com/read/28924310/use-of-corticosteroids-in-acute-respiratory-distress-syndrome-perspective-from-an-indian-intensive-care-unit
#1
Naveen G S Chandra, Saraschandra Vallabhajosyula, Barkur A Shastry, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula, Kavita Saravu
BACKGROUND: Acute respiratory distress syndrome (ARDS) causes overwhelming inflammation, which serves as a potential target for corticosteroids. Despite extensive Western literature, there are no Indian studies evaluating steroids in ARDS. METHODS: This was a retrospective study at an Indian intensive care unit (ICU) on ARDS patients. Demographic, clinical, laboratory, and imaging parameters were collected. Patients were divided into cohorts based on steroid use, and some received high-dose (2 mg/kg/day), whereas others received low-dose (1 mg/kg/day) steroids...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28884313/endocan-as-an-early-biomarker-of-severity-in-patients-with-acute-respiratory-distress-syndrome
#2
Diego Orbegozo, Lokmane Rahmania, Marian Irazabal, Manuel Mendoza, Filippo Annoni, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Plasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation. METHODS: All patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition)...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28875277/-critical-illness-myopathy-and-polyneuropathy
#3
REVIEW
D Senger, F Erbguth
An average of 50-80% of patients treated in the intensive care unit is affected by disturbances of neuromuscular functions due to damage to the nerves and muscles, which has led to the terms critical illness polyneuropathy and myopathy. Both components occur in 30-50% of patients, while the others predominantly show a pure myopathy, while pure neuropathy is rare. Meanwhile, the descriptive term of the concept as intensive care unit-acquired weakness (ICUAW) is preferred. The most significant risk factors for the development of ICUAW are sepsis, multiorgan dysfunction and acute respiratory distress syndrome (ARDS)...
September 5, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28858917/why-do-we-fail-to-deliver-evidence-based-practice-in-critical-care-medicine
#4
Curtis H Weiss
PURPOSE OF REVIEW: The use of evidence-based practices in clinical practice is frequently inadequate. Recent research has uncovered many barriers to the implementation of evidence-based practices in critical care medicine. Using a comprehensive conceptual framework, this review identifies and classifies the barriers to implementation of several major critical care evidence-based practices. RECENT FINDINGS: The many barriers that have been recently identified can be classified into domains of the consolidated framework for implementation research (CFIR)...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28856588/whole-blood-microrna-markers-are-associated-with-acute-respiratory-distress-syndrome
#5
Zhaozhong Zhu, Liming Liang, Ruyang Zhang, Yongyue Wei, Li Su, Paula Tejera, Yichen Guo, Zhaoxi Wang, Quan Lu, Andrea A Baccarelli, Xi Zhu, Ednan K Bajwa, B Taylor Thompson, Guo-Ping Shi, David C Christiani
BACKGROUND: MicroRNAs (miRNAs) can play important roles in inflammation and infection, which are common manifestations of acute respiratory distress syndrome (ARDS). We assessed if whole blood miRNAs were potential diagnostic biomarkers for human ARDS. METHODS: This nested case-control study (N = 530) examined a cohort of ARDS patients and critically ill at-risk controls. Whole blood miRNA profiles and logistic regression analyses identified miRNAs correlated with ARDS...
August 30, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28851893/the-fer-rs4957796-tt-genotype-is-associated-with-unfavorable-90-day-survival-in-caucasian-patients-with-severe-ards-due-to-pneumonia
#6
José Hinz, Benedikt Büttner, Fabian Kriesel, Maximilian Steinau, Aron Frederik Popov, Michael Ghadimi, Tim Beissbarth, Mladen Tzvetkov, Ingo Bergmann, Ashham Mansur
A recent genome-wide association study showed that a genetic variant within the FER gene is associated with survival in patients with sepsis due to pneumonia. Because severe pneumonia is the main cause of acute respiratory distress syndrome (ARDS), we aimed to investigate the effect of the FER polymorphism rs4957796 on the 90-day survival in patients with ARDS due to pneumonia. An assessment of a prospectively collected cohort of 441 patients with ARDS admitted to three intensive care units at the University Medical Centre identified 274 patients with ARDS due to pneumonia...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28815081/robot-assisted-minimally-invasive-thoraco-laparoscopic-esophagectomy-for-esophageal-cancer-in-the-upper-mediastinum
#7
Sylvia van der Horst, Teun Johannes Weijs, Jelle Pieter Ruurda, Nadia Haj Mohammad, Stella Mook, Lodewijk Adriaan Anton Brosens, Richard van Hillegersberg
BACKGROUND: Patients with upper third esophageal cancer or esophageal cancer with upper mediastinal paratracheal lymph node metastases are often precluded from surgery because of technical difficulties. With the aid of robotic surgery, an excellent overview and reach of the thoracic inlet can be accomplished. In this way, patients with upper mediastinal esophageal cancer are eligible for esophageal resection with curative intent. The aim of this study was to review the results of a consecutive series of patients who underwent robot-assisted minimally invasive esophagectomy (RAMIE) for tumors of the upper 1/3 of the esophagus or positive lymph nodes in the upper mediastinum...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28743831/effective-protection-against-acute-respiratory-distress-syndrome-sepsis-injury-by-combined-adipose-derived-mesenchymal-stem-cells-and-preactivated-disaggregated-platelets
#8
Chih-Hung Chen, Yung-Lung Chen, Pei-Hsun Sung, Cheuk-Kwan Sun, Kuan-Hung Chen, Yi-Ling Chen, Tien-Hung Huang, Hung-I Lu, Fan-Yen Lee, Jiunn-Jye Sheu, Sheng-Ying Chung, Mel S Lee, Hon-Kan Yip
This study assessed whether combining adipose-derived mesenchymal stem cells (ADMSC) with preactivated, disaggregated shape-changed platelets (PreD-SCP) was superior to either therapy alone for protecting rat lung from acute respiratory distress syndrome (ARDS) complicated by sepsis. ARDS and sepsis were induced through 100% oxygen inhalation and peritoneal administration of 1.5 mg/kg lipopolysaccharide (LPS), respectively. Adult-male Sprague-Dawley rats (n=40) were randomized into sham-control (SC), ARDS-LPS, ARDS-LPS-ADMSC (1...
July 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28743346/-research-progress-of-iqgap1-in-the-pathogenesis-of-ards-induced-by-sepsis
#9
Wang Zhang, Qiang Fang
Sepsis is one of the main cause of patients' death. Lung is the most vulnerable target organ during sepsis, and sepsis patients are often complicated with acute respiratory distress syndrome (ARDS), of which the main mechanism is vascular leakage caused by cytoskeleton rearrangement and cell-to-cell connection changes. IQ-guanosine triphosphatease-activating protein 1 (IQGAP1) has become the key component of cytoskeleton dynamics regulation in recent years. At present, the relationship between IQGAP1 and ARDS induced by sepsis is not yet clear...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28705304/clinical-practice-of-acute-respiratory-distress-syndrome-in-japan-a-nationwide-survey-and-scientific-evidences
#10
Sadatomo Tasaka, Koichiro Tatsumi
BACKGROUND: There has been limited information about epidemiology and clinical practice of acute respiratory distress syndrome (ARDS) in Japan. METHODS: An invitation letter to the web-based survey was mailed to all 871 board certified hospitals of the Japanese Respiratory Society. The questionnaires were designed to collect data on epidemiology and clinical practice of ARDS, including diagnostic measures and therapeutics. RESULTS: Within 4 months of the survey period, valid responses were obtained from 296 (34%) hospitals...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28690868/mirna-200c-3p-is-crucial-in-acute-respiratory-distress-syndrome
#11
Qiang Liu, Jianchao Du, Xuezhong Yu, Jun Xu, Fengming Huang, Xiaoyun Li, Cong Zhang, Xiao Li, Jiahui Chang, Daozhen Shang, Yan Zhao, Mingyao Tian, Huijun Lu, Jiantao Xu, Chang Li, Huadong Zhu, Ningyi Jin, Chengyu Jiang
Influenza infection and pneumonia are known to cause much of their mortality by inducing acute respiratory distress syndrome (ARDS), which is the most severe form of acute lung injury (ALI). Angiotensin-converting enzyme 2 (ACE2), which is a negative regulator of angiotensin II in the renin-angiotensin system, has been reported to have a crucial role in ALI. Downregulation of ACE2 is always associated with the ALI or ARDS induced by avian influenza virus, severe acute respiratory syndrome-coronavirus, respiratory syncytial virus and sepsis...
2017: Cell Discovery
https://www.readbyqxmd.com/read/28661978/prone-positioning-of-the-burn-patient-with-acute-respiratory-distress-syndrome-a-review-of-the-evidence-and-practical-considerations
#12
Brandon Oto, Rowena I Orosco, Elizabeth Panter, Rama Velamuri, A Reema Kar, Julie Caffrey
Acute respiratory distress syndrome (ARDS) is a common sequela of severe burns and inhalation injury. The massive inflammatory reaction that follows deep burn injury, compounded by episodes of sepsis and organ dysfunction, predisposes patients to the development of ARDS. Prone positioning as a means of improving gas exchange has shown benefit in refractory cases of ARDS, but it is not well described in the burn population. We present a case report of a patient with severe ARDS who underwent prone positioning, review the relevant literature, and provide a discussion of practical concerns...
June 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28611227/lung-injury-etiology-and-other-factors-influencing-the-relationship-between-dead-space-fraction-and-mortality-in-ards
#13
Richard H Kallet, Hanjing Zhuo, Kelly Ho, Michael S Lipnick, Antonio Gomez, Michael A Matthay
BACKGROUND: In ARDS, elevated pulmonary dead-space fraction (VD/VT) is a particularly strong indicator of mortality risk. Whether the magnitude of VD/VT is modified by the underlying etiology of ARDS and whether this influences the strength of its association with mortality remains unknown. We sought to elucidate the impact of ARDS etiology on VD/VT and also to determine whether ARDS severity, as classified by the Berlin definition, has correspondence with changes in VD/VT. METHODS: This single-center, retrospective, observational study (2010-2016) measured VD/VT in 685 subjects with ARDS as part of clinical management with lung-protective ventilation...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28607338/blood-purification-with-continuous-veno-venous-hemofiltration-in-patients-with-sepsis-or-ards-a-systematic-review-and-meta-analysis
#14
Alessandro Putzu, Ming-Xing Fang, Martina Boscolo Berto, Alessandro Belletti, Luca Cabrini, Tiziano Cassina, Giovanni Landoni
INTRODUCTION: Severe inflammatory conditions, as severe sepsis/septic shock and acute respiratory distress syndrome (ARDS), are related to high morbidity and mortality. We performed a meta-analysis of randomized trials to assess if blood purification with continuous veno-venous hemofiltration (CVVH) reduces mortality in these settings. EVIDENCE ACQUISITION: Online databases were searched for pertinent studies up to March 2017. We included randomized-controlled trials on the use of CVVH as blood purification technique in comparison to conventional therapy in adult patients with severe sepsis/septic shock or ARDS but no acute kidney injury needing renal replacement therapy...
August 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28592332/the-negative-effect-of-initial-high-dose-methylprednisolone-and-tapering-regimen-for-acute-respiratory-distress-syndrome-a-retrospective-propensity-matched-cohort-study
#15
Makoto Takaki, Kazuya Ichikado, Kodai Kawamura, Yasuhiro Gushima, Moritaka Suga
BACKGROUND: The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose, long-term use of corticosteroids has been reported to be effective since they provide continued inhibition of the systemic inflammatory response syndrome (SIRS) that accompanies ARDS. Thus far, no reports have been published on the efficacy of initiating treatment with a high-dose corticosteroid regimen with tapering...
June 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28562476/fn14-blockade-on-pulmonary-microvascular-endothelial-cells-improves-the-outcome-of-sepsis-induced-acute-lung-injury
#16
Yun Zou, Suhong Bao, Fang Wang, Long Guo, Jiali Zhu, Jun Wang, Xiaoming Deng, Jinbao Li
Pulmonary microvascular leakage is one of the characteristics of blood-air barrier dysfunction in septic acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Fibroblast growth factor-inducible 14 (Fn14) exerts diverse functions under certain circumstances. However, the role of Fn14 on the integrity of pulmonary microvascular endothelial cells (PMVECs) during sepsis remains unknown. Septic ALI was induced via cecal ligation and puncture (CLP). Fn14 expression on PMVECs was measured 24 h after surgery...
May 30, 2017: Shock
https://www.readbyqxmd.com/read/28559468/severity-of-hypoxemia-and-other-factors-that-influence-the-response-to-aerosolized-prostacyclin-in-ards
#17
Richard H Kallet, Gregory Burns, Hanjing Zhuo, Kelly Ho, Justin S Phillips, Lance P Pangilinan, Vivian Yip, Antonio Gomez, Michael S Lipnick
BACKGROUND: ARDS is characterized by decreased functional residual capacity (FRC), heterogeneous lung injury, and severe hypoxemia. Tidal ventilation is preferentially distributed to ventilated alveoli. Aerosolized prostaglandin I2 exploits this pathophysiology by inducing local vasodilation, thereby increasing ventilation-perfusion matching and reducing hypoxemia. Therefore, aerosolized prostaglandin I2 efficacy may depend upon FRC. Both PaO2 /FIO2 and compliance of the respiratory system (CRS) are indirect signifiers of FRC and thus may partly determine the response to aerosolized prostaglandin I2...
August 2017: Respiratory Care
https://www.readbyqxmd.com/read/28559467/effect-of-ards-severity-and-etiology-on-short-term-outcomes
#18
Haitham El-Haddad, Hyejeong Jang, Wei Chen, Ayman O Soubani
BACKGROUND: We evaluated the outcome of subjects with ARDS in relation to etiology and severity in a retrospective cohort study of the ARDS Network randomized controlled trials. The primary outcome was 28-d mortality. The secondary outcomes were 60-d mortality and ventilator- and ICU-free days. For severity of ARDS, subjects were stratified according to PaO2/FIO2. The etiology of ARDS was classified into sepsis, pneumonia, aspiration, trauma, and others. RESULTS: A total of 2,914 subjects were included in these trials...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28550403/healthcare-utilization-and-costs-in-ards-survivors-a-1-year-longitudinal-national-us-multicenter-study
#19
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Taruja Karmarkar, Victor D Dinglas, Ramona O Hopkins, Dale M Needham
PURPOSE: To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. METHODS: Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey...
July 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28545548/circulating-microparticle-levels-are-reduced-in-patients-with-ards
#20
Ciara M Shaver, Justin Woods, Jennifer K Clune, Brandon S Grove, Nancy E Wickersham, J Brennan McNeil, Gregory Shemancik, Lorraine B Ware, Julie A Bastarache
BACKGROUND: It is unclear how to identify which patients at risk for acute respiratory distress syndrome (ARDS) will develop this condition during critical illness. Elevated microparticle (MP) concentrations in the airspace during ARDS are associated with activation of coagulation and in vitro studies have demonstrated that MPs contribute to acute lung injury, but the significance of MPs in the circulation during ARDS has not been well studied. The goal of the present study was to test the hypothesis that elevated levels of circulating MPs could prospectively identify critically ill patients who will develop ARDS and that elevated circulating MPs are associated with poor clinical outcomes...
May 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
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